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 52-year-old woman presents to a local hospital complaining about a rash on her face and torso, as well as night sweats, low-grade fever, diarrhea, and unintentional weight loss. Her personal history is relevant for homelessness; she also has a history of risky behaviors such as the use and abuse of intravenous drugs, and unprotected intercourse with multiple sexual partners. Upon physical examination, well-demarcated violaceous plaques and papules distributed on her face and back are visible (see image below). Additional findings include fine reticular and interstitial changes on a chest radiograph, a CD4+ count of 50 cells/mm3, and positive HIV serology. Which of the following is the most likely etiology of this patient's dermatological condition?

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?