Pre-Assessment Review: Microbiology, Part 2: Virology. Dr. David Hillyard

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1 Pre-Assessment Review: Microbiology, Part 2: Virology Dr. David Hillyard

2 1. Mutations or deletions within which gene are associated with the hyper-toxin producing strain of Clostridium difficile? a. tcda b. tcdb c. tcdc d. tcdd 2

3 2. The Hepatitis B mutation G1896A: a. Creates a stop codon in the X protein b. Results in over-expression of the HbeAg c. Creates a stop codon in the precore region blocking synthesis of HbeAg d. Is most common in HBV genotype A 3

4 3. Selection of Hepatitis B Virus (HBV) mutations causing lamivudine resistance may also be associated with which of the following viral phenotypes? a. Interferon resistance b. Tenofovir resistance c. HBV vaccine escape d. HBV eantigen loss 4

5 4. A sample is tested using a LightCycler PCR assay for the detection of herpes simplex virus that uses melting point analysis to distinguish between HSV-1 (55 degree melt) and HSV-2 (63 degree melt). Upon analysis, you observe the internal control Ct and melt are within the validated ranges, HSV target Ct 39 with melt of 59 degrees. How do you interpret these results? a. No HSV amplicon generated b. Miscalculation of Tm by instrument c. Likely HSV-2 detected d. Likely HSV-1 detected 5

6 5. PCR testing for enterovirus infections of the central nervous system: a. Is the basis for initiation vs. non-initiation of anti-viral therapy b. Is used to triage patients for admission to hospital c. Results in early hospital discharge when test is negative d. Results in early hospital discharge when test is positive 6

7 6. PCR primers directed against the 5 untranslated region of the enterovirus genome may misidentify which non-enterovirus pathogen? a. Adenovirus b. Rhinovirus c. Bocavirus d. Poliovirus 7

8 7. The high-risk serotypes of human papillomavirus most often associated with cervical cancer in the United States are: a. HPV 16 and HPV 72 b. HPV 45 and HPV 18 c. HPV 16 and HPV 18 d. HPV 42 and HPV 43 8

9 8. The clinical utility of molecular HPV testing is due to its: a. Negative predictive value for cervical cancer. b. Negative predictive value for cervical cancer and CIN c. Positive predictive value for cervical cancer. d. Positive predictive value for cervical cancer and CIN 9

10 9. Interrogation of the 5 UTR region of Hepatitis C Virus is most useful for which of the following applications? a. Measuring HCV viral load b. Distinguishing HCV 1a /1b subtypes c. Predicting interferon sensitivity d. Assessing replication fitness 10

11 10. For patients treated with pegylated interferon/ribavirin combination therapy for chronic HCV infection, what is the best predictor of sustained viral response (SVR)? a. Ethnicity b. IL28B genotype c. Rapid viral response (RVR) d. Viral load at initiation of therapy 11

12 11. The use of which nucleic acid target(s) provides both sensitive and specific detection of Bordatella pertussis? a. B. pertussis toxin b. IS481 c. IS481 and B. pertussis toxin d. Pertactin and IS481 12

13 12. Ongoing standardized calibration of quantitative viral nucleic acid assays for routine testing requires use of: a. WHO lyophilized material reported in copies b. WHO lyophilized material reported in I.U. c. Secondary standards normalized to WHO material reported in copies d. Secondary standards normalized to WHO material reported in I.U. 13

14 13. All of the following specimen types are appropriate for the molecular detection of Borrelia burgdorferi depending upon the stage of Lyme disease except: a. Synovial fluid b. Cerebrospinal fluid c. Skin biopsy d. Urine 14

15 Association for Molecular Pathology 9650 Rockville Pike Bethesda, MD Association for Molecular Pathology,