Home Books Jawetz, Melnick, & Adelberg’s Medical Microbiology, 27e

Chapter 40: Paramyxoviruses and Rubella Virus

A 4-year-old boy develops an acute febrile illness. His pediatrician diagnoses mumps. The organ most commonly exhibiting signs of mumps is the

(A) Lungs

(B) Ovary

(C) Parotid glands

(D) Skin

(E) Testes

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

(A) Genome is negative-sense RNA.

(B) Envelope contains a glycoprotein with fusion activity.

(C) Paramyxoviruses do not undergo genetic reassortment.

(D) Replication cycle occurs in cytoplasm of susceptible cells.

(E) Genome is segmented.

A 2-month-old infant developed a respiratory illness that the pediatrician diagnosed as bronchiolitis. The most likely cause of the disease is

(A) Parainfluenza virus type 4

(B) Respiratory syncytial virus

(C) Influenza virus

(D) Metapneumovirus

(E) Measles virus

Several paramyxoviruses can cause pneumonia in infants or children. For which of the following paramyxoviruses is there an effective vaccine available that would prevent pneumonia?

(A) Parainfluenza virus type 1

(B) Measles virus

(C) Respiratory syncytial virus

(D) Mumps virus

(E) Metapneumovirus

A 27-year-old woman who is 2 months’ pregnant develops fever, malaise, and arthralgia. A fine maculopapular rash appears on her face, trunk, and extremities. Rubella is diagnosed, and there is concern that the fetus will be infected, resulting in the congenital rubella syndrome. Which of the following statements about this syndrome is correct?

(A) The disease can be prevented by vaccination of school-age children with measles vaccine.

(B) Congenital abnormalities occur when a nonimmune pregnant woman is infected at any time during pregnancy.

(C) Deafness is a common defect associated with congenital rubella syndrome.

(D) Only rare strains of rubella virus are teratogenic.

(E) None of the above

A 5-year-old child develops a low-grade fever, coryza, conjunctivitis, and Koplik spots. The physician can conclude that

(A) The child has probably not been successfully vaccinated with the MMR vaccine.

(B) The child’s pregnant mother is at risk of becoming infected and her unborn child developing congenital abnormalities, including mental retardation.

(C) A rash will soon develop on the child’s face and will last only 2–3 days.

(D) Treatment of the child with the antiviral drug ribavirin should be initiated immediately to minimize the chance of development of acute encephalitis.

Parainfluenza viruses are ubiquitous and cause respiratory illnesses in people of all ages. However, reinfections with parainfluenza viruses are common because

(A) Many antigenic types of parainfluenza viruses exist, and exposure to new strains results in new infections.

(B) Infections in the respiratory tract do not elicit a systemic immune response.

(C) Limited virus replication occurs, which fails to stimulate antibody production.

(D) Secretory immunoglobulin A antibody in the nose is short lived, disappearing a few months after infection.

A 20-month-old boy had an illness characterized by fever, irritability, conjunctivitis, and a brick-red rash initially on the face but spreading downward and outward. At age 9 years, the boy had a gradual onset of severe, generalized neurologic deterioration. Subacute sclerosing panencephalitis (SSPE) was diagnosed. Which of the following statements about SSPE is correct?

(A) Defective varicella-zoster virus is present in brain cells.

(B) High titers of measles antibody are found in cerebrospinal fluid.

(C) The incidence of the disease is rising since the introduction of MMR vaccine.

(D) Rapidly progressive deterioration of brain function occurs.

(E) The disease is a rare, late complication of rubella infection.

Which of the following paramyxoviruses has an HN surface glycoprotein lacking hemagglutinin activity?

(A) Measles virus

(B) Mumps virus

(C) Parainfluenza virus type 1

(D) Respiratory syncytial virus

(E) Rubella virus

A 3-year-old girl develops an acute respiratory virus infection that requires hospitalization. Ribavirin therapy is considered. Ribavirin is approved for treatment of which of the following situations?

(A) Lower respiratory tract disease caused by respiratory syncytial virus in infants

(B) Congenital rubella syndrome

(C) Aseptic meningitis caused by mumps infection

(D) Pneumonia caused by measles virus in adults

(E) Encephalitis related to Nipah virus

(F) All of the above

Reverse transcription polymerase chain reaction (RT-PCR) assays are useful in diagnosis of paramyxovirus infections. Which of the following statements about RT-PCR is not accurate?

(A) More sensitive assay than virus isolation

(B) Can identify virus strains

(C) More rapid assay than antigen detection

(D) Can provide data about genetic variation for molecular epidemiology studies

(E) More specific assay for parainfluenza viruses than serology

Each of the following statements concerning measles vaccine is correct except

(A) The vaccine contains live, attenuated virus.

(B) The vaccine should not be given at the same time as the mumps vaccine because the immune system cannot respond to two viral antigens given simultaneously.

(C) Virus in the vaccine contains only one serotype.

(D) The vaccine should not be given before 15 months of age because maternal antibodies can prevent an immune response.

Each of the following statements concerning rubella is correct except

(A) Congenital abnormalities occur primarily when a pregnant woman is infected during the first trimester.

(B) Women who say that they have never had rubella can, nevertheless, have neutralizing antibody in their serum.

(C) In a 6-year-old child, rubella is a mild, self-limited disease with few complications.

(D) Acyclovir is effective in the treatment of congenital rubella syndrome.

Each of the following statements concerning rubella vaccine is correct except

(A) The vaccine prevents reinfection, thereby limiting the spread of virulent virus.

(B) The immunogen in the vaccine is killed rubella virus.

(C) The vaccine induces antibodies that prevent dissemination of the virus by neutralizing it during the viremic stage.

(D) The incidence of both childhood rubella and congenital rubella syndrome has decreased significantly since the advent of the vaccine.

Each of the following statements concerning mumps is correct except

(A) Mumps virus is a paramyxovirus and hence has a single-stranded RNA genome.

(B) Meningitis is a recognized complication of mumps.

(C) Mumps orchitis in children before puberty often causes sterility.

(D) During mumps, the virus spreads through the bloodstream (viremia) to various internal organs.

Each of the following statements concerning subacute sclerosing panencephalitis is correct except

(A) Immunosuppression is a frequent predisposing factor.

(B) Aggregates of helical nucleocapsids are found in infected cells.

(C) High titers of measles antibody are found in cerebrospinal fluid.

(D) Slowly progressive deterioration of brain function occurs.

Which one of the following is the best evidence on which to base a decisive diagnosis of acute mumps disease?

(A) A positive skin test result

(B) A fourfold rise in antibody titer to mumps antigen

(C) A history of exposure to a child with mumps

(D) Orchitis in young adult man

Which one of the following statements concerning mumps is correct?

(A) Although the salivary glands are the most obvious sites of infection, the testes, ovaries, and pancreas can be involved as well.

(B) Because there is no vaccine against mumps, passive immunization is the only means of preventing the disease.

(C) The diagnosis of mumps is made on clinical grounds because the virus cannot be grown in cell culture and serologic tests are inaccurate.

(D) Second episodes of mumps can occur because there are two serotypes of the virus, and protection is type specific.

Which of the following statements is more likely to be true of measles (rubeola) than German measles (rubella)?

(A) Koplik spots are present.

(B) It causes birth defects.

(C) It causes only a mild illness.

(D) Human beings are the only natural host.

(E) Attenuated virus vaccine is available for prevention.

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Chapter 40: Paramyxoviruses and Rubella Virus

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