UNIVERSITY OF ZAMBIA

SCHOOL OF MEDICINE
UNIVERSITY EXAMINATION

2024 TEST 3 (VIROLOGY)

COMPUTER NUMBER:

INSTRUCTIONS
 THE PAPER CONTAINS 50 QUESTIONS WITH FOUR ANSWER OPTIONS.
 CHOOSE THE BEST ANSWER FOR EACH QUESTION
 THERE IS NO NEGATIVE MARKING FOR WRONG ANSWERS
 ATTEMPT ALL QUESTION IN THIS PAPER
 A SEPARATE ANSWER SHEET WILL BE PROVIDED FOR YOU
 TIME DURATION: 1 HOUR 30 MINUTES

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 Things to a great extent happen as a result of what we fear the most.

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Compiled by MusengeMwansa2024

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1. Viral non-structural proteins
a. Form structures of viruses
b. Are involved in receptor-ligand interactions
c. Play enzymatic roles
d. Form the envelope and core of viruses
2. Ebola and Marburg viruses belong to.......... family
a. Picornaviridae
b. Adenoviridae
c. Arenaviridae
d. Filoviridae
3. The receptors for SARS-Cov-2 are
a. CD4
b. Angiotensin-converting enzyme-2 (ACE-2)
c. CCRS
d. Sialic acid
4. Prions are
a. Proteinaceous infectious particles
b. Viroids
c. Infectious plant viruses
d. Animal viruses
5. The reference (gold) standard for viral diagnosis is
a. Serology
b. Molecular diagnosis
c. Culture
d. Immunohistochemistry
6. The following is not a feature of live-attenuated vaccines
a. Produce herd immunity
b. Produce mucosal immunity
d. Epstein-Barr virus
7. The Moderna vaccine administered in Zambia is
a. An mRNA vaccine
b. An adenoviral vector vaccine
c. A protein subunit vaccine
d. A live-attenuated vaccine
8. The recently approved malaria vaccine, RTS, S/AS0i (trade name Mosquirix) is a
a. An mRNA vaccine
b. An inactivated viral vaccine
c. A live-attenuated vaccine
d. Protein sub-unit vaccine
9. Polioviruses enter the brain via
a. Endocytosis
b. Retrograde axonal transport
c. Trojan horse mechanism
d. Infection of brain endothelial cells
10. The following biomarkers are important in Hepatitis C disease monitoring
a. ALT
b. Serum globulin

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c. Full-blood count
d. Haemoglubin (HB)
11. The main mode of transmission of Hepatitis A is
a. Blood
b. Sex
c. Breast milk
d. Faccal-oral
12. The following is a common feature in Respiratory Syncytial Virus-infection
a. Fever
b. Diarrhoea
c. Wheezing
d. Nausea
13. The following is not a zoonotic/arbo virus
a. Chikungunya virus
b. O'nyong-nyong virus
c. Dengue virus
d. Poliovirus
14. The following virus is associated with microcephaly
a. Zika
b. West Nile
c. Hantavirus
d. Lassa
15. Dengue heamorrhagic fever involves (choose one best answer)
a. Massive T cell activation
b. Inflammatory cytokine storm
c. monocytes/macrophages and endothelial cell activation leading to vascular
leakage
d. all the above
16. The following is associated with latent infection
a. Hepatitis A
b. Varicella-zoster virus
c. Respiratory syncytial virus
d. Rotavirus
17. …………is not an oncogenic virus
a. Hepatitis C
b. Human T lymphotropic virus (HTLV)
c. JC-virus
d. Epstein-Barr virus
18. HIV diagnosis in infants is done by
a. Serology (HIV RDT)
b. RT-PCR
c. Immunohistochemistry
d. ELISA
19. The HIV drug Delutegravir (DTG) is
a. A nucleotide reverse transcriptase inhibitor
b. A non-nucleotide reverse transcriptase inhibitor
c. An integrase inhibitor

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d. A protease inhibitor
20. The pathology of acute respiratory distress syndrome in coronavirus diseases-
2019 (COVID-19) is caused by
a. Loss of CD4 cells in the lungs
b. Activation of microglia and astroglia in the brain
c. Granuloma formation and necrosis of pneumocytes in the lungs
d. desquamation of pneumocytes, hyaline membrane formation, and interstitial
lymphocyte infiltration, and multinucleated syncytial cells in the lungs
21. Regarding retroviruses, which of the following is INCORRECT?
a. Enveloped (+) RNA viruses.
b. HTLV-I and HTLV-II are associated with human leukaemia's/lymphomas.
c. HIV-1 and HIV-2 are lentiviruses; they transform cells by various mechanisms.
d. Oncoviruses are usually not cytolytic.
22. Concerning HIV-1, which of the following is CORRECT?
a. HIV-1 infects macrophages with CXCR4 as the initial receptor.
b. HIV-1 infects monocytes and macrophages, but not dendritic cells.
c. HIV-1 infects macrophages and Langerhans, CCCR4 as the initial receptor
d. HIV-1 infects certain cells of the central nervous system, causing Dementia.
23. To design a vaccine against HIV infection, a logical goal would be to alter some
native molecule or product of the virion in order to make it highly immunogenic. If
you wished to prevent the attachment of the virus to helper T lymphocytes, which
molecule or family of molecules might best be targeted?
a. gp41
b. gp120
c. nucleocapsid protein
d. p24
24. Regarding Endogenous retroviruses, which of the following is INCORRECT?
a. May take up as much as 8% of the human chromosome.
b. They are only present when one is immunocompromised.
c. Human placental virus is an example.
d. All of the above.
25. Pertaining to the classification of retroviruses, which of the following is TRUE?
a. Simple retroviruses consist of only three major genes; gag, pol and env.
b. Complex retroviruses encode additional regulatory and accessory proteins.
c. HTLV and HIV-1 are complex retroviruses.
d. All of the above.
26. Concerning HIV, which of the following is CORRECT?
a. There are two types: HIV-1 and HIV-2, which cause AIDS.
b. Most of our present knowledge of HIV is derived from studies on HIV-2
c. In Zambia, we only test for HIV-1.
d. HIV-2, is mainly found in South Africa.
27. Which of the following statement on HIV is CORRECT?
a. Enveloped (-) RNA virus.
b. Encode reverse transcriptase enzyme; an enzyme which follows the central dogma
of molecular biology.
c. Three critical enzymes reverse transcriptase, protease, and integrase are virus-
encoded.

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d. The envelope is acquired after cell lysis from the host cell plasma membrane.
d. None of the above
28. A patient comes to hospital with a history of sore throat, diarrhoea and sexual
contact 2 weeks before. The most appropriate investigation with highest
probability to rule out HIV is:
a. P24 antigen assay.
b. ELISA.
c. Western blot.
d. Lymph node biopsy.
29. A 23-year-old heterosexual male was diagnosed with acute retroviral syndrome.
His CD4 count and viral load at the time of diagnosis were 450/µL (normal 500 to
1,500) and 80,000 copies, respectively. He returns in 6 weeks, and is asymptomatic.
What changes in the CD4 count and viral load are typically expected at this time in
the infection?
a. Decrease in CD4 cells, decrease in viral load.
b. Decrease in CD4 cells, increase in viral load.
c. Increase in CD4 cells, decrease in viral load.
d. Increase in CD4 cells, increase in viral load.
30. Regarding HIV-1, which of the following is INCORRECT?
a. It uses DNA as an intermediate for its replication.
b. It is a positive sense RNA virus.
c. Nef protein prevents the progression of HIV infection to AIDS.
d. None of the above.
31. With reference to HIV-1, which of the following statement is CORRECT?
a. Based on the disease progression, three classes of HIV-1 have developed in Africa.
b. Class M accounts for less than 90% of all HIV-1 cases in Africa.
c. Class M is further classified into several subtypes or clades, including A to H
recombinants.
d. Understanding the immunopathogenesis of the emerging HIV-1 clades is has no in
vaccine development.
32. Regarding HIV disease clinical syndrome the following are true, EXCEPT?
a. Hypothetically speaking, a patient neither being on treatment nor having an
opportunistic infections, a person with HIV is likely to die from AIDS dementia.
b. Pneumocystosis and candidiasis are common.
c. Early symptoms may include flu or mononucleosis like illness.
33. Which of the following is the current first line HIV ART regimen in Zambia?
a. Tenofovir, lamivudine, dolutegravir.
b. Abacavir, dolutegravir, tenofovir.
c. Efavirenz, emtricitabine, lamivudine.
d. Lamivudine, zidovudine, tenofovir.
34. Which of the following is the current first line HIV ART regimen in Zambia?
a. Two NNRTIs and one Protease Inhibitors.
b. Two NRTIs and one Protease Inhibitors.
c. Two NNRTIs and one Integrase Inhibitor.
d. Two NRTIs and one Integrase Inhibitor.
35. Regarding HIV testing, the following are true EXCEPT?
a. Combination 4th-generation HIV test detects both HIV antigen and HIV antibody.

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b. Nucleic acid test detects HIV RNA by PCR in 7 to 28 days after infection.
c. HIV DNA/RNA PCR testing is used to diagnose HIV infection in infants
d. HIV DNA/RNA PCR testing has no role in assessing drug efficacy.
36. Drugs like Maraviroc work on the CCRS to prevent attachment of an HIV viral
protein. The gene coding for the protein is?
a. gag
b. env
c. pol
d. nef
37. During the clinical latency period of a patient with HIV infection, the
appropriate diagnostic test is?
a. ELISA
b. HIV viral load
c. P24 antigen assay
d. CD4
38. The HIV regimen in Zambia is based on Drugs which inhibit certain proteins
which are coded by the virus. The gene coding for the proteins is?
a. gag
b. env
c. pol
d. nef
39. An HIV-positive patient, after treatment with ART, has a CD4 T-cell count of
325/µL and a viral load of less than 50 copies of HIV RNA/mL.. Previously her CD4+
T-cell count was 50/µl. and viral load was 100,000 copies/mL.. However, after
treatment with Art the patient Developed Tuberculosis. Which of the following
best describes the patient?
a. The ART treatment was likely unsuccessful.
b. The patient likely had paradoxical immune reconstitution inflammatory syndrome.
c. The patient likely had unmasking immune reconstitution inflammatory syndrome
d. Options A and B.
40. A 45-year-old HIV positive man complains to a doctor of fever, cough, and a
burning pain in his chest. These symptoms have "lingered on and off" for several
weeks, and weight loss forces him to resolve the vague illness once and for all. The
physician notes no chest sounds, and chest X-ray reveals only a faint interstitial
infiltrate. Suspecting some sort of pneumonia, the physician requests a sputum
analysis. Lab results reveal the presence of Pneumocystis jirovecii confirmed by
PCR. Which of the following is correct?
a. The patient should be treated with drugs like ceftriaxone and gentamicin.
b. Covering the patient on isoniazid could have prevented the illness.
c. Covering the patient on trimethoprim/sulfamethoxazole could have prevented the
illness.
d. The patient should be treated with miconazole.
41. Regarding HIV testing in a new-born from an HIV positive mother. The
following are true, EXCEPT?
a. The antibody test is likely to come out positive, even if the baby is HIV negative.
b. The antibody test is likely to come out positive, when the baby is HIV positive.

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c. The baby is likely to test negative, because the immune system is yet to fully
develop.
d. None of the above.
42. Viral non-structural proteins
a. Form structures of viruses
b. Are involved in receptor-ligand interactions
c. Play enzymatic roles
d. Form the envelope and core of viruses
43. Ebola and Marburg viruses belong to.......... family
a Picornaviridae
b. Adenoviridae
c. Arenaviridae
d. Filoviridae
44. The receptors for SARS-Cov-2 are
a. CD4
b. Angiotensin-converting enzyme-2 (ACE-2)
c. CCRS
d. Sialic acid
45. The reference (gold) standard for viral diagnosis is
a. Serology
b. Molecular diagnosis
c. Culture
d. Immunohistochemistry
46. The pathology of acute respiratory distress syndrome in coronavirus diseases-
2019 (COVID-19) is caused by
a. Loss of CD4 cells in the lungs
b. Activation of microglia and astroglia in the brain
c. Granuloma formation and necrosis of pneumocytes in the lungs
d. desquamation of pneumocytes, hyaline membrane formation, and interstitial
lymphocyte infiltration, and multinuc'eated syncytial cells in the lungs
47. The following is true about Dengue virus
a. Three main serotypes exist
b. It belongs to the lentivirus genus
C. Infection with one serotype gives immunity to all the other serotypes
d. None of the above
48. Concerning viral hemorrhagic fevers, which of the following virus has a high
fatality
a. Rift valley fever
b. Yellow fever
c. Marburg
d. All of the above
49. The following paired statements are true
a. Hepatitis C virus…………………………..Cholangiocarcinoma
b. Epstein-Barr virus……………………….. Nasopharyngeal carcinoma
c. HHV8…………………………………………….. Hemangiomas
d. HTLV……………………………………………. Acute myeloid leukemia
50. The following are flaviviruses except

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a. Influenza
b. Yellow fever viruses
c. West Nile virus
d. Dengue fever virus