Oncogenic viruses Practice Questions

Question 1

A 38-year-old woman makes an appointment with her family physician for a routine check-up after being away due to travel for 1 year. She recently had a screening Pap smear, which was negative for malignancy. Her past medical history is significant for a Pap smear 2 years ago that reported a low-grade squamous intraepithelial lesion (LSIL). A subsequent colposcopy diagnosed high-grade cervical intraepithelial neoplasia (CIN2). The patient is surprised by the differences in her diagnostic tests. You explain to her the basis for the difference and reassure her. With this in mind, which of the following HPV serotypes is most likely to be present in the patient?

Accepted Answer

HPV 16

Answer

HPV 33

Answer

HPV 6

Answer

HPV 31

Answer

HPV 18

Question 2

A research group wants to assess the safety and toxicity profile of a new drug. A clinical trial is conducted with 20 volunteers to estimate the maximum tolerated dose and monitor the apparent toxicity of the drug. The study design is best described as which of the following phases of a clinical trial?

Accepted Answer

Phase I

Answer

Phase 0

Answer

Phase III

Answer

Phase V

Answer

Phase II

Question 3

A 41-year-old man with HIV comes to the physician because of rectal bleeding and itching for 2 weeks. During this period, he has also had pain with defecation. Four months ago, he was diagnosed with anogenital warts that were treated with cryotherapy. Over the past year, he has been sexually active with 3 male partners. He uses condoms inconsistently. Current medications are zidovudine, emtricitabine, and efavirenz. Digital rectal examination and anoscopy show an exophytic mass on the anal margin that is protruding into the anal canal. The mass is tender to palpation and bleeds easily on contact. Laboratory studies show a leukocyte count of 7,600/mm3 and a CD4+ T-lymphocyte count of 410/mm3 (N ≥ 500). A biopsy specimen of the lesion shows a well-differentiated squamous cell carcinoma. Which of the following cellular processes was most likely involved in the pathogenesis of this patient's malignancy?

Accepted Answer

Inactivation of TP53 gene

Answer

Activation of c-myc gene

Answer

Activation of TAX gene

Answer

Inactivation of VHL gene

Answer

Inactivation of WT1 gene

Question 4

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?

Accepted Answer

Burkitt lymphoma

Answer

Kaposi sarcoma

Answer

Hepatocellular carcinoma

Answer

Adult T-cell lymphoma

Answer

Vulvar carcinoma

Question 5

Two viruses, X and Y, infect the same cell and begin to reproduce within the cell. As a result of the co-infection, some viruses are produced where the genome of Y is surrounded by the nucleocapsid of X and vice versa with the genome of X and nucleocapsid of Y. When the virus containing genome X surrounded by the nucleocapsid of Y infects another cell, what is the most likely outcome?

Accepted Answer

Virions containing genome X and nucleocapsid X will be produced

Answer

Virions containing genome Y and nucleocapsid Y will be produced

Answer

No virions will be produced

Answer

Virions containing genome X and nucleocapsid Y will be produced

Answer

Virions containing genome Y and nucleocapsid X will be produced

Question 6

A group of scientists is conducting an experiment on the human cells involved in the immune response. They genetically modify B cells so they do not express the cluster of differentiation 21 (CD21) on their cell surfaces. The pathogenesis of which of the following organisms would most likely be affected by this genetic modification?

Accepted Answer

Epstein-Barr virus (EBV)

Answer

Human papillomavirus

Answer

Human immunodeficiency virus (HIV)

Answer

Parvovirus B19

Answer

Measles virus

Question 7

A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

Accepted Answer

"Can you tell me more about the symptoms you have been experiencing?"

Answer

"Does the diarrhea typically precede the constipation, or vice-versa?"

Answer

"Is the diarrhea foul-smelling?"

Answer

"Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"

Answer

"Are the symptoms worse in the morning or at night?"

Question 8

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?

Accepted Answer

Monospot test

Answer

Enzyme-linked immunosorbent assay

Answer

Throat culture

Answer

Urine culture

Answer

Chest X-ray

Question 9

A 20-year-old man presents to the emergency department with complaints of severe malaise, fevers, and sore throat for the past 7 days. He also has had episodes of nausea and vomiting during this period. He does not smoke or drink alcohol. There is no family history of liver disease. His blood pressure is 130/80 mm Hg, temperature is 38.3℃ (100.9℉), pulse is 102/min, and respiratory rate is 20/min. On physical examination, he appears ill with bilateral cervical lymphadenopathy. His tonsils are erythematous and enlarged. There is no jaundice and he is mildly dehydrated. Abdominal examination demonstrates splenomegaly. The laboratory findings are shown below:
Hemoglobin  15 g/dL
Platelet count  95,000/mm³
Leukocytes 13,500/mm³
Neutrophils  50%
Atypical lymphocytes  34%
AST 232 U/L
ALT 312 U/L
ALP 120 U/L
GGT 35 U/L
Total bilirubin 1.2 mg/dL
Direct bilirubin 0.2 mg/dL
PT 12 seconds
The serologic test for hepatitis A, B, and C, CMV, and leptospirosis are negative. Serology for both serum IgM and IgG antibodies for EBV capsid antigen are positive, but the heterophile antibody test is negative. What is the most likely reason for the negative heterophile test?

Accepted Answer

False negative

Answer

Concurrent viral hepatitis A infection

Answer

CMV infection

Answer

Low specificity

Answer

Age of the patient

Question 10

A group of microbiological investigators is studying bacterial DNA replication in E. coli colonies. While the cells are actively proliferating, the investigators stop the bacterial cell cycle during S phase and isolate an enzyme involved in DNA replication. An assay of the enzyme's exonuclease activity determines that it is active on both intact and demethylated thymine nucleotides. Which of the following enzymes have the investigators most likely isolated?

Accepted Answer

DNA polymerase I

Answer

DNA ligase

Answer

Telomerase

Answer

Primase

Answer

DNA topoisomerase

Oncogenic viruses

Study Resources

Lessons

Questions

Flashcards

Lessons

Human papillomavirus

HPV-associated cancers

HPV vaccination and screening

Epstein-Barr virus

EBV-associated malignancies

Hepatitis B and hepatocellular carcinoma

Hepatitis C and hepatocellular carcinoma

Human T-cell leukemia virus

Merkel cell polyomavirus

Human herpesvirus 8 (Kaposi sarcoma virus)

Mechanisms of viral oncogenesis

Cancer prevention strategies for oncogenic viruses

Therapeutic approaches targeting oncogenic viruses

Practice Questions

Flashcards

About Oncogenic viruses for USMLE

Lessons in Oncogenic viruses

Master Oncogenic viruses