Virology Practice Questions

Q: Herpangina is caused by the virus -

Group A Coxsackie. ***Group A Coxsackie*** - Herpangina is a common viral illness characterized by small, painful ulcers on the **soft palate** and tonsillar pillars, predominantly caused by various serotypes of **Coxsackievirus group A**, particularly A1-A10, A16, and A22. - This **enterovirus** infection is highly contagious and often seen in infants and young children, especially during summer and fall. *Group B Coxsackie* - **Group B Coxsackieviruses** are primarily associated with diseases like **pleurodynia** (**Bornholm disease**), myocarditis, and pericarditis, rather than herpangina. - While both Group A and B Coxsackieviruses are enteroviruses, their typical clinical manifestations differ significantly. *Adenovirus* - **Adenoviruses** are known to cause a range of illnesses, including respiratory infections (**pharyngitis**, pneumonia), conjunctivitis, and gastroenteritis. - They are not typically implicated in the etiology of herpangina, which is characterized by specific oral lesions. *Measles* - **Measles virus** (a paramyxovirus) causes measles, a highly contagious systemic illness characterized by a generalized maculopapular rash, cough, coryza, and conjunctivitis, along with **Koplik spots** in the mouth. - Measles does not cause the vesicular and ulcerative lesions seen in herpangina; Koplik spots are distinct enanthem findings.

Q: Cataracts and PDA in a newborn suggests in utero infection with which viral family?

Togavirus. ***Togavirus*** is the correct answer. **Congenital rubella syndrome**, caused by the **rubella virus** (family Togaviridae), is classically associated with the triad of **cataracts**, **patent ductus arteriosus (PDA)**, and **sensorineural hearing loss**. The virus crosses the placenta and can cause widespread damage to the developing fetus, particularly during the first trimester when organogenesis occurs. *Adenovirus* is incorrect. Adenoviruses typically cause respiratory tract infections, conjunctivitis, and gastroenteritis in newborns, but are not known to cause congenital abnormalities like cataracts and PDA. While they can infect newborns, their presentation does not include the specific congenital malformations seen with rubella. *Paramyxovirus* is incorrect. The Paramyxovirus family includes viruses like measles and mumps, which can cause severe infections but are not typically associated with congenital cataracts and PDA. Measles can lead to complications in pregnancy such as preterm birth or miscarriage, but not the specific triad of congenital rubella syndrome. *Picornavirus* is incorrect. The Picornavirus family includes enteroviruses (like poliovirus, coxsackievirus) and rhinovirus. While some enteroviruses can cause severe systemic infections in newborns (e.g., myocarditis with coxsackievirus), they are not primarily associated with cataracts and PDA as congenital anomalies.

Q: Hand-foot-mouth disease is caused by:

Coxsackie-A virus. ***Coxsackie-A virus*** - Hand-foot-mouth disease (HFMD) is most commonly caused by **Coxsackievirus A16** within the species **Human enterovirus A**. - Other **Coxsackievirus A serotypes** can also cause HFMD, particularly **A6, A10**, and **Enterovirus A71**. *Coxsackie-B virus* - **Coxsackievirus B** is known to cause a range of illnesses, including **myocarditis**, **pleurodynia (Bornholm disease)**, and **pericarditis**. - While it belongs to the same genus (Enterovirus), it is not the typical causative agent of HFMD. *EBV* - **Epstein-Barr Virus (EBV)** is a herpesvirus that causes **infectious mononucleosis**, **Burkitt's lymphoma**, and **nasopharyngeal carcinoma**. - It is transmitted through saliva and is **not associated with HFMD**. *CMV* - **Cytomegalovirus (CMV)** is a common virus that can cause a wide spectrum of diseases, especially in immunocompromised individuals and congenitally. - It is known for causing mononucleosis-like syndrome, congenital infections, and retinitis, but it is **not associated with HFMD**.

Q: Most commonly associated human papilloma virus with Cancer Cervix is?

HPV 16. ***HPV 16*** - **HPV 16** is the most prevalent **high-risk HPV type** responsible for approximately 50-60% of all cervical cancer cases globally. - It contains oncogenes, particularly **E6 and E7**, which interfere with tumor suppressor proteins such as **p53 and Rb**, leading to uncontrolled cell growth. *HPV 36* - **HPV 36** is considered a **low-risk HPV type** and is not commonly associated with the development of cervical cancer. - Low-risk HPV types are typically linked to **genital warts** (condylomas) and generally do not cause malignant transformation. *HPV 32* - **HPV 32** is also classified as a **low-risk HPV type** and does not play a significant role in the etiology of cervical cancer. - Its presence is more often associated with **benign lesions** of the oral cavity or skin, rather than high-grade cervical dysplasia or cancer. *HPV 24* - **HPV 24** is another **low-risk HPV type** with no known significant association with cervical cancer. - Like other low-risk types, it is usually cleared by the immune system and does not persist to cause oncogenic changes.

Q: Periventricular calcification seen in encephalitis is due to -

CMV. ***CMV*** - **Cytomegalovirus (CMV)** encephalitis, particularly in congenitally infected infants, is classically associated with **periventricular calcifications** due to its destructive effect on neural progenitors around the ventricles. - CMV has an **affinity for immature brain tissue**, leading to inflammation, necrosis, and subsequent calcification in these areas. *HSV-I* - **Herpes Simplex Virus type 1 (HSV-1)** encephalitis typically causes focal lesions, often involving the **temporal and frontal lobes**, and is characterized by neuronal necrosis and hemorrhage, not usually periventricular calcifications. - It does not have the same tropism for the germinal matrix responsible for periventricular calcifications as CMV. *HSV-II* - **Herpes Simplex Virus type 2 (HSV-2)** encephalitis can occur in neonates, usually presenting as a disseminated infection or meningitis/encephalitis. While it can cause significant brain damage, **periventricular calcifications are not its hallmark feature**; hydrocephalus or white matter injury may be seen. - HSV-2 tends to cause a more diffuse inflammatory response rather than the localized damage leading to periventricular calcifications. *Herpes Zoster* - **Varicella-zoster virus (VZV)**, which causes herpes zoster, can lead to encephalitis, particularly in immunocompromised individuals. This often presents as **vasculopathy**, stroke, or focal neurological deficits, typically *without* periventricular calcifications. - VZV encephalitis usually involves inflammation of blood vessels and parenchyma but does not target the periventricular region in a way that causes characteristic calcifications.

Q: Subacute sclerosing panencephalitis is a late neurological complication associated with infection due to:

Measles virus. ***Measles virus*** - **Subacute sclerosing panencephalitis (SSPE)** is a rare, fatal degenerative disease of the central nervous system caused by a persistent infection of the **measles virus**. - It occurs years after the initial measles infection, typically in children or young adults, due to mutations in the **measles virus (paramyxovirus)** that allow it to remain latent and cause progressive neurological damage. *Rubella virus* - While rubella can cause congenital syndromes, it is not associated with **subacute sclerosing panencephalitis**. - The congenital rubella syndrome can cause neurological damage, but it is a direct consequence of fetal infection, not a delayed degenerative process like SSPE. *Parainfluenza virus* - **Parainfluenza viruses** are primarily respiratory pathogens causing conditions like croup, bronchitis, and pneumonia. - They are not known to cause chronic, delayed neurological complications such as **subacute sclerosing panencephalitis**. *Mumps virus* - Mumps virus can cause **meningitis** or **encephalitis** as acute complications of the infection. - However, it does not typically lead to a delayed, progressive neurodegenerative condition like **subacute sclerosing panencephalitis**.

Q: An infant presented with the following lesions on his face and limbs. Which of the following is the most likely causative organism?

Coxsackie. ***Coxsackie*** - The description of lesions on the **face and limbs** in an infant is highly suggestive of **Hand-Foot-and-Mouth Disease (HFMD)**, which is primarily caused by **Coxsackievirus A16** and **Enterovirus 71**. - HFMD typically presents with oral ulcers and a vesicular rash on the hands and feet but can also involve the buttocks and limbs. *HPV* - **Human Papillomavirus (HPV)** is responsible for warts (verrucae) and papillomas, which have a different morphology and distribution than the lesions described. - HPV infections are not typically associated with widespread rash on the face and limbs in infants. *HSV* - **Herpes Simplex Virus (HSV)** causes cold sores, genital herpes, and herpetic whitlow, characterized by vesicular eruptions appearing in localized areas. - While HSV can cause widespread infection in neonates (disseminated HSV), the typical presentation differs from the described lesions, and it would usually be a more severe systemic illness. *CMV* - **Cytomegalovirus (CMV)** infection in infants often presents as congenital abnormalities, hearing loss, or systemic symptoms like hepatosplenomegaly or jaundice. - CMV is not typically associated with a rash on the face and limbs like that seen in Hand-Foot-and-Mouth Disease.

Q: The tick-borne hemorrhagic fever found in Karnataka state is:

Kyasanur forest disease. Kyasanur forest disease - **Kyasanur Forest Disease (KFD)** is a **tick-borne hemorrhagic fever** endemic to **Karnataka, India**, particularly in the Shivamogga district. - The disease is caused by the **Kyasanur Forest Disease virus (KFDV)**, a member of the *Flaviviridae* family, transmitted to humans through the bite of infected ticks, primarily *Haemaphysalis spinigera*. *Japanese encephalitis* - **Japanese encephalitis** is a **mosquito-borne viral disease** that can cause encephalitis, but it is not typically characterized as a hemorrhagic fever and is not specifically linked to ticks in Karnataka. - While it can cause neurological symptoms, the primary vector is **mosquitoes**, not ticks, and its epidemiology differs from KFD. *Epidemic nephrosonephritis* - **Epidemic nephrosonephritis** (also known as **Hemorrhagic Fever with Renal Syndrome - HFRS**) is caused by **Hantaviruses** and is typically transmitted through contact with rodent urine, feces, or saliva. - It primarily affects the kidneys and can cause hemorrhagic manifestations, but it is **not tick-borne** and is not the specific hemorrhagic fever found in Karnataka. *Lassa fever* - **Lassa fever** is an **acute viral hemorrhagic illness** caused by the Lassa virus, which is endemic to West Africa and is primarily transmitted to humans through contact with food or household items contaminated with the urine and feces of **multimammate rats (Mastomys natalensis)**. - It is **not found in India** and is not transmitted by ticks.

Q: A 5-year-old previously healthy child is taken from his day care to the pediatrician because his mother is concerned that the child has been fussy for the past few days and now has a rash on his face and torso. The mother also says the boy told her his head hurts, and she thinks he may have a low-grade fever. On examination the child is afebrile and not ill-appearing. He has a rash extending over his entire body except for the palms and soles. The infectious agent causing this disease can lead to what complication in immunocompromised hosts?

Aplastic anemia. ***Aplastic anemia*** - This clinical presentation of a **rash** on the face and torso with **headache** and **low-grade fever** in a previously healthy child is characteristic of **erythema infectiosum** (fifth disease), caused by **Parvovirus B19**. - In immunocompromised hosts or those with underlying hematologic disorders (e.g., **sickle cell disease**), Parvovirus B19 infection can lead to **aplastic crisis** due to its tropism for **erythroid progenitor cells**, resulting in severe anemia. *Progressive multifocal leukoencephalopathy* - This is a severe demyelinating disease of the central nervous system caused by the **JC virus**, primarily affecting immunocompromised individuals. - It is not a complication associated with Parvovirus B19 infection. *Endemic Burkitt's lymphoma* - This aggressive B-cell lymphoma is strongly associated with **Epstein-Barr virus (EBV)** infection, particularly in areas endemic for malaria. - There is no association between Parvovirus B19 and Burkitt's lymphoma. *Orchitis* - **Orchitis**, or inflammation of the testicles, is a common complication of **mumps virus** infection, especially in post-pubertal males. - It is not a known complication of Parvovirus B19 infection.

Q: What is true about gp120?

Virus attachment. ***Correct: Virus attachment*** - **gp120** is a glycoprotein on the **surface of HIV** that is crucial for binding to **CD4 receptors** on host T-helper cells and macrophages. - This initial binding step is essential for the **HIV life cycle** and marks the beginning of the infection process. - gp120 specifically mediates the **attachment phase** of viral entry, making this the correct answer. *Incorrect: Virus penetration* - Viral penetration, or entry into the cell, occurs **after attachment** and involves the fusion of the viral envelope with the host cell membrane, mediated by the **gp41 protein** (not gp120). - While gp120 initiates the process, it does not directly mediate the fusion and penetration step itself. *Incorrect: Virus dissemination* - Virus dissemination refers to the spreading of the virus throughout the host organism after initial infection and replication. - While gp120's role in initial infection enables subsequent dissemination, dissemination is not the primary function of gp120. *Incorrect: Virus detachment* - Virus detachment typically refers to the release of newly formed viral particles from the host cell. - This process is usually mediated by host cell enzymes or viral enzymes like **neuraminidase** in influenza, not by gp120. - gp120 functions at the **entry stage**, not the exit stage of the viral life cycle.

Question 1

Herpangina is caused by the virus -

Accepted Answer

Group A Coxsackie

Answer

Group B Coxsackie

Answer

Adenovirus

Answer

Measles

Question 2

Cataracts and PDA in a newborn suggests in utero infection with which viral family?

Accepted Answer

Togavirus

Answer

Adenovirus

Answer

Paramyxovirus

Answer

Picornavirus

Question 3

Hand-foot-mouth disease is caused by:

Accepted Answer

Coxsackie-A virus

Answer

Coxsackie-B virus

Answer

EBV

Answer

CMV

Question 4

Most commonly associated human papilloma virus with Cancer Cervix is?

Accepted Answer

HPV 16

Answer

HPV 36

Answer

HPV 32

Answer

HPV 24

Question 5

Periventricular calcification seen in encephalitis is due to -

Accepted Answer

CMV

Answer

HSV-I

Answer

HSV-II

Answer

Herpes Zoster

Question 6

Subacute sclerosing panencephalitis is a late neurological complication associated with infection due to:

Accepted Answer

Measles virus

Answer

Rubella virus

Answer

Parainfluenza virus

Answer

Mumps virus

Question 7

An infant presented with the following lesions on his face and limbs. Which of the following is the most likely causative organism?

Accepted Answer

Coxsackie

Answer

HPV

Answer

HSV

Answer

CMV

Question 8

The tick-borne hemorrhagic fever found in Karnataka state is:

Accepted Answer

Kyasanur forest disease

Answer

Japanese encephalitis

Answer

Epidemic nephrosonephritis

Answer

Lassa fever

Question 9

A 5-year-old previously healthy child is taken from his day care to the pediatrician because his mother is concerned that the child has been fussy for the past few days and now has a rash on his face and torso. The mother also says the boy told her his head hurts, and she thinks he may have a low-grade fever. On examination the child is afebrile and not ill-appearing. He has a rash extending over his entire body except for the palms and soles. The infectious agent causing this disease can lead to what complication in immunocompromised hosts?

Accepted Answer

Aplastic anemia

Answer

Progressive multifocal leukoencephalopathy

Answer

Endemic Burkitt's lymphoma

Answer

Orchitis

Question 10

What is true about gp120?

Accepted Answer

Virus attachment

Answer

Virus penetration

Answer

Virus dissemination

Answer

Virus detachment

Virology — MCQs

Virology — MCQs

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