Microbiology Viruses

1. A female presents with the recent onset of vaginal discharge. Physical examination reveals multiple clear vesicles on her vulva and vagina. A smear of material obtained from one of these vesicles reveals several multinucleated giant cells with intranuclear inclusions and groundglass nuclei. These vesicles are most likely the result of an infection with:

*Ground-glass nuclei(Nuclear homogenization),Cowdry inclusions(INTRAnuclear inclusins) with mutltinucleated giant cells is cahracteristic of HSV <Double stranded LINEAR DNA virus which is Enveloped, baby can acquire this virus from mom during delivery>TORCHES in baby.*Patient more likely had HSV2 which is transmitted trough sexual contact,perinatal in contrast with saliva, respiratory secretions which serve as transmission channels for HSV1(associated with KERATOCONJUCTIVITIS,Herpetic withlow on finger=painful infection of nail,GINGIVOSTOMATITIS and TEMPORAL Lobe encephalitis), if you get HSV1 on boards they are most likely to describe patient with acute onset of Seizures,Mental status change/aphasia as HSV1 is MC cause of Sporadic encephalitis, or with uncomplicated herpes labialis while if you get HSV2 it is most likely in the context of herpes genitalis,neonatal herpes.*they LOVE to ask about latent sites, HSV1 usually hides in trigeminal ganglia while HSV 2 usually hides in SACRAL ganglia.*Also don't confuse Viral encephalitis(Can present with grand mal seizure+Lesion in Temporal lobe +Multinucleated giant cells with intranuclear inclusins on brain biopsy) ass. with HSV1 with Viral Meningitis(it is inflammation of meninges around brai/spinal cord instead of inflammation of brain itself whcih is the case with encephalitis) which is more associated with HSV2.

Gonorrhea

Trichomoniasis

Chlamydia

The presentation of clear vesicles on the vulva and vagina with multinucleated giant cells containing intranuclear inclusions and groundglass nuclei is characteristic of HSV infection. This can manifest as HSV1 or HSV2, with HSV2 being more commonly associated with genital herpes.

Explanation

The presentation of clear vesicles on the vulva and vagina with multinucleated giant cells containing intranuclear inclusions and groundglass nuclei is characteristic of HSV infection. This can manifest as HSV1 or HSV2, with HSV2 being more commonly associated with genital herpes.

2. NONcardiogenic pulmonary edema resulting from increased permeability of the pulmonary capillaries. Hypotension with fever and Myalgia(ESP: in Lower legs) leukocytosis, atypical lymphocytes, thrombocytopenia, coagulopathy, and decreased serum protein concentrations. Abdominal pain that mimics acute abdomen. Causative virus belongs to?

Paramyxoviridae

Filoviridae

Flaviviridae

*This is HANTAVIRUS(transmitted from rodents) which belongs to Bunyaviridae<Negative Sense SS,ENVELOPED,RNA virus with Circular RNA structure with 3 segments and with Helical caspid symmetry,*CLASSICALLY hantavirus is associated with Hemorrhagic fever with renal syndrome which presents with hematologic abnormalities,abdominal pain and renal failure with minimal pulmonary involvement however it CAN present with Hantavirus pulmonary syndrome too..dude LISTEN you have to know that it has 3 segments and you should know every detail of its structure .....i've heard that it showed up as Acute repsiratory distress syndrome in young patient from New Mexico who was exposed to rodent excreta.

The correct answer is HANTAVIRUS which belongs to Bunyaviridae. Filoviridae, Paramyxoviridae, and Flaviviridae do not match the description of the symptoms provided in the question.

Explanation

The correct answer is HANTAVIRUS which belongs to Bunyaviridae. Filoviridae, Paramyxoviridae, and Flaviviridae do not match the description of the symptoms provided in the question.

3. What virus is characterized by influenza-like symptoms that progress to rash, muscle pain, joint pain, and bone pain, and can produce a potentially fatal hemorrhagic disorder known as Breakbone fever?

*patient has DENGUE fever(Breakbone fever), it is caused by FLAVIVIRUS which is SS+,LINEAR,Enveloped RNA virus with Icosahedral caspid symmetry.*You should know that Aedes mosquito can transmit it as prevention can be done by using Insect repellent(No vaccine or drug is available)

Ebola virus

Chikungunya virus

Zika virus

Dengue fever, also known as Breakbone fever, is caused by the Flavivirus and transmitted by Aedes mosquito. It presents with symptoms such as rash, muscle pain, joint pain, and bone pain, leading to a potentially fatal hemorrhagic disorder.

Explanation

Dengue fever, also known as Breakbone fever, is caused by the Flavivirus and transmitted by Aedes mosquito. It presents with symptoms such as rash, muscle pain, joint pain, and bone pain, leading to a potentially fatal hemorrhagic disorder.

4. Guy who vomits DARK blood, is jaundiced, on liver biopsy you see councilman bodies(Represent apoptosis of hepatocytes), virus ?

Hepatitis A virus transmitted via contaminated food and water sources

Diphtheria toxin causing hepatotoxicity

*YELLOW FEVER is caused by yellow fever virus which is FLAVIVIRUS(SS+,Linear ,Enveloped RNA,Icosahedral) is ARBO virus and is transmitted by aedes mosquito(But humans and monkeys are reserviors) we have KILLED vaccine for yellow fever.(Give to someone who goes to South America and Africa), LOOK they can make you choose between Mosquito netting and Vaccine and BEST choice is KILLED VACCINE.,HOWEVER if the patient has WEST NILE VIRUS(targets elderly),St.Louis encephalitis or DENGUE fever then PICK management of VECTOR(Mosquitos) as a way of prevention because vaccine is NOT available.*This virus can cause coagulative necrosis of acinar zone2(Midzonal necrosis)*Liver failure leads to jaundice(YELLOW FEVER:) and vomit of clotted blood(DARK).*Culex mosquito transmits St.louis encephalitis>(Stupor,fever,joint pain,neck,stiffnes,HEADACHE)*West-Nile encephalitis LOVES ELDERLY and can present with stiff neck,sleepiness,disorientation,headache,swollen lymph nodes, can progress to convulsions,coma,paralysis)*HCV will have lot's of cards, for now know that it is SS+ linear,icosahedral,enveloped RNA virus common in IV Drug abusers and has tendency to go chronic.

Chikungunya virus transmitted by Aedes mosquitoes

The correct answer is YELLOW FEVER based on the symptoms described in the question such as vomiting dark blood, jaundice, and presence of councilman bodies on liver biopsy. The incorrect answers do not match the symptom presentation or mode of transmission for the described virus.

Explanation

The correct answer is YELLOW FEVER based on the symptoms described in the question such as vomiting dark blood, jaundice, and presence of councilman bodies on liver biopsy. The incorrect answers do not match the symptom presentation or mode of transmission for the described virus.

5. A 6-year-old boy develops a facial rash that has the appearance of a slap to the face. The rash, which is composed of small red spots, subsequently involves the upper and lower extremities. This boy also has arthralgia and suddenly develops a life-threatening aplastic crisis of the bone marrow. The most likely infectious agent causing these symptoms is.

Cytomegalovirus

Rubella virus

Varicella-zoster virus

Parvovirus

Parvovirus infection can cause a distinct facial rash (slapped cheek appearance), followed by a rash on the extremities, arthralgia, and aplastic crisis of the bone marrow. Rubella virus does not typically cause arthralgia or aplastic crisis. Varicella-zoster virus causes chickenpox (vesicular rash) and shingles (dermatomal rash), not the specific rash described. Cytomegalovirus can cause various symptoms but does not typically present with the typical facial rash seen in Parvovirus infection.

Explanation

Parvovirus infection can cause a distinct facial rash (slapped cheek appearance), followed by a rash on the extremities, arthralgia, and aplastic crisis of the bone marrow. Rubella virus does not typically cause arthralgia or aplastic crisis. Varicella-zoster virus causes chickenpox (vesicular rash) and shingles (dermatomal rash), not the specific rash described. Cytomegalovirus can cause various symptoms but does not typically present with the typical facial rash seen in Parvovirus infection.

6. What is the Eclipse phenomenon?

*Time between onset of infection and appearance of INTRAcellular virus.<Not Super HY for boards but you never know...

A software development tool

A celestial event involving the moon blocking the sun

A type of eye condition

The Eclipse phenomenon refers to the time between the onset of infection and the appearance of intracellular virus. It is not related to software development tools, celestial events, or eye conditions.

Explanation

The Eclipse phenomenon refers to the time between the onset of infection and the appearance of intracellular virus. It is not related to software development tools, celestial events, or eye conditions.

7. Which types of hepatitis have vaccines available?

*Hep B(SUBUNIT vaccine, involves HbsAg)and HepA(Killed vaccine)

Hepatitis D

Hepatitis C

Hepatitis E

Hepatitis B and Hepatitis A are the only types for which vaccines are currently available.

Explanation

Hepatitis B and Hepatitis A are the only types for which vaccines are currently available.

8. Why is it important to know that rota virus is non-enveloped?

*Because they will ask you which of the following is Not likely to be killed by Ethanol, and will give you bunch of RNA, DNA viruses that are Enveloped, but the answer would be rota or other Non-enveloped viruses like Picornaviruses.

Because non-enveloped viruses are more common in tropical regions.

Because enveloped viruses like rota virus are easier to neutralize with disinfectants.

Because knowing the structure of the virus affects its mode of transmission.

Understanding the envelope status of a virus can help in selecting appropriate disinfection methods, making it crucial to know that rota virus is non-enveloped to understand its resistance to Ethanol.

Explanation

Understanding the envelope status of a virus can help in selecting appropriate disinfection methods, making it crucial to know that rota virus is non-enveloped to understand its resistance to Ethanol.

9. A medical student on the Caribbean island of Dominica presents at the Student Health Clinic complaining of an increasingly severe headache and back and bone pain. Yesterday she was nauseated and vomited several times during the night. She has a 39.5°C/103°F fever, which appeared suddenly, and a generalized rash that blanches under pressure. She had been hiking in the rainforest 1 week earlier and was particularly bothered by mosquitoes at that time. The most likely infectious agent causing her symptoms is?

*DENGUE Virus-causing "BreakBone fever"*This virus can be transmitted by mosquito bites and is present in Caribbean.

Malaria parasite

Zika virus

Chikungunya virus

Dengue virus is a common mosquito-borne virus in the Caribbean region and can cause symptoms such as severe headache, bone pain, fever, and rash. It is known for causing 'BreakBone fever'. The other options mentioned are also mosquito-borne diseases, but they do not typically present with the combination of symptoms described in the case scenario.

Explanation

Dengue virus is a common mosquito-borne virus in the Caribbean region and can cause symptoms such as severe headache, bone pain, fever, and rash. It is known for causing 'BreakBone fever'. The other options mentioned are also mosquito-borne diseases, but they do not typically present with the combination of symptoms described in the case scenario.

10. After adopting a child from Southeast Asia, a mother develops jaundice, increased AST, ALT (with AST higher than ALT), and mixed hyperbilirubinemia. What virus is likely responsible?

Hepatitis B (HepB)

Rotavirus A

*HepA is very common in Southeast Asia, so it is a good idea to give them HepA vaccine(killed), before they adopt child from this area,or travel there.*Note think of HepA in jaundiced baby in Daycare center, or traveler and remember that transmission if Fecal oral for this Non-enveloped,SS+,icosahedral RNA virus.*Diagnosis is made by serologic tests rather than culturing of the virus.

Hepatitis C (HepC)

Hepatitis A is common in Southeast Asia and can be prevented with vaccination. The transmission is fecal-oral, and diagnosis is typically made using serologic tests.

Explanation

Hepatitis A is common in Southeast Asia and can be prevented with vaccination. The transmission is fecal-oral, and diagnosis is typically made using serologic tests.

11. A 16 year old teen presents with Posterior cervical lymphadenopathy, fever, hepatosplenomegaly, pharyngitis, and a positive Monospot test indicating heterophils antibodies. What type of atypical lymphocytes are likely to be seen on blood smear?

Helper T lymphocytes

*CYTOTOXIC T LYMPHOCYTES.*Yes EBV is DS,Linear,enveloped,icosahedral DNA virus(Herpes virus 4) which is famous for the fact that it can infect B lymphocytes by binding to CD21,yet Atypical lymphocytes on blood smear are reactive cytotoxic CD8+T lymphocytes.*Don't forget association of EBV with Burkitt's lymphoma(endemic form,patient will likely be young African child) and more importantly with nasopharyngeal carcinoma(most likely patient will be Asian)*Most clinically relevant fact:Even if it is young Conor Mcgregor, he has to quit sport for a while <as he can die from splenic rupture ...

B lymphocytes

Natural killer cells

The presence of cytotoxic T lymphocytes on the blood smear is characteristic of Epstein-Barr Virus (EBV) infection, which can cause infectious mononucleosis. These cytotoxic T lymphocytes are reactive and play a role in controlling EBV-infected B lymphocytes.

Explanation

The presence of cytotoxic T lymphocytes on the blood smear is characteristic of Epstein-Barr Virus (EBV) infection, which can cause infectious mononucleosis. These cytotoxic T lymphocytes are reactive and play a role in controlling EBV-infected B lymphocytes.

12. Why was smallpox able to be eradicated?

D. The small size of the Poxvirus made it less likely to spread, aiding in its eradication.

*Because Poxvirus has single stable serotype, so new formulations of vaccine every year aren't needed,so 1 live(attenuated) vaccine was enough to eradicate this fcker.*Note Poxvirus is Largest DNA virus and it is DS,Linear,Enveloped,Non-icosahedral virus that is so bad ass that it can replicate in the cytoplasm(Contrast this with other DNA viruses which replicate inside nucleus, Pox carries Own DNA dependent RNA plymerase).*They are more likely to ask about Molluscum contagiosum which manifests as Flesh-colored papule with central umbilication Large eosinophilic cytoplasmic inclusions are present in the affected epithelia.(Rash can be pruritic and can be transmitted trough skin-skin contact)

B. Smallpox is caused by a retrovirus, which is easier to target with antiretroviral drugs.

C. Lack of effective treatments for smallpox made it easier to eradicate through quarantine measures.

A. Due to the quick mutation rate of Poxvirus, making it easy to develop new vaccines.

Smallpox was able to be eradicated mainly due to the fact that Poxvirus has a single stable serotype, eliminating the need for new vaccine formulations every year. This allowed for the development and administration of a single live (attenuated) vaccine to effectively eradicate the virus.

Explanation

Smallpox was able to be eradicated mainly due to the fact that Poxvirus has a single stable serotype, eliminating the need for new vaccine formulations every year. This allowed for the development and administration of a single live (attenuated) vaccine to effectively eradicate the virus.

13. A pregnant female with HbsAg+, HbeAg+, AntiHbc Ab+(IgG) is highly infectious. What should be done to protect the baby?

*she has Chronic Active HBV(Acute would have igM for Hbc, but we have igG)+She has Highly infective state as HbeAg is present while Ab for it is absent .*Babies infected with HBV have 90% chance to progress to chronic hepatitis.(Contrast this with adults which mostly develop acute infection)*You need to give baby Vaccine(Subunit vaccine for HBV)+HBIG(as mom can transmit HBV to baby)*Perinatal transmission is MC in developing countries like Southeast Asia, in U.S sexual contact is most common cause.

The baby should be isolated from the mother immediately after birth.

The baby should not be breastfed.

The baby should be given antibiotics.

14. Which virus genome is NOT a retrovirus, has Reverse transcriptase, is partially double-stranded, circular, and enveloped?

*Partially double-stranded,circular,enveloped DNA Hepandavirus>Sex,From blood,(parenteral)or from Mom(perinatal)*Patient initially can present with Arthralgia,Fever,Rash(Like serum sickness*Cytotoxic T cells mediate the damage to liver and on biopsy you would see granular eosinophilic"Ground Glass" appearance.*Note Just like HCV and HDV it can increase your risk of HCC.*Note HDV produces same histological manifestations is transmitted in same ways as HBV but is Defective RNA virus that needs envelope from HBV and with Co-infection>Severe prognosis esp.in pregnant patients.

Hepatitis C virus (HCV)

Human Immunodeficiency Virus (HIV)

Influenza virus

HBV fits the description provided in the question including the presence of Reverse transcriptase and its unique characteristics such as being partially double-stranded, circular, and enveloped. The other options do not have these specific features mentioned.

Explanation

HBV fits the description provided in the question including the presence of Reverse transcriptase and its unique characteristics such as being partially double-stranded, circular, and enveloped. The other options do not have these specific features mentioned.

15. A pregnant female developed fulminant hepatitis and died. Liver biopsy shows patchy necrosis. She most likely got the virus from?

Mosquito bites

*From water, food<Transmission of HEV(RNA hepevirus) is Fecal-Oral.>VERY Severe in pregnant patients <Can kill them, Patchy necrosis is characteristic on liver biopsy and just like HAV it has NO CARRIER STATE.*HAV and HEV are much like each other as we see both have fecal-oral transmission, without carrier state and Non of them increase risk of HCC,however HAV is picornavirus which has good prognosis and on liver biopsy you would see Hepatocyte swelling,MONOCYTE INFILTRATION,councilman bodies(indicate apoptosis)

Skin-to-skin contact

Airborne droplets

The correct answer is from water or food because HEV is transmitted fecal-orally. Airborne droplets, mosquito bites, and skin-to-skin contact are not known routes of transmission for HEV.

Explanation

The correct answer is from water or food because HEV is transmitted fecal-orally. Airborne droplets, mosquito bites, and skin-to-skin contact are not known routes of transmission for HEV.

16. A IV drug user dies due to Esophageal varcieal bleeding associated with cirrhosis, on biopsy of liver you see Lymphoid aggregates with focal areas of Macrovesicular steatosis. What is the most likely cause?

Influenza virus is a common respiratory virus that presents with symptoms such as fever, cough, and congestion. It does not cause liver cirrhosis or the histologic findings mentioned.

Escherichia coli is a gram-negative bacterium commonly associated with UTI and diarrheal illness. It is not known to cause liver cirrhosis or the histologic findings described.

HBV is a DNA virus which belongs to Hepadnavirus family. It is commonly transmitted through IV drug use, can cause liver cirrhosis but does not typically present with the described histologic findings.

*HCV is SS+,Enveloped,Icosahedral,RNA virus which belongs to family of Flavivirus, is common in IV drug abusers, has tendency to become chronic (Carrier state is more common)can cause HCC,Liver cirrhosis and is associated with these histologic findings.

17. What is the main mechanism of oncogenesis by Oncogenic Retroviruses (HTLV-1)?

*They carry genes for proteins that act as Cellular growth factors(For example Tax which activates NF-kB).*Contrast this with oncogenic DNA viruses(HPV) which carry genes for proteins that interact with proteins of TS(Like E6,E7 which block effects of P53,Rb)

They induce apoptosis in infected cells

They cause mutations in the host cell DNA

They insert their DNA into the host cell genome

Oncogenic retroviruses like HTLV-1 do not directly insert their DNA into the host cell genome, induce apoptosis, or cause mutations. Instead, they carry genes for proteins that act as cellular growth factors, promoting uncontrolled cell growth and division.

Explanation

Oncogenic retroviruses like HTLV-1 do not directly insert their DNA into the host cell genome, induce apoptosis, or cause mutations. Instead, they carry genes for proteins that act as cellular growth factors, promoting uncontrolled cell growth and division.

18. What virus structure does the Measles virus belong to?

Measles virus belongs to orthomyxovirus family which are SS-, Enveloped, Spherical, DNA viruses.

Measles virus belongs to flavivirus family which are SS+, Enveloped, Icosahedral, RNA viruses.

*Measles virus belongs to paramyxovirus family which are SS-,Enveloped,Helical,RNA viruses.*Vitamin.A supplementation can reduce morbidity,mortality <Know dat....*Don't be surprised if they will make you link Measles infection with Gaint cell Pneumonia in immunocompromised or more importantly SSPE(years after infection in child, it can have early manifestations like sleeplessness,temper outbursts,hallucinations, but when it really takes on hold it is FATAL)Warthin-Finkeldey giant cells are fused lymphocytes which on the backround of Paracortical Hyperplasia(Where T cells increase in number)are characteristic of Measles.<To avoid all this sht give LIVE attenuated MMR(Measles,Mumps,Rubella) don't confuse Rubeola(Measles)with Rubella(German Measles).

Measles virus belongs to retrovirus family which are DS+, Non-enveloped, Icosahedral, DNA viruses.

19. Guy with CCR5 Homozygous mutation is immune to particular virus, what are structural genes of this virus?

*This RNA virus with diploid genome has 3 structural genes.*POL is needed for REVERSE TRANSCRIPTASE(DsDNA>SsRNA,makes lot's of error>Mutant>Reistance),aspartate protease, integrase.(Paul RAPs like T.I).*GAG is needed for P24(CAPSid) and P17(for MATRIX)(Not nuclear envelope).ANtibodies against CAPSID are FIRST detectable in early stages.

ENV (Envelope protein), CAP (Capsid protein), LYS (Lysogenic enzyme)

HAP (Helicase), RNS (Ribonuclease), PRS (Protease)

POL (Polymerase), TAQ (DNA Polymerase), GAG (Glycosylase)

20. How do you diagnose someone with AIDS?

By solely relying on ELISA test results

*Well first you need to check of HIV:1)ELISA(high FP but is sensitive and is good to rule OUT)<Even though it is sensitive BOTH ELISA and WB have lot's of FP in first 2 months of infection.2)Western blot(More specific,but as it has more FN,not good for ruling out but good for rulling IN)*To diagnose someone with AIDS,CD4+Tcell count should be lower than 200 / HIV+ with PCP or other AIDS-defining infection(Oral thrush is NOT one of them,candida esophagitis is:))//CD4+%<14%

By considering oral thrush as an AIDS-defining infection

By using Western blot to exclude HIV infection

21. Why are nucleic acids of -SSRNA and dsRNA not infectious unlike most dsDNA viruses and +SS RNA viruses (except HBV and Poxvirus)?

Because -SSRNA and dsRNA undergo rapid degradation in host cells, making them non-infectious.

Because -SSRNA and dsRNA lack the necessary genetic material to infect host cells.

Because -SSRNA and dsRNA require specific protein receptors on host cells to initiate infection.

*Because -SSRNA and DsRNA recuire Polymerases contained in complete virion, while DsDNA viruses and +SSRNA viruses can use Host cell's machinery.Note that even though HBV and Poxvirus are DsDNA viruses their purified Nucleic acids are NON-Infectious(These guys need Nonhuman enzymes for replication, so but they still need enzyme to be infectious:)

The correct answer explains that -SSRNA and dsRNA viruses require Polymerases contained in complete virions for infection, unlike DsDNA and +SSRNA viruses which can use host cell machinery. The incorrect answers provide plausible but inaccurate explanations for why -SSRNA and dsRNA are not infectious.

Explanation

The correct answer explains that -SSRNA and dsRNA viruses require Polymerases contained in complete virions for infection, unlike DsDNA and +SSRNA viruses which can use host cell machinery. The incorrect answers provide plausible but inaccurate explanations for why -SSRNA and dsRNA are not infectious.

22. A 6-year-old girl presents to the emergency department with a fever and a lacy body rash. Her mother says that yesterday the rash was only on her face, but by this morning, had spread to her trunk and extremities. Which of the following agents is most likely?

D. Rubella

C. Measles

B. HHV-6

Answer: A. The clues are lacy body rash preceded by a facial rash in a school aged child with fever. HHV-6 (choice B) is the causal agent of roseola, which is fever, followed by a lacy body rash in infants. Measles (choice C) is identified by cough, coryza, and conjunctivitis with photophobia, Koplik spots, and an exanthematous rash beginning below the ears then spreading to the trunk and extremities. Rubella (choice D) is the causal agent of German measles, which involves a rash beginning at the forehead and spreading down.

23. What is the status of the ER resident who was accidentally stuck with a needle from a hepatitis B virus-positive patient?

He presence of HBsAg, HBcAb, and HBeAg are all indicators of an acute infection at 2 months postexposure. It is too early to identify a chronic infection (choice B), but the presence of HBsAg after 6 months is the main indication of a chronic infection. With a fulminant infection (choice C),the patient's symptoms are usually much more serious, likely a superinfection with hepatitis D or the delta agent. If he were immune (choice D), he would have had HBsAb in his serum. Since he has hepatitis B viral antigens in his blood, choice E is wrong

Immune

Chronic infection

Fulminant infection

The presence of HBsAg, HBcAb, and HBeAg are all indicators of an acute infection at 2 months postexposure.

Explanation

The presence of HBsAg, HBcAb, and HBeAg are all indicators of an acute infection at 2 months postexposure.

24. Infection of appropriate cells with a composite virus made up of Coxsackie virus capsid components and poliovirus RNA would yield progeny which would

A. Have the host cell range of Coxsackie virus

E

B. Also be composite viruses

C. Show phenotypic mixing

The correct answer is E because the progeny resulting from the infection would react with Sabin-vaccine-induced antibodies due to the presence of poliovirus RNA components in the composite virus.

Explanation

The correct answer is E because the progeny resulting from the infection would react with Sabin-vaccine-induced antibodies due to the presence of poliovirus RNA components in the composite virus.

25. In the eastern United States, what is the most common reservoir of the disease that causes disorientation, confusion, hallucinations, and excessive salivation in a patient presenting to the emergency department?

Squirrel

Raccoon

Bat

Possum

The correct answer is raccoon. Raccoons are the most common reservoir of rabies in the eastern United States, with transmission usually occurring through bites or scratches from infected animals. Bats can also carry rabies, but raccoons are the primary source in this region.

Explanation

The correct answer is raccoon. Raccoons are the most common reservoir of rabies in the eastern United States, with transmission usually occurring through bites or scratches from infected animals. Bats can also carry rabies, but raccoons are the primary source in this region.

26. How are human papilloma virus type 4 warts spread?

*FOMITE OR DIRECT SKIN CONTACT NOT SEXUALA 6-month-old infant presents with painless verrucous growths on the laryngeal folds. What is the most likely causal agent? HPV

Respiratory droplet spread

Fecal-oral

Animal bite

27. What is a correct interpretation of the hepatitis panel?

A

B

C

D

The correct interpretation of the hepatitis panel provided indicates a chronic infection with HBV based on the presence of HBsAg-positive, Total anti-HBcAg-positive, and HBeAg-positive. Acute infection (option A) would typically show different markers, while coinfection with HBV and HAV (option C) would present with additional markers for HAV. Recovery from HBV infection (option D) would show different antibody profiles.

Explanation

The correct interpretation of the hepatitis panel provided indicates a chronic infection with HBV based on the presence of HBsAg-positive, Total anti-HBcAg-positive, and HBeAg-positive. Acute infection (option A) would typically show different markers, while coinfection with HBV and HAV (option C) would present with additional markers for HAV. Recovery from HBV infection (option D) would show different antibody profiles.

28. Which DNA virus is the most likely cause of severe pneumonia in patients with underlying lung disease or who are smokers?

Influenza virus

This DNA virus fam-ily is associated with a variety of respiratory illnesses including pharyngitis, conjunctivitis, colds and fl u-like illness, and pneumonia in persons with underly-ing lung disease or immune suppression.

Parainfluenza virus

Hantavirus

29. Why do we still have cases of post-transfusion hepatitis?

Post-transfusion hepatitis is a completely eradicated disease.

Post-transfusion hepatitis is caused by bacterial infections.

Post-transfusion hepatitis only occurs in patients with a genetic predisposition.

*Window period when,antiviral antibodies for HCV aren't detectable.*But for HBV if we see anti-HbeAgAb with Anti-HbcAg Ab(igM) that means that we have window period..

Post-transfusion hepatitis can still occur due to the window period during which antiviral antibodies may not be detectable, allowing infections to go undetected initially.

Explanation

Post-transfusion hepatitis can still occur due to the window period during which antiviral antibodies may not be detectable, allowing infections to go undetected initially.