Life Sciences IV Final Exam - Set 4

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Terms in this set (39)

Each of the following statements concerning Viruses replicate by binary fission.

viruses is correct EXCEPT:

- Viruses can reproduce only within cells.

- The proteins on the surface of the virus mediate
the entry of the virus into host cells.
- Neutralizing antibody is directed against proteins
on the surface of the virus.
- Viruses replicate by binary fission.

Which of the following statements concerning AIDS The Western blot test is the initial diagnostic test
is incorrect
- The Western blot test is the initial diagnostic test
- Both CD4+ T-cells and macrophages can be
infected
- HIV requires both CD4 and a chemokine
coreceptor to enter cells
- HIV reverse transcriptase changes viral RNA into
DNA

Viral coinfections occur in HIV-1-infected Hepatitis C virus

individuals and may contribute to morbidity and
mortality. The most common coinfection in HIV-1-
positive persons in the United States involves
- Hepatitis C virus
- Hepatitis D virus
- HIV type 2
- Human T-lymphotropic virus
- Kaposi sarcoma herpesvirus

Life Sciences IV Final Exam - Set 4

 Which is NOT true of virions? Reproduce independently

- Contain DNA
- Contain RNA
- Are extracellular
- Reproduce independently
- Induce host metabolism

The paramyxoviruses include the most important Genome is segmented.

causes of respiratory infections in infants and young
children. Which of the following is not characteristic
of paramyxoviruses?

- Genome is negative-sense RNA.

- Envelope contains a glycoprotein with fusion
activity.
- Paramyxoviruses do not undergo genetic
reassortment.
- Replication cycle occurs in cytoplasm of
susceptible cells.
- Genome is segmented.

A 34-year-old electric company worker presents to T lymphocytes

the urgent care clinic with a pruritic skin rash on his
right arm. He relates the rash to recent plant
exposure while doing a repair job for his company
in a wooded area. Physical examination reveals a
linear eruption with vesiculation. Which of the
following cells would be found earliest in this
patient's skin lesion?

- Mast cells
- Eosinophils
- Neutrophils
- Macrophages
- T lymphocytes
- Plasma cells

A 21-year-old male with cough and low-grade fever β-lymphocytes

is diagnosed with Mycoplasma pneumonia. He is
treated with erythromycin and his symptoms
resolve. However, one week after the erythromycin
treatment is completed; the patient's respiratory
secretions still contain Mycoplasma. Which of the
following cell types plays a major role in the
clearance of this organism?

- Cytotoxic T-lymphocytes
- β-lymphocytes
- Macrophages
- Neutrophils
- Eosinophils

Life Sciences IV Final Exam - Set 4

An infant born to 38-year-old primigravida Third pharyngeal pouch
develops carpopedal spasms soon after birth. On
diagnostic workup, the infant is found to have an
absence of the thymic shadow on X-ray and
narrowing of the aortic arch on angiography. Which
of the following embryonic structure derivatives
failed to develop in this patient?

- Second branchial cleft

- Third branchial arch
- Third pharyngeal pouch
- Forth branchial arch
- Septum transversum

A 32-year-old Caucasian male who is treated with Decreased serum CS level

trimethoprim sulfamethoxazole for prostatic
infection complains of joint pain and pruritic skin
rash. There are scattered areas of fibrinoid necrosis
and neutrophil infiltration in his arteries and small
arterioles. Which of the following findings is most
likely to accompany this patient's condition?

- Increased serum IgE level

- Moderate to severe neutropenia
- Decreased serum CS level
- Low serum IgA level
- Thrombocytopenia
- Candida antigen anergy

A 71-year-old male who suffers from chronic Virus entry into cells is impaired
obstructive pulmonary disease receives yearly
shots of a killed viral vaccine. When he is
subsequently exposed to this virus, which of the
following is thought to happen?

- Infective dose of the virus is decreased

- Virus entry into cells is impaired
- Virus replication inside cells is impaired - Viral
progeny release from cells is impaired
- Infected cells are destroyed by sensitized T-
lymphocytes

Circulating immune complexes are an etiologic Farmer's lung

factor in the following diseases:

- Tuberculosis
- Farmer's lung
- Goodpasture's syndrome
- Myastenia gravis

Life Sciences IV Final Exam - Set 4

An outbreak of influenza A infection is reported in a Circulating antibodies against hemagglutinin
small community with 70% of the adult population
remaining uninfected despite prolonged and
repeated exposure to ill contacts. Which of the
following is the most important host factor in
preventing influenza infection in these subjects?

- I-cell response against nucleocapsid proteins

- I-cell response against neuraminidase
- Circulating antibodies against RNA polymerase
- Circulating antibodies against hemagglutinin
- Antigen-nonspecific macrophage response

Bone marrow transplantation in Potentially lethal graft-versus-host disease

immunocompromised patients presents which
major problem?

- Potentially lethal graft-versus-host disease

- High risk of T-cell leukemia
- Inability to use a live donor
- Delayed hypersensitivity

A 35-year-old African American female is being CD4+ lymphocytes

evaluated for exertional dyspnea and dry cough.
She has a hi stow of intravenous dug use and
multiple sexual partners. Chest x-ray shows bilateral
hilar adenopathy and pulmonary infiltrates. Serum
angiotensin converting enzyme levels and calcium
levels are elevated. PPD testing is negative.
Bronchoscopy is arranged to help determine the
diagnosis. Which of the following cell types is most
likely to predominate in this patient's
bronchoalveolar lavage fluid?

- Eosinophils
- Neutrophils
- CD4+ lymphocytes
- CD8+ lymphocytes
- CD22+ lymphocytes
- Mast cells

Rejection of a tumor may involve which of the All answer are correct
following? (Immune)

- T-cell-mediated cytotoxicity
- ADCC
- complement-dependent cytotoxicity
- All answer are correct

Life Sciences IV Final Exam - Set 4

Which of the following is not a Tumor Specific HER2
Antigen?

- EBV
- HPV
- HER2
- HTLV

Defects in neutrophil NADPH oxidase system Chronic granulomatous disease.

produce:

- Chronic granulomatous disease.

- Chediak-Higashi disease.
- Leukocyte adhesion deficiency.
- Hashimoto's disease.
- Streptococcal infection.

An 8-year-old male with a long history of recurrent DNA break repair

pulmonary infections is being evaluated for some
neurological symptoms. His gait is narrow-based,
and he has been known to spontaneously lose his
balance and fall. Physical examination also reveals
numerous superficial blanching nests of distended
capillaries on sun-exposed areas of his skin. The
genetic defect in this child most likely plays a role
in:

- Mitochondrial iron transport

- DNA break repair
- Purine catabolism
- HLA class II antigen expression
- Sphingolipid degradation

A 4-year-old Caucasian male is evaluated in your Chédiak-Higashi syndrome

clinic for recurrent skin and respiratory infections.
He has light skin and silvery hair. Horizontal
nystagmus is present on eye examination.
Peripheral blood smear demonstrates giant
cytoplasmic granules in neutrophils and monocytes.
The patient most likely suffers from which of the
following disorders?

- Chronic granulomatous disease

- Phenylketonuria
- DiGeorge syndrome
- Wiskott-Aldrich syndrome
- Chédiak-Higashi syndrome
- Albinism

Life Sciences IV Final Exam - Set 4

A 23-year-old immigrant gives birth to a term Maternal vaccination during pregnancy
newborn at home. The infant's father cuts the
umbilical cord with a kitchen knife. One week later,
the infant develops rigidity and spasms. This child's
condition could most likely have been prevented
by which of the following?

- Infant vaccination at the time of birth

- Maternal vaccination during pregnancy
- Multivitamins during pregnancy
- Peripartum antibiotics to the mother
- Proper infant nutrition after birth

A 4-year-old Caucasian boy is evaluated for Cerebellar atrophy

difficulty walking. Past medical history includes
frequent respiratory infections. Cultured cells from
this patient demonstrate a high rate of radiation-
induced genetic mutation. This patient is most likely
to experience which of the following?

- Neurofibrillary tangles in neocortex

- Cerebellar atrophy
- Loss of neurons in the substantia nigra
- Atrophy of caudate nucleus
- Posterior column degeneration
- Presence of Lewy bodies

Mary is a 52-year-old woman with end-stage renal Acute allograft rejection

disease secondary to diabetes. She received an
allogeneic renal transplant 2 months ago and has
progressed to a maintenance dose of
immunosuppressive therapy. However, within the
last week she has been experiencing a progressive
decline in renal function [decreased urine output,
elevated blood urea nitrogen (BUN) and creatine]
and currently has a temperature of 39°C. Her kidney
is now tender, painful, and swollen. A renal biopsy
shows a dense interstitial mononuclear infiltration.
Which of the following is most likely responsible for
the change in her clinical course over the past
week?

- An opportunistic viral infection

- Renal toxicity due to her immunosuppressive
drugs
- Graft-versus-host disease
- Acute allograft rejection
- Diabetic nephropathy

Life Sciences IV Final Exam - Set 4

Which of the following statements is incorrect? Contact dermatitis due to poison ivy is an antigen-antibody complex disease

- dsDNA-anti-dsDNA complexes can initiate

glomerulonephritis
- Contact dermatitis due to poison ivy is an antigen-
antibody complex disease
- Macrophages are activated nonspecifically by
IFN-g
- Cross-linkage by antigen of two or more IgE
molecules causes degranulation of sensitized mast
cells

A patient recently diagnosed with SLE is A decline in C3 and C4 levels

experiencing significant symptoms of 3 weeks
duration that include edema and skin rash. Her
serum blood urea nitrogen (BUN) and creatinine
levels are increased, and a biopsy of her kidney
shows IgG and C3b at the glomerular basement
membrane. Her serum complement levels are
monitored over time. Which of the following
findings would be most consistent with a worsening
clinical course?

- A decline in C9 levels
- A decline in C3 and C4 levels
- An increase in Factor P levels
- An increase in C1 inhibitor (C1 Inh) levels
- A decline in C7 levels

37-year-old otherwise healthy man with no Repeat ELISA

complaints wants to donate blood and he tests
positive for HIV ELISA. What is the next best step ?

- Measure HIV viral RNA

- Continue with Western blot
- Measure CD4T cells
- Repeat ELISA

Which of the following would be present in Pulmonary artery stenosis

neonate with congenital rubella Syndrome but not
in a neonate with cytomegalovirus inclusion
disease?

- Hearing loss
- Pulmonary artery stenosis
- Mental retardation
- Hepatosplenomegaly
- Intrauterine growth retardation

Life Sciences IV Final Exam - Set 4

A 14-year-old boy presents with fever, sore throat, Burkitt Lymphoma
and cervical lymphadenopathy. Then he develops
splenomegaly lasting for 2 months. His peripheral
blood smear shows leukocytosis with "atypical"
lymphocytes. Heterophil antibody test is positive.
Which of the following can be caused by the same
infectious agent?

- Burkitt Lymphoma
- Zoster
- Retinitis
- Kaposi sarcoma
- Deafness

45-year-old man with AIDS comes to emergency Mononucleosis

department with fever and decreased vision. He is
eventually diagnosed with viral retinitis. The same
virus causes which of the following conditions in a
healthy host?

- Hepatitis
- Mononucleosis
- Esophagitis
- Brain abscess
- Shingles
- Lymphoma

A 34 year old nurse with recent onset of malaise is Had raw oysters at local restaurant
found to have the following set of laboratory
findings: Anti HAV IgM - positive, Anti HAV IgG -
negative, HBsAg — negative, HBeAg — negative,
Anti-HBsAg — positive, Anti-HBcAg - negative,
AntiHBeAg - negative, Anti- HCV — negative. The
patient most likely:

- Had an accidental needlestick

- Had a recent tattoo
- Had raw oysters at local restaurant
- Had unprotected sexual intercourse

Life Sciences IV Final Exam - Set 4

Previously healthy and physically active 23-year-old Coxsackievirus B
male comes to your office with the complaints of
severe dyspnea. He is a former basketball player
and used to exercise regularly until 10 days ago,
when he developed flu-like febrile illness. Starting
from that, patient gradually developed increasing
fatigue and shortness of breath. He also reports
occasional paroxysms of "heart racing". Serum
levels of Troponin-| and CPK are elevated.
Echocardiography shows decreased ejection
fraction. Which of the following is the most likely
viral cause of his symptoms?

- Enterovirus 71
- Calicivirus
- Echovirus 31
- Parainfluenza virus
- Coxackievirus A
- Coxsackievirus B

An otherwise healthy 11-year-old child presents with Adenovirus

low-grade fever, sore throat and red, irritated eyes.
On examination, the patient is noted to have
pharyngitis and bilateral conjunctivitis. Which of the
following is the most likely etiologic agent?

- Rhinovirus
- Adenovirus
- Metapneumovirus
- Coronavirus
- Influenza virus

6-year-old unvaccinated boy is brought to your Togavirus

office with the complaints of a low-grade fever,
arthralgia and a skin rash. The rash started on his
face and spread rapidly down his body. Physical
exam shows a generalized maculopapular rash and
bilateral cervical lymphadenopathy. Which of the
following is the likely cause of this patient's illness?

- Parainfluenza virus
- Parvovirus
- Paramyxovirus
- Coxsackievirus
- Togavirus
- Herpesvirus 6

Life Sciences IV Final Exam - Set 4

4 year-old unvaccinated child presents with a 3-day Measles
history of malaise, fever of 38.9°C, cough, coryza,
and conjunctivitis. He then develops the
erythematous, maculopapular rash. He is noted to
have white pinpoint lesions on a buccal mucosa.
The most likely diagnosis is:

- Measles
- Rubella
- Chickenpox
- Erythema infectiosum
- Hand-foot-and-mouth Disease
- Roseola infantum

An otherwise healthy 16 year-old boy develops CMV

increasing blurring of vision over the last 2 days.
Necrotizing retinal infiltrates are seen by
funduscopic exam. Which of the following is the
most likely cause?

- Toxoplasma gondii
- Balamuthia mandrilaris
- Measles virus
- CMV
- Acanthamoeba species
- Giardia lamblia

Parvovirus infection, the cause of a mild exanthem Acute hemolytic anemia

in childrcharacterized by

- Acute hemolytic anemia

- Epidemic acute respiratory disease
- Gastroenteritis
- Whooping cough-like disease
- Keratoconjunctivitis

42-year-old male with uncontrolled AIDS CD4 <50/ microliter

complains of progressive blurring of vision in his
right eye. Eye examination reveals evidence of
retinitis with cytomegalic viral inclusion disease .
Risk of this disease is highest, when CD4 T cell
count drops below:

- CD4 <100/ microliter

- CD4 <300/ microliter
- CD4 <400/ microliter
- CD4 <50/ microliter
- CD4 <200/ microliter

Life Sciences IV Final Exam - Set 4

All of the following is associated with chronic Severe fatal illness during pregnancy
Hepatitis C infection. Except: (C. Micro)

- Severe fatal illness during pregnancy

- Essential mixed cryoglobulinemia
- Hepatocellular carcinoma
- Fulminant Hepatitis
- Palpebral Purpura

Which of the following viruses and the potential HPV - Development of ovarian cancer
complications are mismatched?

- EBV - Development of nasopharyngeal carcinoma

- HPV - Development of ovarian cancer
- Measles virus - Transient immunosuppression
- Mumps - Aseptic meningitis
- Rubella - purpuric rash in a newborn

A 43-year-old woman with HIV is admitted with Toxoplasma Gondii: CD4 T cells <100
new-onset seizures. The CT scan of the head
reveals multiple ring-enhancing lesions of the brain.
which of the following is the most appropriate
combination of the causing organism and CD4 T
cell counts?

- Trypanosoma Cruzii: CD4 T cells <200

- MAC: CD4 T cells <50
- Cryptococcus Neoformans: CD4 T cells <100
- Toxoplasma Gondii: CD4 T cells <100
- Pneumocystis Jirovecii: CD4 T cells <200
- Hispoplasma Capsulatum - CD4 T cells <100