RNA Viruses: Paramyxoviruses Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for RNA Viruses: Paramyxoviruses. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 1: Uveo-parotitis is seen in
- A. Mumps
- B. Sarcoidosis (Correct Answer)
- C. Measles
- D. Cystic fibrosis
RNA Viruses: Paramyxoviruses Explanation: ***Sarcoidosis***
- **Uveo-parotitis** (also known as Heerfordt's syndrome or uveoparotid fever) is a rare manifestation of **sarcoidosis**, characterized by swelling of the **parotid glands**, anterior **uveitis**, fever, and sometimes facial nerve palsy [1].
- Sarcoidosis is a chronic inflammatory disease that can affect multiple organs, with **granuloma formation** being its pathological hallmark [1].
*Mumps*
- Mumps primarily causes **parotitis**, an inflammation of the parotid glands, but it is typically not associated with **uveitis**.
- It is a viral infection characterized by sudden onset of fever, headache, malaise, myalgia, and swelling of one or both parotid glands.
*Measles*
- Measles is a viral infection that causes a **generalized maculopapular rash**, fever, cough, coryza, and conjunctivitis, but it does not cause **uveo-parotitis**.
- Ocular involvement in measles is usually limited to **conjunctivitis** rather than deeper inflammatory conditions like uveitis.
*Cystic fibrosis*
- **Cystic fibrosis** is a genetic disorder affecting exocrine glands, leading to thick mucus production in the lungs, pancreas, and other organs.
- While it can lead to various systemic complications, it is not associated with **uveo-parotitis**.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 2: A child presented with bluish-white spots in the mouth followed by a rash. What is the genome of the most likely causative agent?
- A. Enveloped virus with single-stranded RNA (Correct Answer)
- B. Double stranded Naked RNA
- C. Naked virus with single-stranded RNA
- D. Double stranded Enveloped RNA
RNA Viruses: Paramyxoviruses Explanation: ***Enveloped virus with single-stranded RNA***
- Bluish-white spots in the mouth (**Koplik spots**) followed by a rash are pathognomonic for **measles**, which is caused by the **measles virus**.
- The measles virus is a **paramyxovirus**, characterized as an **enveloped, negative-sense, single-stranded RNA virus**.
*Double stranded Naked RNA*
- No major human pathogen belongs to this specific genomic and structural classification.
- Most **dsRNA viruses** like **rotavirus** are **naked** but cause gastroenteritis, not measles.
*Naked virus with single-stranded RNA*
- Viruses like **rhinovirus** (common cold) or **poliovirus** fit this description but do not cause Koplik spots or measles.
- **Naked viruses** lack a lipid envelope, making them generally more resistant to environmental factors.
*Double stranded Enveloped RNA*
- There are no known medically significant human viruses that are both **enveloped** and contain **double-stranded RNA**.
- Viral genomes are typically either DNA or RNA, and RNA viruses are usually single-stranded (positive or negative sense) or double-stranded, with or without an envelope.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 3: What is the primary function of the nucleocapsid proteins in the measles virus?
- A. Protect the RNA from degradation during replication. (Correct Answer)
- B. Facilitate the assembly of the virion structure.
- C. Assist in the packaging of the viral genome.
- D. Protect the genome RNA from nuclease digestion and recognize the location in the cell membrane for budding.
RNA Viruses: Paramyxoviruses Explanation: **Protect the RNA from degradation during replication.**
- The **nucleocapsid proteins** (N proteins) in the measles virus encapsidate the **viral RNA genome**, forming a helical ribonucleoprotein (RNP) complex.
- This **encapsidation** provides crucial protection to the RNA from cellular **nucleases**, preventing its degradation and maintaining its integrity for successful replication and transcription.
*Facilitate the assembly of the virion structure.*
- While nucleocapsid proteins are part of the virion structure, their primary function isn't to **facilitate the assembly** but rather to protect the genetic material within that structure.
- **Matrix proteins** and other viral components are more directly involved in the overall assembly and budding process.
*Assist in the packaging of the viral genome.*
- **Packaging** of the viral genome is a separate, although related, process where the protected nucleocapsid is incorporated into the newly forming virion.
- The fundamental role of the nucleocapsid protein is the **protection and organization of the RNA**, which then enables efficient packaging.
*Protect the genome RNA from nuclease digestion and recognize the location in the cell membrane for budding.*
- **Protecting the genome RNA from nuclease digestion** is indeed a key function of nucleocapsid proteins.
- However, **recognizing the location in the cell membrane for budding** is primarily mediated by the viral **matrix (M) protein**, which links the nucleocapsid to the envelope glycoproteins.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 4: A month old HIV positive child following an upper respiratory infection developed sudden onset of breathlessness. The chest x-ray shows hyperinflation. The O2 saturation was greater than 90%. What is the most appropriate antiviral therapy among the given options?
- A. IV Ganciclovir
- B. Ribavirin (Correct Answer)
- C. Cotrimoxazole
- D. Nebulized Acyclovir
RNA Viruses: Paramyxoviruses Explanation: **Ribavirin**
- The clinical presentation of a 1-month-old HIV-positive infant with sudden breathlessness, hyperinflation on chest X-ray, and oxygen saturation >90%, following an URI, is highly suggestive of **Respiratory Syncytial Virus (RSV) bronchiolitis**.
- **Ribavirin** is an antiviral drug that was historically used for severe RSV infection, especially in high-risk infants like those who are immunocompromised.
- **Note:** Current guidelines emphasize supportive care as primary treatment; ribavirin use is now controversial due to limited efficacy and toxicity concerns.
*IV Ganciclovir*
- **Ganciclovir** is primarily used for the treatment of **Cytomegalovirus (CMV)** infections, which typically present differently than the acute bronchiolitis described.
- CMV pneumonitis often manifests with diffuse interstitial infiltrates and may be accompanied by other systemic CMV manifestations.
*Cotrimoxazole*
- **Cotrimoxazole (trimethoprim-sulfamethoxazole)** is the drug of choice for prophylaxis and treatment of **Pneumocystis jirovecii pneumonia (PJP)**.
- While PJP is common in HIV-positive infants, the acute onset, hyperinflation, and O2 saturation >90% are less typical for severe PJP, and cotrimoxazole is an antibiotic, not an antiviral.
*Nebulized Acyclovir*
- **Acyclovir** is an antiviral agent used to treat **herpes simplex virus (HSV)** and **varicella-zoster virus (VZV)** infections.
- Respiratory involvement with HSV or VZV in an infant would present with different clinical features and radiological findings than those described.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 5: A 4-year-old boy presents with low-grade fever, inspiratory stridor, and barking cough for the past 5 days. Examination reveals a hoarse voice, a moderately inflamed pharynx, and a slightly increased respiratory rate. His chest x-ray showed subglottic narrowing appearing like a steeple. Which among the following is not indicated in the treatment of this condition?
- A. Nebulized racemic epinephrine
- B. Intramuscular dexamethasone
- C. Helium oxygen mixture
- D. Parenteral cefotaxime (Correct Answer)
- E. Nebulized budesonide
RNA Viruses: Paramyxoviruses Explanation: ***Parenteral cefotaxime***
- The clinical presentation (low-grade fever, inspiratory stridor, barking cough, hoarse voice) and the **steeple sign** on chest X-ray are classic for **croup (laryngotracheobronchitis)**, which is predominantly caused by **viral infections**, not bacterial. Therefore, antibiotics like parenteral cefotaxime are generally **not indicated**.
- **Cefotaxime** is a broad-spectrum antibiotic used for serious bacterial infections; its use in viral croup would be inappropriate and could contribute to antibiotic resistance.
*Nebulized racemic epinephrine*
- **Nebulized racemic epinephrine** is a common and effective treatment for moderate to severe croup, as it helps to **vasoconstrict** the subglottic mucosa, reducing edema and improving airflow.
- It provides temporary relief from symptoms, especially stridor, by reducing swelling in the airway.
*Intramuscular dexamethasone*
- **Dexamethasone**, a corticosteroid, is a cornerstone of croup treatment as it reduces inflammation and edema in the airway, improving respiratory symptoms.
- It can be administered orally, intravenously, or intramuscularly, and provides sustained relief, typically for 24-48 hours.
*Nebulized budesonide*
- **Nebulized budesonide** is an alternative corticosteroid treatment for croup that delivers anti-inflammatory medication directly to the airway.
- Studies show it is equally effective to dexamethasone for mild to moderate croup, though dexamethasone is often preferred due to ease of administration and longer duration of action.
*Helium oxygen mixture*
- A **helium-oxygen mixture (heliox)** is a therapeutic gas that is less dense than air, which can reduce the work of breathing in patients with severe airway obstruction, such as refractory croup.
- By decreasing airway turbulence, heliox can temporarily improve air movement past the narrowed subglottic area.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 6: Koplik spots are pathognomonic of which of the following?
- A. Diphtheria
- B. Donovanosis
- C. Gonorrhoea
- D. Measles (Correct Answer)
RNA Viruses: Paramyxoviruses Explanation: ***Measles***
- **Koplik spots** are small, white spots with a bluish-white center on an erythematous base, found on the buccal mucosa opposite the molars.
- They are a **pathognomonic sign** of measles (rubeola) and typically appear 1-2 days before the generalized maculopapular rash.
*Diphtheria*
- Characterized by the formation of a **thick, grayish membrane (pseudomembrane)** in the throat and tonsils, which can cause respiratory obstruction.
- It is caused by **_Corynebacterium diphtheriae_** and does not present with Koplik spots.
*Donovanosis*
- This is a chronic, progressive **genital ulcerative disease** caused by **_Klebsiella granulomatis_**.
- It presents with **beefy-red, granulomatous lesions** on the genitals or perineum and has no association with oral lesions like Koplik spots.
*Gonorrhea*
- A **sexually transmitted infection** caused by **_Neisseria gonorrhoeae_**, primarily affecting the urethra, cervix, rectum, and pharynx.
- Oral manifestations can include pharyngitis, but **Koplik spots are not a feature** of gonorrhea.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 7: A 4-year-old child with barking cough is diagnosed with croup. Which virus is most likely responsible?
- A. Parainfluenza virus (Correct Answer)
- B. Rhinovirus
- C. Adenovirus
- D. Respiratory syncytial virus
RNA Viruses: Paramyxoviruses Explanation: ***Parainfluenza virus***
- **Parainfluenza viruses (PIV)** are the most common cause of **croup**, characterized by a **barking cough**, hoarseness, and inspiratory stridor.
- PIV types 1 and 2 are particularly associated with acute laryngotracheobronchitis (croup) in young children.
*Rhinovirus*
- **Rhinoviruses** are the primary cause of the **common cold** and typically result in upper respiratory tract symptoms like runny nose, sneezing, and sore throat.
- They are generally not associated with the severe laryngeal inflammation that causes the characteristic barking cough of croup.
*Adenovirus*
- **Adenoviruses** can cause a variety of respiratory illnesses, including pharyngitis and pneumonia, and sometimes mimic croup.
- However, they are a less frequent cause of croup compared to parainfluenza viruses.
*Respiratory syncytial virus*
- **Respiratory syncytial virus (RSV)** is the leading cause of **bronchiolitis** and pneumonia in infants and young children.
- While RSV can cause upper respiratory symptoms, it typically leads to wheezing and crackles rather than the barking cough of croup.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 8: All of the following are RNA viruses except
- A. Influenza virus
- B. Parainfluenza virus
- C. Mumps virus
- D. Herpes virus (Correct Answer)
RNA Viruses: Paramyxoviruses Explanation: ***Herpes virus***
- **Herpesviruses** are a large family of **DNA viruses** that cause diseases in animals, including humans.
- They are characterized by their ability to establish **latent infections** and periodically reactivate.
*Influenza virus*
- The **influenza virus** is an **RNA virus** belonging to the family **Orthomyxoviridae**.
- It is known for causing the seasonal **flu** and respiratory infections.
*Parainfluenza virus*
- **Parainfluenza viruses** are a group of **RNA viruses** in the family **Paramyxoviridae**.
- They are a common cause of **respiratory tract infections**, especially in children, leading to conditions like **croup**.
*Mumps virus*
- The **mumps virus** is an **RNA virus** that is part of the **Paramyxoviridae** family.
- It is well-known for causing **mumps**, which is characterized by the swelling of the **parotid glands**.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 9: Which of the following statements about paramyxoviruses is false?
- A. Belong to the family Paramyxoviridae
- B. Are DNA viruses (Correct Answer)
- C. Are RNA viruses
- D. Have linear nucleic acid
RNA Viruses: Paramyxoviruses Explanation: ***Are DNA viruses***
- Paramyxoviruses are characterized by their **single-stranded, negative-sense RNA genome**, not DNA.
- Their replication and transcription processes occur in the cytoplasm, which is typical for RNA viruses.
*Belong to the family Paramyxoviridae*
- This statement is correct; paramyxoviruses are indeed classified under the **family Paramyxoviridae**.
- This family includes important human pathogens like measles, mumps, and respiratory syncytial virus (RSV).
*Have linear nucleic acid*
- This statement is correct as paramyxoviruses possess a **linear, non-segmented RNA genome**.
- The linear nature differentiates them from viruses with segmented genomes, such as influenza viruses.
*Are RNA viruses*
- This statement is correct; paramyxoviruses are characterized by their **RNA genome**.
- Specifically, they are **negative-sense, single-stranded RNA viruses**.
RNA Viruses: Paramyxoviruses Indian Medical PG Question 10: Which of the following is an RNA oncogenic virus?
- A. Cytomegalovirus (CMV)
- B. Hepatitis B Virus (HBV)
- C. Human T-lymphotropic Virus (HTLV) (Correct Answer)
- D. Human Immunodeficiency Virus (HIV)
RNA Viruses: Paramyxoviruses Explanation: ***Human T-lymphotropic Virus (HTLV)***
- **HTLV-1** is a well-established **RNA oncogenic virus** that causes Adult T-cell Leukemia/Lymphoma (ATLL).
- It utilizes **reverse transcriptase** to convert its RNA genome into DNA, which then integrates into the host cell's genome, leading to malignant transformation.
*Cytomegalovirus (CMV)*
- CMV is a **DNA virus** and belongs to the Herpesviridae family.
- While it can cause disease, it is not primarily classified as an **oncogenic virus**, although some studies suggest associations with certain cancers.
*Hepatitis B Virus (HBV)*
- HBV is a **DNA virus** that primarily causes acute and chronic hepatitis.
- It is a major risk factor for **hepatocellular carcinoma (HCC)**, but it itself is a DNA virus, not an RNA virus.
*Human Immunodeficiency Virus (HIV)*
- HIV is an **RNA retrovirus**, but it is generally considered **non-oncogenic** in the direct sense.
- While HIV-infected individuals have an increased risk of certain cancers (e.g., Kaposi's sarcoma, non-Hodgkin lymphoma), these are usually due to **immunosuppression** allowing co-infecting oncogenic viruses (like HHV-8 or EBV) to proliferate, rather than direct oncogenic action of HIV itself.
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