Cancer prevention strategies for oncogenic viruses — MCQs

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 31-year-old female presents to her gynecologist for a routine Pap smear. Her last Pap smear was three years ago and was normal. On the current Pap smear, she is found to have atypical squamous cells of unknown significance (ASCUS). Reflex HPV testing is positive. What is the best next step?

A 20-year-old man who is a biology major presents to his physician for a simple check-up. He is informed that he hasn't received a hepatitis B vaccine. When the first injection is applied, the medical professional informs him that he will need to come back 2 more times on assigned days, since the vaccine is given in 3 doses. Which of the following antibodies is produced first in the college student as a result of the first vaccination?

A 3255-g (7-lb) female newborn is delivered at term. Pregnancy and delivery were uncomplicated. On the day of her birth, she is given a routine childhood vaccine that contains a noninfectious glycoprotein. This vaccine will most likely help prevent infection by which of the following pathogens?

A 27-year-old woman comes to the physician for a routine health maintenance examination. She feels well. She had a chlamydia infection at the age of 22 years that was treated. Her only medication is an oral contraceptive. She has smoked one pack of cigarettes daily for 6 years. She has recently been sexually active with 3 male partners and uses condoms inconsistently. Her last Pap test was 4 years ago and results were normal. Physical examination shows no abnormalities. A Pap test shows atypical squamous cells of undetermined significance. Which of the following is the most appropriate next step in management?

A 17-year-old high school student presents to the physician’s office for a health maintenance examination. He is a recent immigrant from Venezuela and has no complaints at this time. Past medical history is significant for appendicitis at age 10, treated with an appendectomy. He denies the use of alcohol and cigarettes. He admits to occasionally smoking marijuana with his friends. He is sexually active with 1 woman partner and uses condoms inconsistently. The vital signs are within normal limits. Physical examination is unremarkable except for a laparoscopic surgical scar on the right iliac region. Routine blood tests are pending. What is the most appropriate next step in management?

A 16-year-old girl comes to her primary care physician for an annual check-up. She has no specific complaints. Her medical history is significant for asthma. She uses an albuterol inhaler as needed. She has no notable surgical history. Her mom had breast cancer and her grandfather died of colon cancer. She received all her childhood scheduled vaccinations up to age 8. She reports that she is doing well in school but hates math. She is sexually active with her boyfriend. They use condoms consistently, and they both tested negative recently for gonorrhea, chlamydia, syphilis and human immunodeficiency virus. She asks about birth control. In addition to educating the patient on her options for contraception, which of the following is the best next step in management?

A previously healthy 53-year-old man is brought to the emergency department 45 minutes after the onset of a severe headache. He returned from a vacation in the mountains 4 days ago, during which he went swimming in a freshwater lake. On arrival, he is confused. His temperature is 39°C (102.2°F) and blood pressure is 105/68 mm Hg. Neurologic examination shows diffuse hyperreflexia. An MRI of the brain shows asymmetrical, bitemporal hyperintensities. A lumbar puncture is performed. Cerebrospinal fluid analysis shows: Leukocyte count 120/mm3 Segmented neutrophils 10% Lymphocytes 90% Erythrocyte count 15/mm3 Glucose 45 mg/dL Opening pressure 130 mm Hg Protein 75 mg/dL Which of the following is the most likely causal pathogen?

An investigator studying influenza virus variability isolates several distinct influenza virus strains from the respiratory secretions of a study subject. Mass spectrometry analysis of one strain shows that it expresses neuraminidase on its surface. Subsequent sequencing of this strain shows that its genome lacks the neuraminidase gene. Which of the following is the most likely explanation for this finding?

A 30-year-old woman presents to the clinic because of fever, joint pain, and a rash on her lower extremities. She admits to intravenous drug use. Physical examination reveals palpable petechiae and purpura on her lower extremities. Laboratory results reveal a negative antinuclear antibody, positive rheumatoid factor, and positive serum cryoglobulins. Which of the following underlying conditions in this patient is responsible for these findings?