A Trivia On Viral Respiratory Infection! Quiz
What do you know about viral respiratory infection? Virus entering the human body usually comes from contact through the mouth or nose. It is an infection that is caused by either a virus or bacteria. Some common symptoms include sore throat, sneezing, headache, weakness, and cough. If you need to discover further about viral respiratory infections, this is the quiz for you.
Questions and Answers
- 1.
A 10-month-old boy is brought to an outpatient clinic by his mother. The child has been sneezing, has a cough, and his nose is constantly running. There is no evidence of fever, pharyngeal inflammation or lower respiratory tract involvement. It is late February and the regional health authorities have requested that physicians provide them with nasopharyngeal samples for an epidemiological study. A nasopharyngeal aspirate is collected and sent to the regional health authorities. The virology lab establishes that this sample contained an enveloped, segmented, negative-polarity, single-stranded RNA virus, approximately 100 nm in diameter. What is the most likely etiology for this infant’s illness?
- A.
An adenovirus
- B.
A coronavirus
- C.
A rhinovirus
- D.
An orthomyxovirus
- E.
A paramyxovirus
Correct Answer
D. An orthomyxovirusExplanation
Influenza A virus, which is the main etiological agent responsible for the flu, is an enveloped segmented (-) ssRNA virus of the Orthomyxoviridae family; Influenzaviruses: • Orthomyxoviridae • Segmented (7-8) (-) ssRNA • Enveloped spherical • 120 nm • Many types characterized by their hemagglutinin (15 HA recognized subtypes) and neuraminidase (9 recognized NA subtypes) • Seasonality: Winter to early spring • Wide host range (birds, swine, humans)Rate this question:
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- 2.
A fourteen-year-old female student consults for a sore throat and signs of coryza. Her symptoms are caused by a pleiomorphic, enveloped, positive-polarity, single-stranded RNA virus. What is the most likely etiology of this student’s illness?
- A.
An influenza A virus
- B.
A parainfluenza-2 virus (PIV-2)
- C.
A rhinovirus
- D.
A coronavirus
- E.
An adenovirus
Correct Answer
D. A coronavirusExplanation
VIRAL COLD SYNDROME Etiology The plurality of common colds is due to rhinoviruses (30-50%, sometimes more). Other etiological agents include coronaviruses (10-15%), influenzaviruses A (5-15%; especially in children) and B, RSV (5%), other human parainfluenzaviruses (5%; HPIV-1, HPIV-2, HPIV-3 & HPIV-4), enteroviruses (<5%), adenoviruses (<5%; types 1, 2, 5, & 6 are endemic, types 4, 7, 14 & 21 cause epidemics, whereas type 3 is both), and metapneumoviruses. Other systemic viral infections can present with similar upper respiratory tract symptoms, but these are usually followed by other, more characteristic, symptoms. These include measles, or rubeola, (Morbillivirus, Paramyxoviridae), rubella (Rubivirus, Togaviridae) and mumps (Rubulavirus, Paramyxoviridae).
Spearmint Rhino is a club in vegas with NAKED women.
the Rhino virus is NAKED
Coronaviruses:
• Coronaviridae = (+) ssRNA • Enveloped PLEOMORPHIC • 100 nm to 150 nm
• 2 antigenic groups (229E and OC43)
• Seasonality: Winter or spring
• Narrow host range (humans)
Rhinoviruses:
• Picornaviridae • (+) ssRNA • NAKED icosahedral capsid • 30 nm
• >100 serotypes in 3 groups based on receptor specificity
• Seasonality: Mostly early fall and late spring (but rhinoviruses still account for half of the colds during the SUMMER…)
• Narrow host range (primates)Rate this question:
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- 3.
A 7-year-old boy presents to an outpatient clinic accompanied by his mother. The child is sneezing and coughing and has a runny nose, sore throat, but no fever. What are the characteristics of the most likely etiology?
- A.
Enveloped, (+) ssRNA
- B.
Enveloped, (-) ssRNA
- C.
Naked, (+) ssRNA
- D.
Naked, (-) ssRNA
- E.
Enveloped, DNA
- F.
Naked, DNA
Correct Answer
C. Naked, (+) ssRNAExplanation
VIRAL COLD SYNDROME Etiology The plurality of common colds is due to rhinoviruses (30-50%, sometimes more). Other etiological agents include coronaviruses (10-15%), influenzaviruses A (5-15%; especially in children) and B, RSV (5%), other human parainfluenzaviruses (5%; HPIV-1, HPIV-2, HPIV-3 & HPIV-4), enteroviruses (<5%), adenoviruses (<5%; types 1, 2, 5, & 6 are endemic, types 4, 7, 14 & 21 cause epidemics, whereas type 3 is both), and metapneumoviruses. Other systemic viral infections can present with similar upper respiratory tract symptoms, but these are usually followed by other, more characteristic, symptoms. These include measles, or rubeola, (Morbillivirus, Paramyxoviridae), rubella (Rubivirus, Togaviridae) and mumps (Rubulavirus, Paramyxoviridae). Rhinoviruses: • Picornaviridae • (+) ssRNA • NAKED icosahedral capsid • 30 nm • >100 serotypes in 3 groups based on receptor specificity • Seasonality: Mostly early fall and late spring (but rhinoviruses still account for half of the colds during the SUMMER…) • Narrow host range (primates) Enteroviruses: • Picornaviridae • (+) ssRNA • NAKED icosahedral capsid • 27 nm to 30 nm • Tens of numbered serotypes • Seasonality: Mostly SUMMER and early fall • Fairly wide host range depending on serotype (mice, primates)Rate this question:
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- 4.
A 4-year-old girl presents to the emergency department accompanied by her mother. It is summer, and the child is sneezing and coughing and has a runny nose, sore throat, and a fever of 39.4C. What are the characteristics of the most likely etiology?
- A.
Enveloped, (+) ssRNA
- B.
Enveloped, (-) ssRNA
- C.
Naked, (+) ssRNA,; Naked, DNA
- D.
Naked, (-) ssRNA; Naked, DNA
- E.
Enveloped, DNA
Correct Answer
C. Naked, (+) ssRNA,; Naked, DNAExplanation
Rhinoviruses:
• Picornaviridae
• (+) ssRNA
• NAKED icosahedral capsid
• 30 nm
• >100 serotypes in 3 groups based on receptor specificity
• Seasonality: Mostly early fall and late spring (but rhinoviruses still account for half of the colds during the ******SUMMER ******)
• Narrow host range (primates)
Enteroviruses:
• Picornaviridae
• (+) ssRNA
• NAKED icosahedral capsid
• 27 nm to 30 nm
• Tens of numbered serotypes
• Seasonality: Mostly SUMMER and early fallRate this question:
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- 5.
A 4-year-old girl presents to the emergency department accompanied by her mother. It is summer, and the child is sneezing and coughing and has a runny nose, sore throat, and a fever of 39.4C. To which family does that (these) virus(es) belong to?
- A.
Adenoviridae; Picornaviridae
- B.
Orthomyxoviridae; Paramyxoviridae
- C.
Paramyxoviridae; Picornaviridae
- D.
Coronaviridae; Paramyxoviridae
Correct Answer
A. Adenoviridae; PicornaviridaeExplanation
Rhinoviruses:
• Picornaviridae
• (+) ssRNA
• NAKED icosahedral capsid
• 30 nm
• >100 serotypes in 3 groups based on receptor specificity
• Seasonality: Mostly early fall and late spring (but rhinoviruses still account for half of the colds during the SUMMER…)
• Narrow host range (primates)
Enteroviruses:
• Picornaviridae
• (+) ssRNA
• NAKED icosahedral capsid
• 27 nm to 30 nm
• Tens of numbered serotypes
• Seasonality: Mostly SUMMER and early fall
• Fairly wide host range depending on serotype (mice, primates)
Adenoviruses, often associated with pharyngitis, are naked dsDNA viruses of the Adenoviridae family;
Adenoviruses (types 1, 2, 3, 4, 5, 6, 7, 14 & 21):
• Adenoviridae
• Linear dsDNA
• NAKED icosahedral capsid
• 65 nm to 80 nm
• 49 serotypes
• NO SEASONALITY
• Wide host specificityRate this question:
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- 6.
A 3-year-old boy presents in late summer with a sore throat, poor appetite and a low-grade fever, followed by the appearance of painful vesicular lesions that ulcerate in the pharynx and the insides of the cheeks, and a non-itchy rash localized around the mouth, the palms of the hands and the margins of the heels. What is the most likely etiological agent responsible for this child’s disease?
- A.
Enterovirus 71
- B.
Adenovirus 3
- C.
Coxsackievirus A16
- D.
Coronavirus 229E
- E.
Rhinovirus 49
Correct Answer
C. Coxsackievirus A16Explanation
VIRAL PHARYNGITIS SYNDROME
Etiology
Pharyngitis is often associated with the common cold and flu (influenza) and, consequently, many of the viruses that cause common colds and the flu also can cause pharyngitis. These include rhinoviruses, adenoviruses (types 3, 4, 7, 14 & 21; types 3 & 7 are associated with bilateral conjunctivitis),
enteroviruses [COXSACKIEVIRUS A (types 2, 4, 5, 6, 8 & 10)
and echoviruses], influenzaviruses A and B, human parainfluenzaviruses (HPIV-1, HPIV-2 & HPIV-3), coronaviruses, and RSV. Other viruses associated with pharyngitis include Epstein-Barr virus (Human herpesvirus 4 or EBV), human cytomegalovirus (Human herpesvirus 5 or CMV), herpes simplex viruses (Human herpesvirus 1 & Human herpesvirus 2 or HSV-1 & HSV-2 respectively), and Human immunodeficiency virus 1 (HIV-1).
Symptoms associated with specific viral etiologies:
• Exudate (adenoviruses 3 & 7, HSV & EBV)
• Conjunctivitis (influenzaviruses A & B & adenoviruses 3 & 7)
• Influenza A and B pharyngitis is associated with the flu syndrome
• Vesicular lesions and ulcers [COXSACKIEVIRUSES (enteroviruses) cause HERPANGINA & HAND-&-FOOT-&-MOUTH DISEASE
& echoviruses (enteroviruses) also cause herpangina. HSV pharyngitis is also associated with vesicular lesions & ulcers]Rate this question:
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- 7.
Comfortably sitting in your office in Cleveland, Ohio, you read, in the latest issue of the Morbidity and Mortality Weekly Report, of an H9N2 influenza A outbreak affecting humans in China. What is the most likely time frame until the appearance of this virus in your community?
- A.
1 week
- B.
1 month
- C.
3 months
- D.
6 months
- E.
Unknown, if it ever appears
Correct Answer
E. Unknown, if it ever appearsExplanation
The most likely time frame until the appearance of the H9N2 influenza A virus in the person's community is unknown, as stated in the answer. It is not possible to determine when or if the virus will reach their community based on the given information.Rate this question:
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- 8.
A 1-year-old child is brought to the emergency department by his parents. The parents explain that their child had a cold with a cough and a runny nose, but realized that things took a turn for the worse when he started wheezing. Worried, they presented to the ED with their child. Physical examination further revealed air trapping, nasal flaring, hypoxia, and subcostal retraction. What is the most likely syndrome?
- A.
A cold
- B.
Bronchitis
- C.
Bronchiolitis
- D.
Croup
- E.
Pneumonia
Correct Answer
C. BronchiolitisExplanation
BRONCHIOLITIS
Etiology
RESPIRATORY SYNCYTIAL VIRUS (RSV) is the main virus responsible for bronchiolitis.
Other viruses associated with bronchiolitis are human metapneumoviruses, HPIVs (especially HPIV-3), influenzaviruses A and B, mumps virus, adenoviruses (types 3, 7 & 21), and rhinoviruses.
Incidence
11% (Rate this question:
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- 9.
A 1-year-old child is brought to the emergency department by his parents. The parents explain that their child had a cold with a cough and a runny nose, but realized that things took a turn for the worse when he started wheezing. Worried, they presented to the ED with their child. Physical examination further revealed air trapping, nasal flaring, hypoxia, and subcostal retraction. What is the most likely etiology?
- A.
Influenza A virus
- B.
Parainfluenza-2 virus (PIV-2)
- C.
A rhinovirus
- D.
Measles virus
- E.
Respiratory Syncytial Virus (RSV)
Correct Answer
E. Respiratory Syncytial Virus (RSV)Explanation
(scroll to bottom)
BRONCHIOLITIS
Etiology
RESPIRATORY SYNCYTIAL VIRUS (RSV) is the main virus responsible for bronchiolitis.
Other viruses associated with bronchiolitis are human metapneumoviruses, HPIVs (especially HPIV-3), influenzaviruses A and B, mumps virus, adenoviruses (types 3, 7 & 21), and rhinoviruses.
Incidence
11% (Rate this question:
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- 10.
A 1-year-old child is brought to the emergency department by his parents. The parents explain that their child had a cold with a cough and a runny nose, but realized that things took a turn for the worse when he started wheezing. Worried, they presented to the ED with their child. Physical examination further revealed air trapping, nasal flaring, hypoxia, and subcostal retraction. What are the characteristics of this virus?
- A.
Enveloped, (+) ssRNA
- B.
Enveloped, (-) ssRNA
- C.
Naked, (+) ssRNA
- D.
Naked, (-) ssRNA
- E.
Enveloped, DNA
- F.
Naked, DNA
Correct Answer
B. Enveloped, (-) ssRNAExplanation
Respiratory Syncytial Virus (RSV):
• Paramyxoviridae
• (-) ssRNA
• Enveloped pleomorphic
• 100 nm to 350 nm
• 2 subgroups (A and B) based on the G surface glycoprotein
• Seasonality: Mid-winter to early spring
• Wide host specificity (humans and non-primates)Rate this question:
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- 11.
A 15-month-old girl presents in early fall with a fever, hoarseness, a barking cough and inspiratory stridor. What is the most likely causative agent?
- A.
Coronavirus
- B.
Human parainfluenza virus
- C.
Rhinovirus
- D.
Influenzavirus
- E.
Mycoplasma pneumoniae
Correct Answer
B. Human parainfluenza virusExplanation
CROUP (ACUTE LARYNGOTRACHEOBRONCHITIS)
Etiology
Acute laryngotracheobronchitis, or CROUP, IS MOSTLY CAUSED BY HUMAN PARAINFLUENZA VIRUSES (3 CASES OUT OF 4).
HPIV-1, HPIV-2 and HPIV-3 are the most common culprits (mostly HPIV-1 & HPIV-3; children between 1 & 5 yoa), but other viruses are associated with acute croup: These include influenza A and B viruses (mostly influenza A; children >5 yoa), RSV (in children 5 yoa).
Incidence
10 to 20% of lower respiratory tract diseases of children
Epidemiology
• Croup is almost exclusively an illness of young children (Rate this question:
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- 12.
A 15-month-old girl presents in early fall with a fever, hoarseness, a barking cough and inspiratory stridor What description best applies to the etiological agent most likely responsible for this disease? (from question above)
- A.
Enveloped, segmented, (-) ssRNA
- B.
Enveloped, segmented, (+) ssRNA
- C.
Enveloped, (-) ssRNA
- D.
Enveloped, (+) ssRNA
- E.
Naked, dsDNA
- F.
Aerobic bacterium lacking a cell wall
Correct Answer
C. Enveloped, (-) ssRNAExplanation
Parainfluenzaviruses:
• Paramyxoviridae
• (-) ssRNA
• Enveloped pleomorphic
• 150 nm to 200 nm
• Four types HPIV-1 to HPIV-4; no clinically relevant antigenic strains
• Seasonality: Early fall of even-numbered years until 1970 (HPIV-1), early fall of odd-numbered years since 1973 (HPIV-1 and HPIV-2), and late winter-early spring (HPIV-3)
• Narrow host range (humans), although human counterparts infect other mammals (rodents, cattle, sheep, dogs)Rate this question:
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- 13.
A 15-month-old girl presents in early fall with a fever, hoarseness, a barking cough and inspiratory stridor. What syndrome is above patient suffering from?
- A.
Common cold
- B.
Bronchiolitis
- C.
Croup
- D.
Flu
- E.
Laryngitis
Correct Answer
C. CroupExplanation
CROUP (ACUTE LARYNGOTRACHEOBRONCHITIS)
Etiology
Acute laryngotracheobronchitis, or croup, is mostly caused by human parainfluenza viruses (3 cases out of 4). HPIV-1, HPIV-2 and HPIV-3 are the most common culprits (mostly HPIV-1 & HPIV-3; children between 1 & 5 yoa), but other viruses are associated with acute croup: These include influenza A and B viruses (mostly influenza A; children >5 yoa), RSV (in children 5 yoa).
Incidence
10 to 20% of lower respiratory tract diseases of children
Epidemiology
• Croup is almost exclusively an illness of young children (Rate this question:
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- 14.
What is the pathophysiologic mechanism responsible for the inspiratory stridor?
- A.
Obstruction of the bronchioles due to inflammation and mucus secretion along the bronchiolar epithelium
- B.
Non-specific release of inflammatory mediators with stimulation of cholinergic pathways in the nasal mucosa
- C.
Destruction and inflammation of the respiratory epithelium, as well as mucus secretion, especially around the subglottic area
- D.
Epithelial cell destruction by the virus and inflammation of the trachea
- E.
Virus-induced apoptosis of alveolar macrophages
Correct Answer
C. Destruction and inflammation of the respiratory epithelium, as well as mucus secretion, especially around the subglottic areaExplanation
Pathogenesis
Most of the symptoms are the result of inflammation and seem proportional to viral replication (in the case of HPIVs at least) in both the upper and lower respiratory tract (respiratory epithelium). Viral infection is initiated in the upper respiratory tract, with inflammation of the nasal passages and nasopharynx, and then moves to the lower respiratory tract. STRIDOR, HOARSENESS AND COUGH RESULT FROM THE INFLAMMATION OF THE LARYNX AND TRACHEA, ESPECIALLY AT THE SUBGLOTTIC LEVEL.Rate this question:
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- 15.
What is the pathophysiologic mechanism responsible for the symptoms of bronchitis?
- A.
Obstruction of the bronchioles due to inflammation and mucus secretion along the bronchiolar epithelium
- B.
Non-specific release of inflammatory mediators with stimulation of cholinergic pathways in the nasal mucosa
- C.
Destruction and inflammation of the respiratory epithelium, as well as mucus secretion, especially around the subglottic area
- D.
Intra-alveolar and intra-bronchiolar hemorrhage, as well as interstitial edema and hemorrhage due to inflammation
- E.
Necrosis and denudation of ciliated epithelial cells of the bronchi, with inflammation, cellular infiltration, edema and mucus secretion
Correct Answer
E. Necrosis and denudation of ciliated epithelial cells of the bronchi, with inflammation, cellular infiltration, edema and mucus secretionExplanation
infection initiates in the respiratory tract mucosa. Viral replication progresses along the respiratory epithelium, leading to a loss and desquamation of respiratory epithelial cells, associated with inflammatory cell infiltration. Direct cytopathic effects are believed to be responsible for most of the pathological changes, but inflammation is also involved
Pathogenesis --CROUP (ACUTE LARYNGOTRACHEOBRONCHITIS)
Most of the symptoms are the result of inflammation and seem proportional to viral replication (in the case of HPIVs at least) in both the upper and lower respiratory tract (respiratory epithelium). Viral infection is initiated in the upper respiratory tract, with inflammation of the nasal passages and nasopharynx, and then moves to the lower respiratory tract. Stridor, hoarseness and cough result from the inflammation of the larynx and trachea, especially at the subglottic level.Rate this question:
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.JPG "A 3-year-old boy presents in late summer with a sore throat, poor appetite and a low-grade fever, followed by the appearance of painful vesicular lesions that ulcerate in the pharynx and the insides of the cheeks, and a non-itchy rash localized around the mouth, the palms of the hands and the margins of the heels.
What is the most likely etiological agent responsible for this child’s disease?")
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