Paramyxoviruses & Rubella Virus

True or false IgG rubella antibodies persist in for 6 weeks after the infection

False they persist for life

True or false Paramyxovirus replicates in the nucleus of the cell

False, the cytoplasm

begins with malaise, low-grade fever, and a morbilliform rash appearing on the same day. The rash starts on the face, extends over the trunk and extremities, and rarely lasts more than 3 days. Transient arthralgia and arthritis are commonly seen in adults, especially women

Rubella

an acute febrile illness characterized by a rash and lymphadenopathy that affects children and young adults

Rubella (german measles) virus

Rubella incidences peak during what time of year

Spring

have a hemagglutinin-neuraminidase (HN), a fusion protein (F), a matrix protein (M) associated with the envelope, and a nucleocapsid-associated transcriptase (P).

paramyxovirus

spherical, enveloped viruses with a single helical nucleocapsid containing single-stranded, negative-sense RNA; exist in few antigenic types.

paramyxovirus

What are the two three classifications of paramyxoviruses?

paramyxoviruses (parainfluenza and mumps viruses) morbilliviruses (measles virus) pneumoviruses (respiratory syncytial virus and metapneumovirus)

frequently forms giant multinucleated cells (syncytia) as part of its replica- tion process (called Warthin-Finkeldey cells in nasal secretions). a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV) d. Newcastle disease virus

A

parainfluenza and mumps viruses are classified as a. paramyxovirus b. measles virus c. pneumovirus

A

prevented by a live attenuated measles vaccine (Moraten strain) a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV) d. Newcastle disease virus

A

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

A

This large surface glycoprotein has both hemagglutinating and neuraminidase activity, except in measles virus, which lacks neuraminidase activity, and in respiratory syncytial virus, in which both activities have been lost a. hemagglutinin-neuraminidase (HN) b. fusion protein (F) c. matrix protein (M)

A

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.

A

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.

A

all exist in one serotype except a. parainfluenza virus b. mumps virus c. measles d. resp. syncytial virus

A

cause a variety of fall and winter upper and lower respiratory tract illnesses; croup (type 2 virus) is a well-known infant disease a. parainfluenza virus b. mumps virus

A

causes an acute generalized disease characterized by a maculopapular rash, fever, respiratory distress, and Koplik's spots on the buccal mucosa a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV) d. Newcastle disease virus

A

exist in four serotypes a. parainfluenza virus b. mumps virus

A

A 15-year-old home-schooled boy presented with a 3-day history of low-grade fever and malaise, followed by significant swelling and tenderness in the submaxillary area bilaterally and unilateral, painful, testicular edema. His history is significant for a lack of most childhood vaccines due to parental concerns of vaccine-related autism. Two weeks previously, he had attended summer camp with other home schooled children from various countries. Other teenaged boys attending the summer camp developed similar symptoms and some also developed meningitis. The etiologic agent was isolated from respiratory secretions and urine. What is the most likely etiologic agent? (A) Haemophilus influenzae b (B) Mumps virus (C) Neisseria meningitidis (D) Respiratory syncytial virus (E) Streptococcus pneumoniae

B

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

B

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) Hightitersofmeaslesantibodyarefoundincerebrospinal 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

B

A 3-year-old child presents with a 3-day history of cough, a profusely runny nose, conjunctivitis, a 1-day history of 40°C fever, and a blotchy, erythematous, maculopapular rash that began on his face and is now appearing on his chest. The child is toxic appearing. His history is significant for a lack of most childhood vaccines due to family religious beliefs. Which is the most likely diagnosis? (A) Echovirus summer rash (B) Measles (C) Mumps (D) Rubella (E) Varicella

B

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.

B

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.

B

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

B

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

B

a live attenuated vaccine containing the Jeryl Lynn strain of virus is used in the prevention of a. parainfluenza virus b. mumps virus

B

a member of the Togaviridae family a. paramyxovirus b. rubella c. measles d. HIV

B

causes a potentially serious respiratory tract pathogen of infants a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV) d. Newcastle disease virus

B

measles virus is classified as a. paramyxovirus b. measles virus c. pneumovirus

B

often causes asymptomatic infections, but can cause a generalized dis- ease involving enlargement of the parotid glands a. parainfluenza virus b. mumps virus

B

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 con- genital 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 non-immune 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

C

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

C

All have hemagglutinin, but no neuraminidase activity (H protein rather than HN protein) EXCEPT a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV)

C

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 blood- stream (viremia) to various internal organs.

C

is a newly discovered virus that causes bronchiolitis and pneumonia in infants and lower respiratory tract infection in the elderly. a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV) d. Newcastle disease virus

C

respiratory syncytial virus and metapneumovirus are classified as a. paramyxovirus b. measles virus c. pneumovirus

C

A 3-year-old boy presented to the emergency department with a 2-day history of coldlike illness and a 1-day history of difficulty breathing and an unusual, barklike cough. Physical exam revealed a fever of 38 °C, tachypnea, tachycardia, and stridor. A chest radiograph revealed narrowing of the upper airways (a steeple sign). A clinical diagnosis of croup was made. What is the most likely etiologic agent in the above case? (A) Haemophilus influenzae (B) Moraxella catarrhalis (C) Mycoplasma pneumoniae (D) Parainfluenza virus (E) Respiratorysyncytialvirus

D

A 9-month-old child is hospitalized with viral pneumonia. Which virus is the most likely cause? (A) Adenovirus (B) Influenza virus (C) Parainfluenza virus (D) Respiratory syncytial virus (E) Varicella-zoster virus

D

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.

D

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

D

natural respiratory tract pathogen of birds, particularly chickens. Causes an occupational disease of poultry workers presenting as a mild conjunctivitis without corneal involvement a. measles virus b. respiratory syncytial virus c. Human metapneumovirus (hMNV) d. Newcastle disease virus

D

A 21-year-old college student contracted mumps infection as did several other students at the college. He had received a single dose of the measles, mumps, rubella (MMR) vaccine at 15 months of age. What is the most likely reason that he became infected despite having been vaccinated? (A) Early vaccines only contained one of the four strains of mumps virus (B) Early versions of the mumps vaccine were heat-inactivated and induced immune suppression in some recipients (C) Fifteen months of age is too early to receive the MMR vaccine (D) Mumps virus rapidly undergoes antigenic variation (E) Some individuals who receive a single dose of mumps vaccine do not respond adequately

E

A 45-year-old AIDS patient was enrolled in a drug development study. As part of the study, he underwent anergy skin testing. He was inoculated intradermally with candidal and mumps virus antigens. No reaction was demonstrable after 48h. What is the most likely explanation for this? (A) Antiretroviral drugs are known to interfere with this type of test (B) He has neutropenia and cannot control the growth of Candida (C) He lacks antibodies to both Candida and mumps virus (D) His CD8 cells are not being activated due to decreased CD4 cell numbers (E) His Th1 cells are unable to carry out a delayed type hypersensitivity reaction

E

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.

E