Virology MCQs – 22 MCQs | Kenya MBChB

22 Year 3: Medical Virology exam questions on Virology MCQs for medical students. Includes MCQs, answers, explanations and written questions. Sample: Which of t

This MCQ set contains 22 questions on Virology MCQs in the Year 3: Medical Virology unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.

Q1: Which of the following statements is true about the pathogenesis of HSV-2?

  1. A. Up to 90% of persons seropositive for HSV-2 have a clinical history of anogenital herpes outbreaks
  2. B. Most persons who are seropositive for HSV-2 but report no symptoms still shed virus from the genital area intermittently
  3. C. HSV-2 is not associated with HIV acquisition or transmission
  4. D. All herpes viruses establish active infection in specific target cells
  5. E. All the above

Correct answer: B – Most persons who are seropositive for HSV-2 but report no symptoms still shed virus from the genital area intermittently

Most HSV-2 seropositive individuals are asymptomatic but still shed virus intermittently from the genital mucosa — making them unknowing transmitters. This asymptomatic shedding is the primary driver of HSV-2 spread. HSV-2 is actually associated with increased HIV acquisition risk, making C false.

Q2: Which clinical presentation is typical of a primary first episode HSV-2 infection?

  1. A. No lesions or symptoms, HSV-1 antibodies may or may not be present, HSV-2 antibodies are present
  2. B. Lesions present, symptoms usually mild, HSV-1 antibodies may or may not be present, HSV-2 antibodies are present
  3. C. Lesions present, symptoms usually severe, HSV-1 and HSV-2 antibodies are not present
  4. D. Lesions present, symptoms usually moderate, HSV-1 antibodies are present, HSV-2 antibodies are not present
  5. E. All the above

Correct answer: C – Lesions present, symptoms usually severe, HSV-1 and HSV-2 antibodies are not present

A true primary first episode HSV-2 infection means no prior HSV exposure of any type. Therefore both HSV-1 and HSV-2 antibodies are absent, and the clinical presentation is typically severe — extensive lesions, systemic symptoms (fever, malaise, lymphadenopathy), and prolonged viral shedding.

Q3: Viruses that contain two complete copies of positive strand RNA and the enzyme reverse transcriptase are:

  1. A. Toga viruses
  2. B. Rhabdoviruses
  3. C. Retroviruses
  4. D. Reoviruses
  5. E. Enteroviruses

Correct answer: C – Retroviruses

Retroviruses (e.g., HIV) carry two identical copies of positive-sense single-stranded RNA and the enzyme reverse transcriptase, which converts viral RNA into DNA for integration into the host genome. This diploid RNA genome is unique to retroviruses among animal viruses.

Q4: Bacteriophages that can enter into stable, long-term relationships with their hosts are called:

  1. A. Lytic phages
  2. B. Defective phages
  3. C. Virulent phages
  4. D. Lazy phages
  5. E. Temperate phages

Correct answer: E – Temperate phages

Temperate phages integrate their genome into the bacterial chromosome as a prophage, establishing a stable long-term lysogenic relationship with the host. They replicate silently with the bacterium until triggered to enter the lytic cycle. Examples include bacteriophage lambda (λ).

Q5: The positive strand of certain viruses does not act as a messenger but becomes converted into DNA and integrated into the host cellular DNA. These viruses are:

  1. A. Rhinoviruses
  2. B. Enteroviruses
  3. C. Retroviruses
  4. D. Reoviruses
  5. E. Picornaviruses

Correct answer: C – Retroviruses

This describes the retrovirus replication cycle. Their positive-strand RNA genome is converted to double-stranded DNA by reverse transcriptase, then integrated into the host genome by integrase as a provirus. This is distinct from other positive-strand RNA viruses that use their genome directly as mRNA.

Q6: Infants infected with cytomegaloviruses (CMV) in utero may suffer from:

  1. A. Mental retardation
  2. B. Enlarged spleen
  3. C. Liver damage
  4. D. Any of these
  5. E. None of these

Correct answer: D – Any of these

Congenital CMV is the most common intrauterine infection. It can cause a wide spectrum of damage including mental retardation, sensorineural hearing loss, hepatosplenomegaly (enlarged spleen and liver), microcephaly, and chorioretinitis. Severely affected infants may present with "blueberry muffin" rash due to extramedullary hematopoiesis.

Q7: Viroids are unusual in that they:

  1. A. Have no capsid protein or envelope
  2. B. Contain RNA
  3. C. Are barely visible with the light microscope
  4. D. Can cause disease in plants
  5. E. Are retroviral

Correct answer: A – Have no capsid protein or envelope

Viroids are the smallest known infectious agents — they consist of a short, circular, single-stranded RNA molecule with no protein coat (capsid) and no envelope whatsoever. They are even smaller than viruses and cause disease primarily in plants (e.g., potato spindle tuber disease).

Q8: Creutzfeldt-Jakob disease (CJD), Kuru, scrapie, and Mad Cow disease are caused by:

  1. A. Viroids
  2. B. Retroviruses
  3. C. DNA viruses
  4. D. Prions
  5. E. RNA viruses

Correct answer: D – Prions

Prions are misfolded proteins (PrP^Sc) that cause fatal neurodegenerative spongiform encephalopathies. They contain no nucleic acid — making them unique among all known infectious agents. They are extraordinarily resistant to heat, radiation, and standard disinfection. CJD, Kuru, scrapie (sheep), and variant CJD (Mad Cow) are all prion diseases.

Q9: The human virus that has been associated with Burkitt's lymphoma (a malignant tumor of the jaw) is:

  1. A. Cytomegalovirus
  2. B. Human papilloma virus (HPV)
  3. C. Retroviruses
  4. D. Epstein-Barr virus
  5. E. Enterovirus

Correct answer: D – Epstein-Barr virus

EBV is strongly associated with Burkitt's lymphoma — a B-cell malignancy classically presenting as a jaw tumor in African children. EBV immortalizes B lymphocytes. It is also associated with infectious mononucleosis, nasopharyngeal carcinoma, and Hodgkin's lymphoma.

Q10: What causes Encephalitis or Acute Encephalitis Syndrome (AES)?

  1. A. Inflammation caused by an infection in the brain
  2. B. The main causative agents of this disease are viruses
  3. C. Both A and B
  4. D. Only B
  5. E. None of the above

Correct answer: C – Both A and B

Acute Encephalitis Syndrome (AES) is defined as inflammation of the brain parenchyma, most commonly caused by viral infections (HSV, JE virus, enteroviruses, arboviruses). Both statements are correct — AES is viral-mediated inflammatory brain disease.

Q11: What are the symptoms of Encephalitis or Acute Encephalitis Syndrome?

  1. A. High fever
  2. B. Vomiting
  3. C. Confusion
  4. D. A and B
  5. E. All the above

Correct answer: E – All the above

AES presents with the classic triad of fever, altered consciousness/confusion, and neurological deficits. Additional symptoms include vomiting, seizures, headache, photophobia, and focal neurological signs depending on the brain region affected.

Q12: Treatments given to encephalitis or AES patients are:

  1. A. Corticosteroids
  2. B. Mechanical ventilation
  3. C. Anticonvulsants
  4. D. All the above
  5. E. A and C

Correct answer: D – All the above

Management of AES is supportive and includes corticosteroids (to reduce cerebral edema), mechanical ventilation (if respiratory compromise), and anticonvulsants (to control seizures). Acyclovir is added if HSV encephalitis is suspected. ICU-level care is often required.

Q13: Genital herpes are caused by the herpes simplex viruses:

  1. A. HPV, HSV-1 and HSV-2
  2. B. HSV-1 and HSV-2
  3. C. HTLV-1
  4. D. HIV, HSV-1 and HSV-2
  5. E. All of the above

Correct answer: B – HSV-1 and HSV-2

Genital herpes is caused by both HSV-1 and HSV-2. Historically HSV-2 was the dominant cause, but HSV-1 now accounts for a significant and growing proportion of genital herpes cases, especially in young adults, likely due to orogenital transmission.

Q14: Which of the following statements is true about the transmission of HSV?

  1. A. The average incubation period is 10 days
  2. B. Likelihood of transmission does not change with increased duration of infection
  3. C. HSV is readily inactivated by drying and soap and water
  4. D. Most sexual transmission occurs while the source contact case is symptomatic
  5. E. None of the above

Correct answer: C – HSV is readily inactivated by drying and soap and water

HSV is an enveloped virus and is therefore relatively fragile outside the host. It is rapidly inactivated by desiccation (drying), soap, and water — explaining why fomite transmission is rare. Most transmission actually occurs during asymptomatic shedding (making D false).

Q15: HSV systemic antiviral chemotherapy includes which of the following oral medications?

  1. A. Acyclovir
  2. B. Valacyclovir
  3. C. Famciclovir
  4. D. All of the above
  5. E. A and B

Correct answer: D – All of the above

All three are nucleoside analogue antivirals active against HSV. Acyclovir is the prototype; Valacyclovir is the oral prodrug of acyclovir with better bioavailability; Famciclovir is the prodrug of penciclovir. All three are used for genital herpes treatment and suppression.

Q16: The patient becomes very upset after learning that she has HSV infection and inquires about future risks, especially transmission risks if she has other sexual partners without HSV. Which is the most appropriate answer?

  1. A. Daily vitamin supplementation decreases viral shedding
  2. B. HSV infection has been associated with uterine cancer
  3. C. Oral contraception has a protective effect on transmission of HSV
  4. D. She is always at risk for shedding the virus
  5. E. She is never at risk for future transmission of HSV

Correct answer: D – She is always at risk for shedding the virus

Once infected with HSV, the virus establishes lifelong latency in sensory ganglia. Viral shedding — both symptomatic and asymptomatic — occurs intermittently for life. There is no cure, and she will always carry transmission risk. Suppressive antiviral therapy (acyclovir/valacyclovir) can reduce but not eliminate shedding.

Q17: What is the only DNA virus that causes hepatitis?

  1. A. Hepatitis A virus
  2. B. Hepatitis B virus
  3. C. Hepatitis C virus
  4. D. Hepatitis D virus

Correct answer: B – Hepatitis B virus

Hepatitis B virus (HBV) is the only DNA virus among the major hepatitis viruses. It belongs to the Hepadnaviridae family with a partially double-stranded circular DNA genome. HAV is a picornavirus (ssRNA), HCV is a flavivirus (ssRNA), and HDV is a virusoid (negative-sense ssRNA).

Q18: Poliovirus has an affinity for what body system?

  1. A. Gastrointestinal system
  2. B. Nervous system
  3. C. Genitourinary system
  4. D. Circulatory system
  5. E. Reticuloendothelial system

Correct answer: B – Nervous system

Poliovirus enters via the fecal-oral route and replicates in the gut, but its primary tropism is the anterior horn motor neurons of the spinal cord. Destruction of these neurons causes the flaccid paralysis characteristic of paralytic poliomyelitis. The virus uses CD155 (PVR) as its receptor on neural cells.

Q19: How is hepatitis A transmitted?

  1. A. Respiratory droplets
  2. B. Fomites
  3. C. Sexually transmitted
  4. D. Fecal-oral route
  5. E. Bite of an infected vector

Correct answer: D – Fecal-oral route

HAV is transmitted exclusively by the fecal-oral route — contaminated water, raw shellfish, unwashed produce, and poor hand hygiene. It is a non-enveloped virus, making it resistant to environmental conditions. Unlike HBV/HCV, it is NOT sexually transmitted or bloodborne as a primary route.

Q20: Which of the following specimens contain/s hepatitis B virus in an infected person?

  1. A. Blood
  2. B. Semen
  3. C. Saliva
  4. D. All of these
  5. E. None of the above

Correct answer: D – All of these

HBV is found in blood, semen, vaginal secretions, saliva, breast milk, and other body fluids. Blood has the highest viral concentration. This explains its transmission routes — sexual contact, needlesharing, vertical (mother to child), and rarely saliva (deep kissing, bites).

Q21: The diagnosis of hepatitis A virus infection is carried out from the method based on:

  1. A. Aminotransferase levels
  2. B. Detection of faecal HAV by immunoelectron microscopy
  3. C. Detection of IgM anti-HAV by ELISA
  4. D. Both (a) and (b)
  5. E. Both a and b

Correct answer: C – Detection of IgM anti-HAV by ELISA

The gold standard for acute HAV diagnosis is detection of IgM anti-HAV antibodies by ELISA — these appear at onset of symptoms and persist for 3-6 months. Elevated aminotransferases indicate liver injury but are nonspecific. Fecal HAV detection is possible but not the standard diagnostic method.

Q22: Which statement regarding the herpesvirus family is incorrect?

  1. A. They replicated in the host cell cytoplasm
  2. B. They tend to be latent viruses and cause recurrent infections
  3. C. They are enveloped viruses
  4. D. They often incorporate their nucleic acid into the host genome
  5. E. They commonly cause infections in immunocompromised individuals

Correct answer: A – They replicated in the host cell cytoplasm

Herpesviruses are DNA viruses that replicate in the nucleus, NOT the cytoplasm. DNA replication, transcription, and capsid assembly all occur in the nucleus. The virus then acquires its envelope by budding through the nuclear membrane. This distinguishes them from poxviruses, which are the only DNA viruses that replicate in the cytoplasm.

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