Oncogenic viruses — MCQs

A 16-year-old male is brought to the clinic by his mother for the complaints of fever, nonproductive cough, fatigue, lack of appetite, and sore throat for the past 2 months. Several other students at his high school have had similar symptoms. Physical exam shows a whitish membrane in his oropharynx, bilateral enlarged cervical lymphadenopathy, and mild splenomegaly. Which of the following tests is most likely to diagnose his condition?

A 55-year-old Caucasian male presents for a routine colonoscopy. A polyp is found in the patient's transverse colon and is found to be cancerous on histological evaluation. Upon examination, it is found that these cancerous cells have decreased MHC class I expression on their surface. Which immune system cell is most capable of killing these tumor cells?

A 28-year-old male with a history of HIV infection is found to have a CD4+ T lymphocyte count of 68 cells per microliter. As a consequence of his HIV infection, this patient is at increased risk of malignancy due to which of the following?

A scientist is researching the long term effects of the hepatitis viruses on hepatic tissue. She finds that certain strains are oncogenic and increase the risk of hepatocellular carcinoma. However, they appear to do so via different mechanisms. Which of the following answer choices correctly pairs the hepatitis virus with the correct oncogenic process?

A 48-year-old man comes to the physician because of a skin lesion on his nose and in his mouth. The lesions have been gradually increasing in size and are not painful or pruritic. Two months ago, he was treated for esophageal candidiasis. Physical examination shows one pinkish-brown papule on the right wing of the nose and two similar nodular lesions on the hard palate and buccal mucosa. A biopsy of one of the lesions shows spindle-shaped endothelial cells and infiltration of lymphocytes, plasma cells, and macrophages. Which of the following is the most likely causal organism of this patient's condition?

A 42-year-old man presents with an oral cavity lesion, toothache, and weight loss. He is known to have been HIV-positive for 6 years, but he does not follow a prescribed antiretroviral regimen because of personal beliefs. The vital signs are as follows: blood pressure 110/80 mm Hg, heart rate 89/min, respiratory rate 17/min, and temperature 37.1°C (100.8°F). The physical examination revealed an ulcerative lesion located on the lower lip. The lesion was friable, as evidenced by contact bleeding, and tender on palpation. A CT scan showed the lesion to be a solid mass (7 x 6 x 7 cm3) invading the mandible and spreading to the soft tissues of the oral cavity floor. A biopsy was obtained to determine the tumor type, which showed a monotonous diffuse lymphoid proliferation of large cells with plasmablastic differentiation, and oval-to-round vesicular nuclei with fine chromatin. The cells are immunopositive for VS38c. DNA of which of the following viruses is most likely to be identified in the tumor cells?

A 36-year-old woman comes to the physician because of growths around her anus that developed over the past 4 weeks. They are not painful and she does not have blood in her stool. She is sexually active with two male partners and uses condoms inconsistently. She appears healthy. Vital signs are within normal limits. Examination shows nontender, irregular, hyperkeratotic sessile lesions in the perianal area around 4–7 mm in diameter. There is no lymphadenopathy. The application of a dilute solution of acetic acid turns the lesions white. Which of the following is the most likely cause of the lesions?

A 63-year-old man presents to his primary care physician because he has been having headaches and hearing loss. In addition, he says that he has been having difficulty opening his jaw to eat and recurrent middle ear infections. Physical exam reveals enlarged neck lymph nodes and a mass in the nasopharynx. Biopsy of the mass reveals undifferentiated squamous epithelial cells. The organism that is most likely associated with this patient's disease is also associated with which of the following disorders?

A group of scientists is studying the mechanism by which the human papillomavirus (HPV) vaccine confers immunity. They observe that during inoculation of test subjects, certain viral proteins are taken up by the organism's antigen-presenting cells (APCs) and presented on major histocompatibility complex (MHC) class I molecules. Which of the following is the correct term for the process that the scientists are observing in this inoculation?

A 55-year-old Chinese man presents to the office with a complaint of progressive unilateral nasal obstruction for 10 months. Though he was able to tolerate his symptoms at the beginning, he can’t breathe properly through the obstructed nostril anymore. Also, a bloody nasal discharge has started recently through the occluded nostril. He also complains of double vision during the past 2 months but did not pay attention to it until now. Past medical history is insignificant except for occasional sore throats. His vitals include: blood pressure of 120/88 mm Hg, respiratory rate of 14/min, pulse of 88/min, temperature 37.0°C (98.6°F). Blood analysis shows: Hemoglobin 15 g/dL Hematocrit 46% Leukocyte count 15000/mm3 Neutrophils 72% Lymphocytes 25% Monocytes 3% Mean corpuscular volume 95 fL Platelet count 350,000/mm3 Which of the following viral etiology is most likely associated with the development of this patient’s condition?