Page 313 - Review of Medical Microbiology and Immunology ( PDFDrive )

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mebooksfree.com mebooksfree.com mebooksfree.com (C) The vaccine contains killed smallpox virus so the virus in the mebooksfree.com
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PART IV Clinical Virology
302
2. Your patient is a woman who is due to give birth next week. She
asks you about the risk of her baby becoming infected with her-
vaccine does not cause adverse effects.
pes simplex virus type 2 (HSV-2). Which one of the following is
(D) Smallpox virus has a single stable serotype, so new formula-
the most accurate response?
tions of the vaccine do not have to be made each year.
(E) Because domestic animals such as cows are the main reservoir
(A) HSV-2 is a significant cause of congenital abnormalities.
for smallpox virus, the vaccine must interrupt transmission
(B) The risk is higher if the mother has visible lesions than if she
from these sources.
does not.
(C) The risk is higher if the mother has IgG antibody to HSV-2
this morning. Magnetic resonance imaging revealed a lesion in
than if she has IgM antibody.
the temporal lobe. A brain biopsy showed multinucleated giant
(D) The risk is higher if the delivery occurs by cesarean section 7. Your patient is a 35-year-old man who had a grand-mal seizure
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mebooksfree.com mebooksfree.com mebooksfree.com 8. Regarding the patient in Question 7, which one of the following mebooksfree.com
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cells with intranuclear inclusion bodies. Which one of the fol-
than if the delivery is performed vaginally.
lowing is the most likely cause of this disease?
(E) The risk is higher if the mother is having an episode of recur-
rent disease caused by HSV-2 than if it were a primary
(A) Cytomegalovirus
(B) Epstein–Barr virus
episode.
(C) Herpes simplex virus type 1
3. Regarding varicella-zoster virus (VZV), which one of the follow-
ing is most accurate?
(D) Human herpesvirus 8
(E) Varicella-zoster virus
(A) High-dose acyclovir can eliminate the latent state caused by
VZV.
is the best choice of drug to treat his infection?
(B) The principal site of latency of VZV is in the nucleus of motor
neurons.
(A) Acyclovir
(B) Lamivudine
(C) Domestic animals, such as pigs and chickens, are the main
reservoir for VZV.
(C) Oseltamivir
(D) Ritonavir
(D) The vaccine against varicella contains all three serotypes of
(E) Zidovudine
formalin-killed VZV as the immunogen. 9. Your patient is a 22-year-old woman with several episodes of
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mebooksfree.com mebooksfree.com mebooksfree.com ter were negative. An assay for Clostridium difficile toxin was mebooksfree.com
(E) When zoster occurs in an immunocompromised patient,
bloody diarrhea. She is HIV antibody positive with a CD4 count
acyclovir should be given to prevent disseminated infection.
of 50. Stool cultures for Shigella, Salmonella, and Campylobac-
4. Regarding cytomegalovirus (CMV), which one of the following
is most accurate?
negative. Colonoscopy revealed many ulcerated lesions. Biopsy
(A) CMV is usually acquired by the fecal–oral route in adults.
revealed cells with “owl’s eye” inclusions in the nucleus. Which
(B) Neonates born from infected mothers should be given the
one of the following is the most likely cause of this disease?
subunit vaccine.
(C) Reactivation of CMV in sensory ganglion cells leads to pain-
(A) Cytomegalovirus
(B) Epstein–Barr virus
ful vesicles along nerves.
(D) Lamivudine should be used to treat CMV infections in
(C) Herpes simplex virus type 1
immunocompromised patients.
(D) Human herpesvirus 8
(E) CMV infection of a fetus during the first trimester results in
(E) Varicella-zoster virus
more congenital abnormalities than infection in the third
is the best choice of drug to treat her infection?
trimester. 10. Regarding the patient in Question 9, which one of the following
5. Regarding Epstein–Barr virus (EBV) and infectious mononu-
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(A) Amantadine
cleosis, which one of the following is most accurate?
(B) Enfuvirtide
(A) EBV enters the latent state primarily in CD4-positive helper T
(C) Ganciclovir
(D) Nevirapine
cells.
(E) Ribavirin
(B) Approximately 10% of people in the United States have been
exposed to EBV.
(C) People with infectious mononucleosis produce antibodies
that agglutinate sheep red cells.
(D) The atypical lymphs in the blood of people with infectious
mononucleosis are EBV-infected T helper cells.
1. (B)
(E) Patients with deficient cell-mediated immunity should receive
passive–active immunization against EBV.
3. (E)
6. Naturally occurring smallpox disease has been eradicated from
4. (E)
the face of the Earth. Eradication was achieved by the use of the 2. (B)
5. (C)
vaccine. Regarding this vaccine, which one of the following is the
6. (D)
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most accurate?
7. (C)
8. (A)
(A) The vaccine should be given in conjunction with preformed
antibody to the virus.
10. (C)
(B) Administration of the vaccine 1 day after exposure to the
virus does not protect against disease.
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