Micro 41 Flashcards

Enlarged keratinocytes seen in HPV infection are called what?

A. Koilocytes

B. Acanthocytes

C. Spherocytes

D. Keratohyalin cells

HPV belongs to which type of virus?

A. RNA virus

B. DNA virus

C. Retrovirus

D. Prion

HPV has what type of viral envelope?

A. Lipid envelope

B. Double envelope

C. No envelope

D. Partial envelope

Why can HPV persist relatively well outside the host?

A. Lacks lipid envelope

B. Forms bacterial spores

C. Has a capsule

D. Produces exotoxin

Lack of a lipid envelope makes HPV relatively resistant to what?

A. Host antibodies only

B. Desiccation and detergents

C. DNA replication

D. Phagocytosis

Would viral polymerase nucleoside analogs directly target HPV effectively?

A. Usually yes

B. Only in children

C. Generally no

D. Only in genital infection

Why are viral polymerase inhibitors generally ineffective against HPV?

A. HPV lacks DNA

B. HPV lacks capsid

C. HPV lacks viral proteins

D. HPV uses host DNA polymerase

Which virus would be more amenable to viral polymerase inhibition?

A. Herpesvirus

B. HPV

C. Adenovirus only

D. Parvovirus only

Which HPV types commonly cause cutaneous warts?

A. HPV 6–9

B. HPV 1–4

C. HPV 16–19

D. HPV 31–34

Which HPV type is classically associated with plantar warts?

A. HPV-2

B. HPV-6

C. HPV-1

D. HPV-11

Which HPV type commonly causes ordinary cutaneous warts and can appear genitally in children?

A. HPV-1

B. HPV-6

C. HPV-11

D. HPV-2

Which HPV types most commonly cause genital condylomata?

A. HPV-6 and HPV-11

B. HPV-1 and HPV-2

C. HPV-16 and HPV-18

D. HPV-31 and HPV-33

HPV most efficiently enters through what?

A. Intact epidermis

B. Respiratory mucosa

C. Disrupted epithelium

D. Vascular endothelium

What facilitates HPV entry into epithelial tissue?

A. Hyperkeratosis

B. Vasodilation

C. Lymphatic obstruction

D. Microabrasions

HPV commonly infects which type of body surface?

A. Frequently traumatized epithelium

B. Deep skeletal muscle

C. Bone marrow

D. Vascular endothelium

Which locations are commonly affected by HPV warts?

A. Liver and spleen

B. Hands, soles, genital areas

C. Kidney and bladder

D. Brain and spinal cord

HPV can spread efficiently through which type of contact?

A. Airborne droplets

B. Fecal-oral only

C. Direct skin-to-skin contact

D. Arthropod vectors

Perinatal HPV transmission can rarely cause what condition?

A. Epiglottitis

B. Bronchiolitis

C. Croup

D. Respiratory papillomatosis

Recurrent respiratory papillomatosis is classically associated with which HPV types?

A. HPV-6 and HPV-11

B. HPV-16 and HPV-18

C. HPV-1 and HPV-2

D. HPV-31 and HPV-33

Which immune arm is especially important for controlling HPV infection?

A. Complement only

B. Cell-mediated immunity

C. IgE immunity

D. Neutrophils only

Immunosuppressed patients with HPV are more likely to develop what?

A. Fewer warts

B. Rapid spontaneous clearance

C. Numerous persistent warts

D. Immediate viremia

HPV warts in immunocompromised patients may respond how to treatment?

A. Always rapidly

B. Only to antibiotics

C. Never recur

D. May be treatment-resistant

Which HPV protein is essential for viral DNA replication?

A. E6

B. E7

C. L1

D. E1

What type of enzyme is HPV E1?

A. Helicase

B. Protease

C. Integrase

D. Neuraminidase

Which HPV protein regulates transcription and replication?

A. E6

B. E2

C. E7

D. L2

HPV DNA is generally maintained in benign infection as what?

A. Linear chromosome

B. RNA intermediate

C. Integrated prophage

D. Episome

An episome is best described as what?

A. Extrachromosomal circular DNA

B. Viral RNA segment

C. Host ribosomal RNA

D. Capsid subunit

What epithelial cells are initially infected by HPV?

A. Superficial keratinocytes

B. Melanocytes

C. Langerhans cells

D. Basal cells

HPV gains access to basal cells primarily through what?

A. Epithelial microtrauma

B. Hematogenous spread

C. Lymphatic spread

D. Neural spread

Which HPV capsid protein undergoes cleavage during viral entry?

A. E1

B. L2

C. E6

D. L1

Cleavage of L2 promotes conformational changes in which protein?

A. E2

B. E7

C. L1

D. E6

Which host molecules mediate initial HPV attachment?

A. Integrins

B. Collagen fibers

C. Fibronectin

D. Heparan sulfate proteoglycans

HPV initially infects basal cells but replicates efficiently in what cells?

A. Differentiating keratinocytes

B. Melanocytes

C. Fibroblasts

D. Langerhans cells

Why does HPV depend on differentiating keratinocytes for replication?

A. They lack nuclei

B. They reenter DNA synthesis

C. They secrete antibodies

D. They undergo phagocytosis

HPV is considered nonlytic because it does what?

A. Destroys basal cells

B. Causes immediate apoptosis

C. Preserves infected host cells

D. Ruptures epithelial cells

As infected keratinocytes migrate toward the surface, what happens to HPV DNA?

A. It is destroyed

B. It integrates immediately

C. It enters blood

D. It moves upward with cells

Why must HPV manipulate the host cell cycle?

A. It lacks its own DNA polymerase

B. It lacks a capsid

C. It lacks viral DNA

D. It lacks attachment proteins

HPV oncogenesis requires stimulation of what host process?

A. Apoptosis

B. Cell division

C. Complement activation

D. Autophagy

Which general mechanism contributes to viral transformation?

A. Increased contact inhibition

B. Decreased proliferation

C. Inhibition of growth regulation

D. Enhanced apoptosis

Which second mechanism contributes to viral oncogenesis?

A. Reduced DNA synthesis

B. Increased senescence

C. Enhanced contact inhibition

D. Stimulation of cell division

Transformed cells commonly lose which normal property?

A. Contact inhibition

B. DNA synthesis

C. Membrane proteins

D. Mitochondria

Compared with normal cells, transformed cells may have what nutritional requirement?

A. Increased requirement

B. Decreased requirement

C. No glucose use

D. No amino acid use

Which tumor suppressor normally restricts repeated cell-cycle entry?

A. p53

B. Telomerase

C. Rb

D. E2F

Loss of which protein permits inappropriate cell-cycle progression?

A. E6

B. E7

C. L1

D. Rb

Which tumor suppressor can induce apoptosis after DNA damage?

A. p53

B. Rb

C. E2F

D. Telomerase

Which enzyme protects chromosome ends from progressive shortening?

A. Helicase

B. Polymerase

C. Telomerase

D. Protease

Activation of telomerase allows tumor cells to avoid what?

A. DNA replication

B. Transcription

C. Mitosis

D. Senescence

Which HPV proteins are consistently expressed in cervical cancers?

A. E6 and E7

B. E1 and E2

C. L1 and L2

D. E4 and E5

Which HPV oncoprotein primarily targets Rb?

A. E6

B. E7

C. E1

D. L1

Release of E2F promotes what process?

A. Apoptosis

B. DNA synthesis

C. Protein degradation

D. Cell adhesion

What is the result of E7-mediated Rb inhibition?

A. Cell-cycle arrest

B. Increased apoptosis

C. Increased proliferation

D. Telomere shortening

Retinoblastoma is associated with loss of function of which protein?

A. p53

B. E2F

C. E6

D. Rb

Which HPV oncoprotein primarily targets p53?

A. E6

B. E7

C. E1

D. E2

Together, E6 and E7 primarily promote what outcome?

A. Cellular differentiation

B. Uncontrolled proliferation

C. Viral latency only

D. Immune tolerance

Besides degrading p53, high-risk HPV E6 promotes what oncogenic process?

A. Telomerase expression

B. Rb activation

C. E2F inhibition

D. Apoptosis

E6-mediated telomerase activation primarily promotes what?

A. Senescence

B. Cellular immortality

C. Differentiation

D. Contact inhibition

Anogenital HPV warts are called what?

A. Verruca vulgaris

B. Molluscum contagiosum

C. Condyloma acuminata

D. Condyloma lata

Common HPV warts on the hands are typically what?

A. Elevated and firm

B. Deeply ulcerated

C. Vesicular

D. Fluctuant

Common cutaneous warts often have what type of border?

A. Indistinct

B. Sharp

C. Necrotic

D. Erythematous only

HPV warts on the face, knees, and arms often appear how?

A. Deeply embedded

B. Pedunculated

C. Flat and clustered

D. Ulcerated

Plantar warts characteristically appear how?

A. Soft and pedunculated

B. Vesicular

C. Superficial only

D. Deeply embedded

Compared with many other warts, plantar warts are often what?

A. Scalier

B. More vascular

C. More vesicular

D. Less keratinized

Cervical HPV lesions are often what morphologically?

A. Deeply cavitary

B. Flat

C. Pedunculated

D. Nodular

Oropharyngeal HPV lesions affecting the larynx commonly cause what symptom?

A. Hemoptysis

B. Dysphagia

C. Stridor

D. Hoarseness

Hoarseness from oropharyngeal HPV reflects impaired function of what?

A. Larynx

B. Esophagus

C. Trachea

D. Tongue

Which HPV type is the prototype high-risk oncogenic strain?

A. HPV-6

B. HPV-16

C. HPV-1

D. HPV-11

Approximately half of cervical cancers are associated with which HPV type?

A. HPV-6

B. HPV-11

C. HPV-16

D. HPV-2

High-risk HPV is strongly associated with which additional malignancy?

A. Anal cancer

B. Renal cancer

C. Thyroid cancer

D. Pancreatic cancer

Which HPV types commonly cause low-risk genital warts?

HPV-6 and HPV-11 are rarely associated with what?

A. Cutaneous warts

B. Genital warts

C. Respiratory papillomas

D. Cervical cancer

HPV-associated malignant tumor cells characteristically contain what?

A. HPV DNA

B. Bacterial DNA

C. Only viral RNA

D. No viral material

HPV-associated cancer cells characteristically express which genes?

A. E1 and E2

B. E6 and E7

C. L1 and L2

D. E4 and E5

Persistent expression of E6 and E7 promotes what?

A. Viral clearance

B. Keratinocyte death

C. Malignant transformation

D. Antibody production

HPV diagnosis of visible warts is often based primarily on what?

A. Blood culture

B. Serology

C. Viral culture

D. Clinical appearance

Which wart feature may result from ruptured dermal capillaries?

A. Black dots

B. White plaques

C. Vesicles

D. Pustules

The black dots seen in some HPV warts represent what?

A. Melanin deposits

B. Thrombosed capillaries

C. Fungal colonies

D. Viral inclusions

Which screening test detects cervical cytologic abnormalities?

A. Monospot

B. Western blot

C. ELISA

D. Pap smear

Pap screening helps detect what clinically important condition?

A. Acute HPV viremia

B. Precancerous cervical lesions

C. Latent HBV

D. Ovarian cysts

Which test directly detects high-risk HPV nucleic acid clinically?

A. Gram stain

B. Culture

C. HPV DNA testing

D. Monospot

Do most uncomplicated cutaneous HPV warts require treatment?

A. Not necessarily

B. Always

C. Only surgically

D. Only systemically

Many cutaneous HPV warts undergo what natural course?

A. Malignant transformation

B. Spontaneous regression

C. Continuous enlargement

D. Hematogenous spread

Most therapies for visible HPV warts are what type?

A. Antiviral

B. Antibiotic

C. Ablative

D. Immunosuppressive

Liquid nitrogen treats HPV warts through what mechanism?

A. Antibody production

B. Polymerase inhibition

C. Ribosome blockade

D. Cryoablation

Surgical excision treats HPV warts primarily by doing what?

A. Removing infected tissue

B. Blocking E6 transcription

C. Neutralizing virions

D. Stimulating antibodies

Laser treatment of HPV warts is an example of what?

A. Antiviral chemotherapy

B. Physical ablation

C. Vaccination

D. Immune suppression

Does destruction of visible warts guarantee complete HPV eradication?

Imiquimod is used primarily as what type of treatment?

A. Oral antiviral

B. Systemic antibiotic

C. Cytotoxic chemotherapy

D. Topical immune modulator

Imiquimod can be used for which HPV manifestation?

A. Anogenital warts

B. Hepatitis C

C. Herpes encephalitis

D. Influenza

Imiquimod treats HPV partly by stimulating what?

A. Viral polymerase

B. Host immune response

C. Bacterial ribosomes

D. DNA integration

Condom use has what effect on HPV transmission risk?

A. Eliminates it

B. Increases it

C. Has no possible benefit

D. Reduces but does not eliminate it

Why can HPV still spread despite condom use?

A. Uncovered skin can transmit virus

B. Virus is airborne

C. Virus travels through blood

D. Condoms increase viral replication

Acetic acid makes HPV-associated cervical lesions appear what?

A. Black

B. Red

C. White

D. Blue

HPV vaccine particles are primarily composed of which protein?

A. E6

B. E7

C. L2

D. L1

HPV L1 proteins self-assemble into what?

A. Virus-like particles

B. Infectious virions

C. Bacterial spores

D. Lipid envelopes

Why can HPV vaccine Virus-like particles not cause HPV infection?

A. Lack capsid proteins

B. Lack viral genome

C. Lack antibodies

D. Lack host receptors

The original quadrivalent Gardasil targeted which HPV types?

A. 1, 2, 3, 4

B. 16, 18, 31, 33

C. 6, 11, 31, 45

D. 6, 11, 16, 18

Which vaccine historically targeted HPV-16 and HPV-18?

A. Cervarix

B. Gardasil quadrivalent

C. MMR

D. Varicella

The currently used U.S. HPV vaccine is what?

A. Cervarix

B. Quadrivalent Gardasil

C. Bivalent HPV vaccine

D. Gardasil 9

HPV warts usually grow at what rate?

A. Slowly

B. Rapidly

C. Overnigh

t D. Immediately

HPV warts affect skin and what other tissue?

A. Bone

B. Mucous membranes

C. Skeletal muscle

D. Tendons

HPV belongs to which viral family?

A. Herpesviridae

B. Flaviviridae

C. Papillomaviridae

D. Picornaviridae

Which two proteins form the HPV capsid?

A. E1 and E2

B. E6 and E7

C. L1 and E6

D. L1 and L2

Which HPV protein is the major capsid protein?

A. L1

B. L2

C. E1

D. E2

Which HPV protein is the minor capsid protein?

A. E7

B. L2

C. E6

D. L1

An HPV virion contains how many copies of its viral genome?

A. Two

B. Four

C. One

D. Eight

What is the shape of the HPV genome?

A. Linear

B. Segmented

C. Helical

D. Circular

HPV types are distinguished primarily based on what?

A. DNA sequences

B. Capsid color

C. Host age

D. Lesion size

HPV-2 most commonly causes what?

A. Cervical cancer

B. Plantar warts

C. Common cutaneous warts

D. Respiratory papillomatosis

HPV-2 may also be isolated from what lesions?

A. Anal carcinoma only

B. Oral ulcers

C. Plantar ulcers

D. Genital warts

Which HPV protein has additional oncogenic activity besides E6/E7?

A. L1

B. E5

C. L2

D. E1

HPV can spread from one body site to another by what?

A. Viremia

B. Lymphatic spread

C. Bacteremia

D. Autoinoculation

Which disorder causes inherited susceptibility to certain HPV types?

A. DiGeorge syndrome

B. Bruton agammaglobulinemia

C. Epidermodysplasia verruciformis

D. Chronic granulomatous disease

Epidermodysplasia verruciformis involves impaired immunity against what?

A. Bacteria

B. Fungi

C. Protozoa

D. HPV

HPV episomal DNA is maintained in what configuration?

A. Linear integrated DNA

B. Covalently closed circular DNA

C. Segmented RNA

D. Single-stranded linear DNA

An HPV episome is located where relative to host chromosomes?

A. Permanently integrated

B. Inside mitochondria

C. Extrachromosomal

D. Inside nucleoli only

HPV replication occurs in concert with differentiation of what cells?

A. Melanocytes

B. Keratinocytes

C. Fibroblasts

D. Langerhans cells

HPV-positive head and neck cancers are most associated with which type?

A. HPV-6

B. HPV-11

C. HPV-16

D. HPV-2

What is the shape of the HPV capsid?

A. Helical

B. Complex

C. Bullet-shaped

D. Icosahedral

What is the shape of the HPV genome?

A. Circular

B. Linear

C. Segmented

D. Helical

HPV contains which type of genome?

A. ssRNA

B. dsDNA

C. ssDNA

D. dsRNA

Which epidermal layer is initially infected by HPV?

A. Stratum corneum

B. Stratum granulosum

C. Stratum basale

D. Stratum lucidum

Which HPV capsid protein participates prominently in initial attachment?

A. E6

B. L1

C. E7

D. E2

HPV infection can cause thickening of which epidermal layer?

A. Stratum lucidum

B. Stratum basale

C. Stratum corneum only

D. Stratum spinosum

What is a major oncogenic function of HPV E5?

A. Enhances EGFR signaling

B. Degrades p53

C. Binds Rb

D. Forms capsid

Which tumor suppressor is primarily targeted by HPV E6?

A. Rb

B. E2F

C. APC

D. p53

Which tumor suppressor is primarily targeted by HPV E7?

A. Rb

B. p53

C. BRCA1

D. APC

The p105 protein targeted by HPV E7 corresponds to what?

A. p53

B. Retinoblastoma protein

C. E2F

D. Telomerase

Which HPV types commonly cause cutaneous or genital warts?

A. 16, 18, 31, 33

B. 18, 31, 45, 52

C. 5, 8, 16, 18

D. 1, 2, 6, 11

Which HPV types classically cause laryngeal papillomas?

A. HPV-6 and HPV-11

B. HPV-16 and HPV-18

C. HPV-1 and HPV-2

D. HPV-31 and HPV-33

Why is cervical screening still needed after HPV vaccination?

A. Vaccine does not cover all oncogenic HPV types

B. Vaccine causes dysplasia

C. Pap smears detect antibodies

D. Vaccines increase HPV mutation

JC virus and BK virus belong to which viral group?

A. Papillomaviruses

B. Polyomaviruses

C. Herpesviruses

D. Adenoviruses

JC and BK viruses contain which type of genome?

A. ssRNA

B. dsRNA

C. dsDNA

D. ssDNA

What is the shape of the polyomavirus genome?

A. Linear

B. Segmented

C. Helical

D. Circular

JC virus primarily infects which CNS cells?

A. Glial cells

B. Neurons

C. Microglia

D. Ependymal cells

Which glial cells are especially affected by JC virus in PML?

A. Schwann cells

B. Oligodendrocytes

C. Satellite cells

D. Microglia

JC virus reactivation in immunocompromised patients causes what disease?

A. Guillain-Barré syndrome

B. Multiple sclerosis

C. Progressive multifocal leukoencephalopathy

D. Viral meningitis

BK virus establishes latent infection primarily in what organ?

A. Liver

B. Kidneys

C. Spleen

D. Lung

BK virus reactivation is particularly important in which patients?

A. Asthma patients

B. Healthy children

C. Renal transplant recipients

D. Iron-deficient patients

BK virus reactivation in renal transplant patients classically causes what?

A. PML

B. Cervical dysplasia

C. Hepatitis

D. BK virus nephropathy

BK virus reactivation may also cause which urinary complication?

A. Ureteral stenosis

B. Nephrolithiasis

C. Renal artery aneurysm

D. Bladder carcinoma