ماتذكر يمتى مسوية ذن بس عاشت إيدي

Microbiology - Lecture 7 ↓

📍Herpes Simplex Virus (HSV) :

1. What are the two main types of Herpes Simplex Virus?
A. HSV-1 and HSV-3
B. HSV-1 and HSV-2
C. HSV-2 and HSV-4
D. HSV-3 and HSV-4
Answer : B

2. What percentage of herpes simplex infections are typically asymptomatic?
A. Up to 50%
B. Up to 60%
C. Up to 70%
D. Up to 80%
Answer : D

3. Which characteristic best describes the structure of HSV?
A. Single-stranded RNA with envelope
B. Double-stranded RNA with envelope
C. Double-stranded DNA with envelope
D. Single-stranded DNA without envelope
Answer : C

4. What is the primary tropism difference between HSV-1 and HSV-2?
A. HSV-1 affects neurons while HSV-2 affects skin cells
B. HSV-1 targets genital epithelium while HSV-2 targets oral epithelium
C. HSV-1 targets oral epithelium while HSV-2 targets genital epithelium
D. Both target the same epithelial cells with equal preference
Answer : C

5. Which viral classification group does HSV belong to?
A. Beta herpesvirus
B. Gamma herpesvirus
C. Delta herpesvirus
D. Alpha herpesvirus
Answer : D

📍HSV Characteristics and Transmission :

1. What is neurovirulence in the context of HSV infections?
A. The ability of the virus to remain dormant in nerve cells
B. The capacity to invade and multiply within the nervous system
C. The transmission through respiratory droplets
D. The reactivation of the virus due to stress
Answer : B

2. Which statement accurately describes viral latency in HSV infections?
A. Active viral replication in nerve cells
B. Immediate symptoms after infection
C. Residence of virus in body without symptoms in nerve cell ganglia
D. Continuous transmission of the virus
Answer : C

3. Which of the following is NOT a known trigger for HSV reactivation?
A. Emotional stress
B. Antibiotic treatment
C. Menstruation
D. Sunlight exposure
Answer : B

4. How is HSV-1 primarily transmitted?
A. Through sexual contact only
B. Through blood transfusions
C. Through oral-to-oral contact and infected saliva
D. Through contaminated food and water
Answer : C

5. What distinguishes HSV-2 transmission from HSV-1?
A. HSV-2 is transmitted through respiratory droplets
B. HSV-2 is primarily a sexually transmitted infection
C. HSV-2 can only infect the oral cavity
D. HSV-2 cannot be transmitted to newborns
Answer : B

📍Oropharyngeal Disease (HSV-1/Cold Sores)

1. What is typically true about primary HSV-1 infections?
A. They are always symptomatic
B. They are usually asymptomatic
C. They only affect adults
D. They last for 6-8 weeks
Answer : B

2. In which age group does symptomatic HSV-1 disease occur most frequently?
A. Teenagers (13-19 years)
B. Adults (over 18 years)
C. Children (1-5 years)
D. Infants (under 1 year)
Answer : C

3. What is the typical duration of clinical illness in primary HSV-1 infection?
A. 1 week
B. 2-3 weeks
C. 4-6 weeks
D. 8-10 weeks
Answer : B

4. Which symptom is NOT typically associated with primary HSV-1 infection?
A. Fever
B. Sore throat
C. Skin rash on hands
D. Vesicular lesions in mouth
Answer : C

5. In recurrent HSV-1 disease, what is the characteristic presentation?
A. Widespread body rash
B. Cluster of vesicles at lip border
C. Throat inflammation only
D. Persistent fever
Answer : B

📍Keratoconjunctivitis :

1. What type of herpes simplex virus typically causes eye infections leading to keratoconjunctivitis?
a. HSV-2
b. HSV-1
c. EBV
d. VZV
Answer : b

2. Which of the following ocular manifestations is characteristic of HSV eye infection?
a. Retinal detachment
b. Glaucoma
c. Corneal ulcers
d. Cataracts
Answer : c

3. What is the typical causative agent of genital herpes?
a. HSV-3
b. VZV
c. CMV
d. HSV-2
Answer : d

4. How long does primary genital herpes infection typically last?
a. 1 week
b. 2 weeks
c. 3 weeks
d. 4 weeks
Answer : c

5. Which symptom is NOT typically associated with genital herpes infection?
a. Painful lesions
b. Fever
c. Chronic cough
d. Genital ulcers
Answer : c

6. In males, where do genital herpes lesions typically appear?
a. Penis
b. Scalp
c. Fingers
d. Knees
Answer : a

7. Which of the following is a characteristic manifestation of ocular HSV infection?
a. Permanent blindness
b. Vesicles on the eyelids
c. Loss of eye color
d. Excessive tearing
Answer : b

8. In females, genital herpes lesions can appear in all the following locations EXCEPT:
a. Cervix
b. Vulva
c. Breast tissue
d. Perineum
Answer : c

9. What is a common characteristic of HSV eye infections?
a. They never recur
b. They only occur once
c. They commonly recur
d. They are always mild
Answer : c

10. Which statement about genital herpes lesions is correct?
a. They are painless
b. They are highly painful
c. They never cause fever
d. They heal within 24 hours
Answer : b

📍Encephalitis and Neonatal Herpes :
1. Which virus is considered the most common cause of sporadic, fatal encephalitis in the United States?
A. HSV-2
B. HSV-1
C. Varicella zoster
D. Epstein-Barr virus
Answer : B

2. When can neonatal HSV infection be acquired?
A. Only during birth
B. Only after birth
C. Only in utero
D. In utero, during birth, or after birth
Answer : D

3. What is the primary source of HSV infection in newborns?
A. Hospital equipment
B. Other infected newborns
C. The mother
D. Nursery toys
Answer : C

4. Which preventive measure may be used for pregnant women with active genital herpes lesions?
A. Antiviral medication only
B. Cesarean section delivery
C. Natural birth with protective barriers
D. Induced early labor
Answer : B

5. What are potential sources of postnatal HSV infection?
A. Only family members
B. Only hospital staff
C. Both family members and hospital personnel
D. Only other infected infants
Answer : C

6. Which of the following describes one of the main presentations of neonatal herpes?
A. Lesions confined to internal organs
B. Lesions localized to skin, eye, and mouth
C. Lesions only in the respiratory system
D. Lesions only in the digestive system
Answer : B

7. What characterizes the disseminated form of neonatal herpes?
A. Single organ involvement
B. Only skin manifestations
C. Multiple organ involvement with possible encephalitis
D. Respiratory symptoms only
Answer : C

8. What is a key characteristic of HSV encephalitis?
A. Low mortality rate
B. High mortality rate
C. Complete recovery in all cases
D. Only affects elderly patients
Answer : B

9. Which statement about neonatal herpes transmission is correct?
A. Only HSV-1 can cause neonatal infection
B. Only HSV-2 can cause neonatal infection
C. Both HSV-1 and HSV-2 can cause neonatal infection
D. Neither HSV type affects newborns
Answer : C

10. Who should be monitored for viral shedding to prevent neonatal HSV infection?
A. Only the mother
B. Only hospital staff
C. Only family members
D. All potential contacts with the newborn
Answer : D

📍Acyclovir and Penciclovir :

1. Which mechanism of action is shared by both Acyclovir (Zovirax) and Penciclovir (Denavir)?
A. Inhibition of viral RNA synthesis
B. Blocking viral entry into host cells
C. Inhibition of viral DNA polymerase
D. Prevention of viral protein assembly
Answer : C

2. What is a key difference between Acyclovir and Penciclovir in terms of their available formulations?
A. Only Penciclovir is available in oral form
B. Only Acyclovir can be administered parenterally
C. Penciclovir is only available in topical form
D. Both drugs are available only in injectable forms
Answer : C

3. For which condition would systemic Acyclovir be the more appropriate choice compared to Penciclovir?
A. Cold sores
B. Genital herpes
C. Minor skin infections
D. Superficial HSV lesions
Answer : B

4. Which of the following represents an appropriate use of topical Acyclovir?
A. Viral encephalitis
B. Neonatal herpes
C. Keratoconjunctivitis
D. Systemic HSV infection
Answer : C

5. What is a key clinical application of Penciclovir (Denavir)?
A. Treatment of HSV encephalitis
B. Management of cold sores
C. Treatment of neonatal herpes
D. Therapy for systemic viral infections
Answer : B

📍Varicella (Chickenpox) & Herpes Zoster (Shingles):

1. What is the primary mode of transmission for chickenpox?
A) Fecal-oral route
B) Inhalation of respiratory droplets
C) Mosquito bites
D) Blood transfusion
Answer: B

2. Where does Varicella-Zoster Virus (VZV) establish latency after primary infection?
A) Liver
B) Sensory nerve ganglia
C) Spleen
D) Skin cells
Answer: B

3. Reactivation of latent VZV infection causes:
A) Measles
B) Herpes zoster (shingles)
C) Epstein-Barr virus infection
D) Hand, foot, and mouth disease
Answer: B

4. Which of the following is a characteristic clinical feature of chickenpox?
A) Petechial rash
B) Generalized vesicular rash
C) Bullous lesions
D) Maculopapular rash without vesicles
Answer: B

5. High viral titers in chickenpox are found in:
A) Blood
B) Urine
C) Vesicular fluid
D) Cerebrospinal fluid (CSF)
Answer: C

6. The initial site of VZV replication after infection is the:
A) Liver
B) Mucosa of the upper respiratory tract
C) Kidneys
D) Bone marrow
Answer: B

7. Secondary viremia in chickenpox spreads the virus to the:
A) Brain
B) Skin
C) Lungs
D) Heart
Answer: B

8. Which population is primarily affected by chickenpox?
A) Elderly adults
B) Infants under 6 months
C) Children
D) Pregnant women only
Answer: C

9. What is the risk of transmission through direct contact with chickenpox vesicles compared to respiratory droplets?
A) Higher
B) Lower
C) Equal
D) No risk
Answer: B

10. Primary infection with VZV causes:
A) Herpes zoster
B) Varicella (chickenpox)
C) Infectious mononucleosis
D) Cold sores
Answer: B

📍 Varicella (Chickenpox):

1. What is the typical incubation period for chickenpox?
A) 1–3 days
B) 10–21 days
C) 4–7 days
D) 22–30 days
Answer: B

2. The earliest symptoms of chickenpox include:
A) Rash and blisters
B) Malaise and fever
C) Severe headache
D) Joint pain
Answer: B

3. The rash in chickenpox progresses to which of the following forms?
A) Non-itchy macules
B) Fluid-filled blisters that crust over
C) Purpuric spots
D) Pustules without crusting
Answer: B

4. Where does the chickenpox rash typically appear FIRST?
A) Limbs
B) Face
C) Trunk
D) Scalp
Answer: C

5. How long does the chickenpox rash usually last?
A) 1–2 days
B) 5 days
C) 10 days
D) 3 weeks
Answer: B

6. What is the standard treatment for chickenpox in otherwise healthy children?
A) Antiviral drugs (e.g., acyclovir)
B) Antibiotics
C) Supportive care (e.g., antihistamines for itching)
D) Corticosteroids
Answer: C

7. What happens to the varicella-zoster virus (VZV) after primary infection in immunocompetent individuals?
A) It is completely eliminated by the immune system.
B) Some virions establish latency in nerve cells.
C) It persists in the liver.
D) It remains active in the bloodstream.
Answer: B

8. Herpes zoster (shingles) occurs when:
A) A new VZV infection is acquired.
B) Latent VZV reactivates due to weakened immunity.
C) Bacteria infect the skin.
D) The rash of chickenpox recurs.
Answer: B

9. Which of the following is a common complication of chickenpox in children?
A) Pneumonia
B) Secondary bacterial infection of skin lesions
C) Encephalitis
D) Myocarditis
Answer: B

10. Antiviral treatment (e.g., acyclovir) for chickenpox is typically reserved for:
A) All healthy children.
B) High-risk groups (e.g., immunocompromised patients).
C) Patients with mild fever.
D) Those with no rash.
Answer: B

📍 Herpes Zoster (Shingles) :

1. What is the primary cause of herpes zoster (shingles) reactivation?
A) New exposure to VZV
B) Weakened immunity due to aging, disease, or therapy
C) Bacterial co-infection
D) Genetic mutation of VZV
Answer: B

2. Where does VZV remain latent before reactivating as shingles?
A) Liver
B) Sensory nerve ganglia
C) Spleen
D) Skin cells
Answer: B

3. The skin lesions of herpes zoster are histologically identical to those of:
A) Measles
B) Varicella (chickenpox)
C) Impetigo
D) Scabies
Answer: B

4. Which dermatome is MOST commonly affected in herpes zoster?
A) Lumbar
B) Thoracic
C) Cervical
D) Sacral
Answer: B

5. What is the typical duration for herpes zoster skin lesions to heal?
A) 1 week
B) 2–4 weeks
C) 6 months
D) 1 year
Answer: B

6. Which symptom is characteristic of herpes zoster BEFORE the rash appears?
A) Fever
B) Pain, itching, or tingling in the affected dermatome
C) Joint swelling
D) Cough
Answer: B

7. How does reactivated VZV reach the skin to cause shingles?
A) Through the bloodstream
B) By traveling down the sensory nerve
C) Via lymphatic vessels
D) Through inhalation
Answer: B

8. Which population is at HIGHEST risk for herpes zoster?
A) Infants
B) Adults over 50 or immunocompromised individuals
C) Teenagers
D) Pregnant women
Answer: B

9. What is the main route of VZV transmission to others during a shingles outbreak?
A) Fecal-oral
B) Direct contact with vesicular fluid or respiratory secretions
C) Blood transfusion
D) Sexual contact
Answer: B

10. Which complication is unique to herpes zoster (not seen in chickenpox)?
A) Fever
B) Vesicular rash
C) Postherpetic neuralgia (chronic pain)
D) Cough
Answer: C

📍Infant Roseola (HHV-6 Infection) :

1. What virus causes roseola infantum?
A) Varicella-zoster virus (VZV)
B) Human herpesvirus 6 (HHV-6)
C) Epstein-Barr virus (EBV)
D) Cytomegalovirus (CMV)
Answer: B

2. What is the classic presentation of roseola?
A) Low-grade fever with immediate rash
B) High fever for 3 days followed by rash as fever subsides
C) Fever with sore throat
D) Fever with joint pain
Answer: B

3. How is HHV-6 primarily transmitted?
A) Fecal-oral route
B) Saliva or respiratory droplets
C) Blood transfusion
D) Mosquito bites
Answer: B

4. Where does HHV-6 replicate during primary infection?
A) Liver
B) Leukocytes and salivary glands
C) Skin cells
D) Kidney
Answer: B

5. What is a potential complication of roseola's high fever?
A) Hepatitis
B) Febrile seizure
C) Meningitis
D) Pneumonia
Answer: B

6. What type of rash appears in roseola?
A) Vesicular (blister-like)
B) Maculopapular (flat red spots with bumps)
C) Petechial (pinpoint bleeding)
D) Bullous (large blisters)
Answer: B

7. What is the standard treatment for roseola?
A) Antiviral therapy (e.g., acyclovir)
B) Supportive care (antipyretics for fever)
C) Antibiotics
D) Corticosteroids
Answer: B

8. Which age group is most affected by roseola?
A) Adolescents
B) Adults
C) Infants and toddlers (6 months–2 years)
D) Elderly
Answer: C

9. What is unique about the rash in roseola?
A) It itches intensely
B) It appears AFTER fever resolves
C) It leaves permanent scars
D) It spreads from limbs to trunk
Answer: B

10. Which diagnostic method confirms HHV-6 infection?
A) Blood culture
B) PCR (detects viral DNA)
C) Urinalysis
D) Skin biopsy
Answer: B