Chapter 37: DNA Enveloped Viruses

Chapter 37: DNA Enveloped Viruses

SELF-ASSESSMENT QUESTIONS

1. Your patient is a 30-year-old man who has frequent episodes of

herpes labialis. He asks you to tell him something about herpes

simplex virus type 1 (HSV-1). Which one of the following would

be the most accurate statement to make?

(A) Acyclovir can eradicate the latent state of HSV-1 but not

HSV-2.

(B) The main site of latency by HSV-1 is the neurons in the sensory

ganglia of the face.

(C) HSV-1 is an enveloped virus that has a DNA genome and a

DNA polymerase in the virion.

(D) The lesions of primary HSV-1 infections are less extensive

and less severe than the lesions of recurrent HSV-1

infections.

(E) The laboratory diagnosis of HSV-1 infections typically

involves the detection of a greater than fourfold rise in antibody

titer against the virus.

1. Your patient is a woman who is due to give birth next week. She

asks you about the risk of her baby becoming infected with herpes

simplex virus type 2 (HSV-2). Which one of the following is

the most accurate response?

(A) HSV-2 is a significant cause of congenital abnormalities.

(B) The risk is higher if the mother has visible lesions than if she

does not.

(C) The risk is higher if the mother has IgG antibody to HSV-2

than if she has IgM antibody.

(D) The risk is higher if the delivery occurs by cesarean section

than if the delivery is performed vaginally.

(E) The risk is higher if the mother is having an episode of recurrent

disease caused by HSV-2 than if it were a primary

episode.

1. Regarding varicella-zoster virus (VZV), which one of the following

is most accurate?

(A) High-dose acyclovir can eliminate the latent state caused by

VZV.

(B) The principal site of latency of VZV is in the nucleus of motor

neurons.

(C) Domestic animals, such as pigs and chickens, are the main

reservoir for VZV.

(D) The vaccine against varicella contains all three serotypes of

formalin-killed VZV as the immunogen.

(E) When zoster occurs in an immunocompromised patient,

acyclovir should be given to prevent disseminated infection.

1. Regarding cytomegalovirus (CMV), which one of the following

is most accurate?

(A) CMV is usually acquired by the fecal–oral route in adults.

(B) Neonates born from infected mothers should be given the

subunit vaccine.

(C) Reactivation of CMV in sensory ganglion cells leads to painful

vesicles along nerves.

(D) Lamivudine should be used to treat CMV infections in

immunocompromised patients.

(E) CMV infection of a fetus during the first trimester results in

more congenital abnormalities than infection in the third

trimester.

1. Regarding Epstein–Barr virus (EBV) and infectious mononucleosis,

which one of the following is most accurate?

(A) EBV enters the latent state primarily in CD4-positive helper T

cells.

(B) Approximately 10% of people in the United States have been

exposed to EBV.

(C) People with infectious mononucleosis produce antibodies

that agglutinate sheep red cells.

(D) The atypical lymphs in the blood of people with infectious

mononucleosis are EBV-infected T helper cells.

(E) Patients with deficient cell-mediated immunity should receive

passive–active immunization against EBV.

1. Naturally occurring smallpox disease has been eradicated from

the face of the Earth. Eradication was achieved by the use of the

vaccine. Regarding this vaccine, which one of the following is the

most accurate?

(A) The vaccine should be given in conjunction with preformed

antibody to the virus.

(B) Administration of the vaccine 1 day after exposure to the

virus does not protect against disease.

(C) The vaccine contains killed smallpox virus so the virus in the

vaccine does not cause adverse effects.

(D) Smallpox virus has a single stable serotype, so new formulations

of the vaccine do not have to be made each year.

(E) Because domestic animals such as cows are the main reservoir

for smallpox virus, the vaccine must interrupt transmission

from these sources.

1. Your patient is a 35-year-old man who had a grand-mal seizure

this morning. Magnetic resonance imaging revealed a lesion in

the temporal lobe. A brain biopsy showed multinucleated giant

cells with intranuclear inclusion bodies. Which one of the following

is the most likely cause of this disease?

(A) Cytomegalovirus

(B) Epstein–Barr virus

(C) Herpes simplex virus type 1

(D) Human herpesvirus 8

(E) Varicella-zoster virus

1. Regarding the patient in Question 7, which one of the following

is the best choice of drug to treat his infection?

(A) Acyclovir

(B) Lamivudine

(C) Oseltamivir

(D) Ritonavir

(E) Zidovudine

1. Your patient is a 22-year-old woman with several episodes of

bloody diarrhea. She is HIV antibody positive with a CD4 count

of 50. Stool cultures for Shigella, Salmonella, and Campylobacter

were negative. An assay for Clostridium difficile toxin was

negative. Colonoscopy revealed many ulcerated lesions. Biopsy

revealed cells with “owl’s eye” inclusions in the nucleus. Which

one of the following is the most likely cause of this disease?

(A) Cytomegalovirus

(B) Epstein–Barr virus

(C) Herpes simplex virus type 1

(D) Human herpesvirus 8

(E) Varicella-zoster virus

1. Regarding the patient in Question 9, which one of the following

is the best choice of drug to treat her infection?

(A) Amantadine

(B) Enfuvirtide

(C) Ganciclovir

(D) Nevirapine

(E) Ribavirin

ANSWERS

1. (B)
2. (B)
3. (E)
4. (E)
5. (C)
6. (D)
7. (C)
8. (A)
9. (A)
10. (C)