Myxoviruses Multiple Choice Question & Answers

Myxoviruses and Rubella

Question 1. Identify the organism from the given life cycle.

1. Influenza A
2. Para-influenza
3. RSV
4. SARS virus

Answer. (1) (Influenza A)

• This life cycle belongs to the influenza virus. Major replication of the influenza virus occurs inside the nucleus. This differentiates it from paramyxoviruses which replicate mainly in cytoplasm.

Read And Learn More: Micro Biology And Immunology Multiple Choice Question And Answers

Question 2. Influenza, incorrect is:

1. Vaccine efficacy is around 60%
2. Vaccine efficacy is >90%
3. The most common strain H3N2
4. Belongs to the family Orthomyxoviridae
5. 3 types: A, B, and C

Answer. (2, 5) (Vaccine efficacy is >90%, 3 types: A, B, and C)

• Four types of influenza virus types: A, B, C, and D
• The vaccine efficacy varies from 25–67% (25% for H3N2, 42% against type B and 67% against H1N1).
• The efficacy is lower if the vaccine virus does not match to currently circulating viruses in the locality. Immunity lasts for 6-12 months
• Although H1N1, H3N2, and type B are the flu types occur worldwide, the most common strain type is H3N2

Question 3. Drug of choice for prophylaxis of influenza A[H1N1]:

1. Amantadine
2. Oseltamivir
3. Acyclovir
4. Ribavirin

Answer. (2) (Oseltamivir)

Oseltamivir is the drug of choice for prophylaxis of influenza A[H1N1]

Question 4. An adult patient with a history of smoking is presented with consolidation of the lung. He had a history of influenza 15 days back. The most common organism implicated is:

1. Streptococcus pneumoniae
2. Klebsiella pneumoniae
3. Staphylococcus aureus
4. Streptococcus pyogenes

Answer. (3) (S.aureus)

Secondary bacterial pneumonia is the most common complication to occur in patients infected with the influenza virus. Common agents are staphylococci followed by pneumococci and Haemophilus influenzae.

Question 5. True about antigenic drift:

1. Caused only by influenza A
2. This leads to seasonal epidemics
3. Leads to pandemic
4. Arises due to frameshift mutations

Answer. (2) (Leads to seasonal epidemics)

• Antigenic drift is seen in both Influenza A and B; leads to seasonal periodic epidemics and minor outbreaks and arises due to point mutation.
• Antigenic shift is seen in only Influenza A; leads to endemics and major epidemics and arises due to genetic recombination.

Question 6. About Killed Influenza vaccine dosage, all are true except:

1. It can be given to pregnant patient
2. An adult dose is 0.5 ml
3. At the age of 6–36 months, the dose is 0.25 ml
4. Immunity lasts for 3 years

Answer. (4) (Immunity lasts for 3 years)

Immunity lasts for 6—12 months; hence, on an annual basis, revaccination is recommended.

Question 7. Trivalent Influenza vaccine contains all except:

1. H1N1
2. H2N1
3. Influenza B
4. H3N2

Answer. (2) (H2N1)

Trivalent influenza vaccine include H1N1, H3N2, Influenza B

Question 8. True about Swine flu:

1. Older bird influenza vaccine is equally effective in swine flu
2. Oseltamivir is effective in prevention
3. Zanamivir can be used for treatment
4. Influenza vaccine provides immunity just after vaccination

Answer. (2, 3) (Oseltamivir is effective in prevention, and Zanamivir can be used for treatment)

• Oseltamivir is DOC for chemoprophylaxis. For treatment, both Oseltamivir (DOC).
• Zanamivir can be given.
• Avian influenza (H5N1) vaccine is not effective for swine flu.
• There is a separate pandemic influenza vaccine is available for swine flu, composed of
• H1N1 (both live and inactive forms). It is effective only after 14 days of vaccination.

Question 9. Avian influenza is due to:

1. H1N1
2. H3N1
3. H5N1
4. H7N1

Answer. (3) (H5N1)

• Avian influenza strains are: H5N1 (most common), H7N9, H7N3, H7N7, and H9N2

Question 10. A 70-year-old woman refused to take the influenza vaccine and developed flu. The death happened 1 week after pneumonia Most common cause of Post influenza pneumonia is:

1. Staphylococcus aureus
2. Measles
3. Legionella
4. CMV

Answer. (1) (Staphylococcus aureus)

• The most common causes of postinfluenza secondary pneumonia are bacterial pathogens such as Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae.

Question 11. Reason for H5N1 influenza not becoming a pandemic:

1. Man-to-man transmission is rare
2. No human-to-human transmission occurs
3. Less virulent
4. Bird-to-bird transmission is not efficient

Answer. (2) (No human-to-human transmission occurs)

• Avian flu strain (H5N1)
• Transmission to man occurs only from birds and requires close respiratory contact.
• There is no human-to-human transmission documented so far. Hence the morbidity is less. Only 500 cases were reported between 1977 to 2010 from Asia and the Middle East.
• However, the avian flu strains are highly virulent (due to the presence of PB1F2 protein) and the mortality rate is > 60%.

Question 12. The outbreak of the avian influenza epidemic in China in 2013 was caused by to following:

1. H1N1
2. H3N2
3. H5N1
4. H7N7
5. H7N9

Answer. (5) (H7N9)

• A recent outbreak of Avian Influenza reported from China in April 2013 was due to type A/H7N9, > 130 human infections were reported, and 43 deaths were controlled later, due to containment measures taken by China Govt.

Question 13. True about influenza:

1. Asymptomatic cases rare
2. IP-10–12 days
3. Pandemic – rare
4. Extra human reservoir not seen
5. All ages and sex equally affected

Answer. (3) (Pandemic – rare)

• Asymptomatic cases are more common with influenza infection.
• The incubation period of influenza has ranged from 18 to 72 hr.
• Pandemic – rare, occurs every 10–15 years
• The major reservoir of influenza persists in animals and birds.
• Influenza attacks all the ages of both sexes. However the attack rate is low in adults and the mortality rate is high in children, older age, patients with diabetes, chronic heart/renal/respiratory disease.

Question 14. Swine flue in 2009 was caused by:

1. H1N1
2. H5N1
3. H3N1
4. H3N3

Answer. (1) (H1N1)

• Swine flu in 2009 was due to H1N1

Question 15. Antigenic variation is seen in all except:

1. Influenza type A
2. Influenza type B
3. Influenza type C
4. None of the above

Answer. (3) (Influenza type C)

Antigenic variation is commonly seen in type A and to a lesser extent type Type C influenza is antigenically stable.

Question 16. Myxoviruses include:

1. Orthomyxovirus
2. Influenza
3. Measles
4. Polio
5. HSV

Answer. (1, 2, 3) (Orthomyxovirus, Influenza, Measles)

• Myxoviruses are enveloped RNA viruses
• They are divided as
• Orthomyxovirus: Influenza A, B, C
• Paramyxovirus: Parainfluenza, Measles, Mumps, RSV, Metapneumovirus

Question 17. H5N1 is a strain of:

1. Avian flue
2. A new vaccine against AIDS
3. Agent for Japanese encephalitis
4. Causes Chikungunya fever

Answer. (1) (Avian flu)

• In 1997, human cases of influenza caused by avian influenza viruses (A/H5N1) were detected in Hong Kong during an extensive outbreak of influenza in poultry.
• Mortality rates have been high (60%)
• Only bird-to-human transmission was seen, but no human-human transmission was seen
• Highly virulent due to PB1F2 which targets host mitochondria, induces apoptosis

Question 18. Antigenic variation is seen in which of the following?

1. Influenza virus
2. Hepatitis virus
3. Yellow fever virus
4. Leptospira

Answer. (1) (Influenza virus)

• Antigenic variation is a unique feature of influenza virus.
• The surface antigens hemagglutinin and neuraminidase are primarily responsible for antigenic variations exhibited by influenza viruses.

Question 19. The period of isolation for measles is from:

1. The onset of catarrhal symptoms 3 days after
2. The onset of catarrhal symptoms 7 days after
3. The onset of catarrhal symptoms 6 days after
4. The onset of catarrhal symptoms 8 days after

Answer. (1) (Onset of catarrhal symptoms to 3 days after)

• Measle patients are infectious from four days before to four days after the onset of rash.
• Patients are highly contagious, and isolation is recommended from the onset of the prodromal stage until the third day of the rash.

Question 20. Warthin-Finkeldey giant cell is seen in:

1. Mumps
2. Measles
3. Rubella
4. Yellow fever

Answer. (2) (Measles)

• The cytopathic effect produced by the measles virus may be observed after 7–10 days of inoculation into cell lines characterized by multinucleated giant cells (WarthinFinkeldey cells) containing both intranuclear and intracytoplasmic inclusion bodies.

Question 21. True about measles is/are:

• The period of communicability is 3 days before to 5 days after the rash
• The period of communicability is 4 days before to 4 days after the rash
• The period of communicability is 5 days before to 3 days after the rash
• It is caused by a DNA paramyxovirus
• The incubation period is around 10-14 days

Answer. (2, 5) (Period of communicability -4 to +4 days, IP 10-14 days)

The period of communicability of measles is 4 days before to 4 days after the rash.

22. Warthin–Finkeldey cell seen in:

1. Measles
2. Rubella
3. Mumps
4. VZV

Answer. (1) (Measles)

• Measles produces a cytopathic effect after 7–10 days of inoculation into cell lines characterized by multi-unucleated giant cells (Warthin-Finkeldey cells) containing both intranuclear and intracytoplasmic inclusion bodies.

Question 23. A child is presented with fever, conjunctivitis, and a bluish-white spot on the buccal mucosa. Four days later, she developed rashes. What is the characteristic feature of the virus that is responsible for this condition?

1. ss- naked RNA virus
2. ds- naked RNA virus
3. ss- enveloped RNA virus
4. ds- enveloped RNA virus

Answer. (3) (ss- enveloped RNA virus)

• The history of fever, conjunctivitis, and Koplik spots on buccal mucosa and rashes suggestive of measles.

Question 24. According to WHO’s measles elimination strategy, vaccination campaigns are done in which phase?

1. Mop up
2. Follow up
3. Keep up
4. Catch up

Answer. (4) (Catch up)

• WHO measles Elimination strategy: ‘Catch up, Keep up and Follow up’
• Catch-up is defined as a one-time national-wide vaccination campaign targeting children of 9 months to 14 years regardless of measles disease or vaccination status.
• Keep-up is defined as routine services aimed at vaccinating >95% of each successive birth cohort.
• Follow-up is defined as subsequent national vaccination campaigns conducted every 2–4 years targeting usually all children born after the catch-up campaign.

Question 25. Which of the following is not true about measles?

1. High secondary attack rate
2. Only one serotype
3. Not infectious in the prodromal stage
4. Infection confers lifelong immunity

Answer. (3) (Not infectious in prodromal stage)

• Measles: infectious during the prodromal stage
• A high secondary attack rate of 90%
• Once infected provides lifelong immunity
• Only one serotype (antigenically homogenous)

Question 26. Least common complication in measles:

1. Diarrhea
2. Pneumonia
3. Otitis media
4. SSPE

Answer. (4) (SSPE)

• SSPE is a rare but severe most complication following measles with an occurrence rate of 1:300,000
• Most complications of measles result from secondary bacterial infections of the respiratory tract Otitis media and bronchopneumonia are most common and may be caused by S. pneumoniae, H. influenzae type b, or staphylococci.

Question 27. Reservoir of measles:

1. Man
2. Soil
3. Monkey
4. Fomites

Answer. (1) (Man)

• There are no latent or persistent measles virus infections that result in prolonged contagiousness, nor are there animal reservoirs for the virus.
• Thus, the measles virus can be maintained in human populations only by an unbroken chain of acute infections, which requires a continuous supply of susceptible individuals

Question 28. True about measles:

1. Koplik spot appears in the prodromal stage
2. Fever stops after onset of rash
3. Vaccine – at 9 month
4. IP- 6 days
5. Not diagnosed when coryza and rhinitis are absent

Answer. (1, 3) (Koplik spot appears in prodromal stage, Vaccine – at 9 months)

• Koplik spot appears in prodromal stage: 2 days after fever appears
• Both fever and rash will gradually disappear within 3–4 days of the onset of the rash
• Vaccine: indicated at 9 month
• IP of measles: 10 days
• Clinical diagnosis: Based on typical rashes and Koplik’s spot. The diagnosis would be incorrect if red eye and cough are absent.

Question 29. Most fatal complication of measles:

1. Pneumonia
2. Otitis media
3. SSPE

Answer. (3) (SSPE)

Question 30. In measles, the patient is infectious:

1. 3 days before to 4 days after the onset of the rash
2. 4 days before to 3 days after the onset of the rash
3. 4 days before to 5 days after the onset of the rash
4. 5 days before to 4 days after the onset of the rash

Answer. (3) (4 days before to 5 days after the onset of rash)

Question 31. Immune thrombocytopenic purpura is a complication following which of the following vaccines?

1. DPT
2. OPV
3. MMR
4. Typhoid
5. Influenza

Answer. (3) (MMR)

• A causal association between the MMR vaccine and ITP was confirmed in this study. The absolute risk of ITP within six weeks of immunization was 1 in 22 300 doses, with two of every three cases occurring in the six-week post-immunization period being caused by MMR.

Question 32. Chemoprophylaxis is not done for:

1. Measles
2. TB
3. Diphtheria
4. Conjunctivitis
5. Cholera

Answer. (1) (Measles)

• There are no antiviral drugs available for measles. Hence, vaccine prophylaxis is the only option for the prevention of measles.
• Chemoprophylaxis is indicated for:
• Cholera: Tetracycline
• Conjunctivitis (bacterial): Erythromycin ointment
• Diphtheria: Erythromycin and 1st dose of vaccine
• Meningococcal meningitis: Sulfadiazine or Rifampicin or ciprofloxacin and vaccine against type A and C
• Plague: Tetracycline (for contacts of pneumonic plague)
• Influenza A: Amantadine and vaccine

Question 33. The patient presented with fever, coughing, and headache. He developed a rash on 4th day of the onset of the fever, what is the probable diagnosis?

1. Measles
2. Mumps
3. Smallpox
4. Chickenpox
5. Mumps

Answer. (1) (Measles)

Question 34. Parotitis and orchitis are common manifestations of:

1. Measles
2. Mumps
3. Rubella
4. Diphtheria

Answer. (2) (Mumps)

In Mumps: The common manifestation is Parotitis, and the common complication is orchitis

Question 35. Concerning mumps which of the following is true?

1. Meningoencephalitis can precede parotitis
2. Salivary gland involvement is limited to the parotid
3. The patient is not infectious before clinical parotid enlargement.
4. Mumps orchitis frequently leads to infertility
5. Nipah virus and hendra virus

Answer. (1) (Meningoencephalitis can precede parotitis)

• States – ‘Aseptic meningitis, which may develop before, during, after, or in the absence of parotitis, is common in both children and adults.
• The parotid gland is commonly involved, and occasionally sublingual, and submandibular glands also may be involved
• Period of communicability: 4 days before to 5 days after the appearance of the rash
• Mumps orchitis is usually unilateral, Rarely can be bilateral and then it leads to low sperm count and sterility. Since orchitis is bilateral in < 15% of cases, sterility after mumps is rare.

Question 36. The depicted image below represents:

1. Biomedical waste
2. Cytotoxic waste
3. Radiation hazard
4. Bioterrorism
5. RSV

Answer. (3) (Radiation hazard)

This symbol belongs to radiation hazard.

Question 37. RSV causes all except:

1. Coryza in kids
2. ARDS
3. Bronchitis
4. Common cold

Answer. (2) (ARDS)

• RSV: In infants, 25–40% of infections result in lower respiratory tract involvement, including pneumonia, bronchiolitis, and tracheobronchitis.
• RSV: In adults, the most common symptoms common cold, with rhinorrhea, sore throat, and cough.
• RSV: Also called as Chimpanzee Coryza Agent

Question 38. Regarding respiratory viruses, all are true except:

1. RSV is the most common cause of bronchiolitis in infants
2. Mumps causes septic meningitis in adult
3. Measles causes SSPE
4. EBV causes pleuritis

Answer. (4) (EBV causes pleuitis)

• Options 1, 2, and 3 are correct. (Already explained)
• EBV causes glandular fever and it is an oncogenic virus

Question 39. Which pathogens adhere to respiratory epithelium?

1. RSV
2. Influenza
3. Parainfluenza
4. HBV
5. Picornavirus

Answer. (1, 2, 3, 5) (RSV, Influenza, Parainfluenza, Picornavirus)

• Influenza and parainfluenza viruses attach to the ciliated cells of the respiratory tract
• RSV is the pathogen of the lower respiratory tract
• Rhinovirus, which belongs to the Picornavirus family attaches to ciliated cells of the respiratory tract.

Question 40. Which of the following pairs is correct?

1. RSV: Bronchiolitis
2. Orf: Viral infection is transmitted from sheep
3. Parvovirus B 19: Exanthema subitum
4. HHV6: Kaposi Sarcoma
5. Human metapneumovirus

Answer. (1, 2) (RSV: Bronchiolitis, Orf: Viral infection is transmitted from sheep)

• Orf/Contagious pustular dermatitis is a disease of sheep and goats transmitted to humans by contact
• RSV is responsible for half of the cases of bronchiolitis occurring in the first few months of life
• Exanthem subitum caused by HHV-6
• Kaposi sarcoma by HHV-8.

Question 41. True regarding metapneumovirus is:

1. Non-segmented negative-sense single-stranded RNA virus
2. Incidence is 5% of total respiratory infection
3. Spreads through sexual contact and blood transfusion
4. Human metapneumovirus contains NS1 and NS2 antigens

Question 42. All vaccines reduce pneumonia-induced morality except:

1. Measles
2. Rubella
3. Hib
4. Pneumococcal

Question 43. A pregnant female got infected with the rubella virus at 22 weeks of pregnancy. The management of the patient should be:

1. Rubella vaccination
2. Rubella immunoglobulin IM
3. Antiviral drug
4. Reassurance

Question 44. The classical triad of congenital rubella includes all, except:

1. Cardiac abnormality
2. Renal anomalies
3. Deafness
4. Cataract

Question 45. A female became pregnant after 1 month of taking the MMR vaccine; though was advised to avoid pregnancy. What advice the doctor should give to the patient?

1. Termination of pregnancy is mandatory
2. High risk of anomalies, serious consideration for termination
3. Low risk, no action needed
4. Wait and watch

Answer. (4) (Wait and watch)

• Receipt of Rubella vaccine during pregnancy is not ordinarily a reason to consider termination of the pregnancy.
• Vaccines should not be administered during pregnancy.
• If pregnancy occurs within 28 days of immunization, the patient should be counseled on the theoretical risks to the fetus.
• Studies of over 200 women who had been inadvertently immunized with rubella vaccine during pregnancy showed that none of their offspring developed congenital rubella syndrome.
• Therefore, interruption of pregnancy is probably not warranted

Question 46. If a lady has taken a live vaccine recently, she can plan for pregnancy at least after:

1. 1 month
2. 3 months
3. 6 months
4. 1 year

Answer. (1) (1 month)

Question 47. All are true about congenital rubella except:

1. IgG persists for more than 6 months
2. IgM antibody is present at birth
3. The most common anomalies are hearing and heart defects
4. Increased congenital malformation if infection after 16 weeks

Answer. (4) (Increased congenital…)

• Congenital malformations are commonest during the first trimester and if infection occurs very early in pregnancy fetus may d

Question 48. The age group most prone to Rubella is:

1. Children 3–10 years
2. Adolescent girls
3. Pregnant females
4. Women of childbearing age

Answer. (1) (Children 3–10 years)

Rubella is mainly a disease of childhood particularly 3–10 yrs.

Question 49. Which of the following is a cause of acute laryngotracheal bronchitis?

1. H influenzae
2. Parainfluenza virus
3. Influenza
4. Coxsakie virus

Answer. (2) (Parainfluenza virus)

• Parainfluenza virus type 2 (sometimes type 1) is the causative agent of croup (acute laryngotracheal bronchitis)

Question 50. A newborn presents with PDA and cataracts. Infection with which group of viruses is likely to be the cause?

1. Rubella
2. Togavirus
3. Measles
4. Chickenpox

Answer. (1) (Rubella)

Question 51. Forschheimer spots seen in:

1. Rubella
2. Measles
3. Mumps
4. Chickenpox

Answer. (1) (Rubella)