MRCOG I Single best answers: Virolog

1) Hepatitis A virus

A) Is a DNA virus

B) Is associated with chronic liver disease

C) Can be transmitted from mother to fetus during child birth

D) Infection can be prevented using an inactivated virus vaccine

E) Has an incubation period of 3-7 weeks

2) Which virus is typically spread by the feco-oral route?

A) Hepatitis A

B) Hepatitis B

C) Hepatitis C

D) Hepatitis D

E) Herpes simplex type I

3) The Hepatitis B virus

A) Is an RNA virus

B) Has an incubation period of 10-21 days

C) Multiplies in hepatocytes and erythrocytes

D) Infection can be prevented by passive immunisation

E) Vertical transmission is associated with a 10% risk of chronic carriage

4) A 33 year old woman has been infected with hepatitis B

A) The hepatitis B surface antigen is not detectable until jaundice has developed

B) The hepatitis B e antigen is not detectable until jaundice has developed

C) Antibodies to the hepatitis B surface antigen are detectable 1-2 weeks before the onset of jaundice

D) Detection of IgG to the hepatitis B surface antigen 3 years later indicates that the woman is a chronic carrier

E) Detection of hepatitis B surface antigen 12 months later indicates that the woman is a chronic carrier

5) A 34 year old doctor had been vaccinated against hepatitis B. Testing during pregnancy would show

A) Positive IgG to hepatitis B surface antigen

B) Positive IgM to hepatitis B surface antigen

C) Positive hepatitis B surface antigen

D) Positive hepatitis B e antigen

E) Negative hepatitis B surface antigen and negative IgG to hepatitis B surface antigen

6-10) Five pregnant women (A, B, C, D, E) have been screened for hepatitis B during pregnancy. The results are shown in the table . The hepatitis B status of these women are:

A) Previously vaccinated

B) Previous infection with immunity

C) Chronic carrier

D) Acute infection

E) Susceptible

6) Patient A 

7) Patient B 

8) Patient C 

9) Patient D 

10) Patient E 

11) A 24 year old woman has been referred to the antenatal clinic at 16 weeks gestation. She is known to be HBs antigen positive and anti-HBs IgG negative

A) She has previously been vaccinated against hepatitis B

B) Fetal blood sampling should be avoided during labour

C) Caesarean section should be recommended

D) The woman should be vaccinated against hepatitis B after delivery

E) Hepatitis B viral load should be monitored during pregnancy

12) Which statement regarding the hepatitis C virus is not true?

A) RNA virus

B) Spread by feco-oral route

C) Associated with hepatocellular carcinoma

D) Associated with chronic liver disease

E) No treatment is currently available

12) The hepatitis D virus

A) Is a DNA virus

B) Is spread by the feco-oral route

C) Is not associated with chronic liver disease

D) Has an incubation period of 10-21 days

E) Can be transmitted from mother to fetus

13) A 17 year old woman attends the antenatal clinic at 20 weeks gestation. She has a history of genital herpes

A) The virus is an RNA virus

B) There is an increased risk of congenital anomalies

C) The virus has an incubation period of 10-21 days

D) Herpetic lesions may be present on her cervix

E) In the absence of vesicles or a prodrom, there is no risk to the neonate following vaginal birth

14) A 21 year old woman is thought to have primary genital herpes at 6 weeks gestation. The diagnosis should be confirmed using

A) Clinical history and examination

B) Viral culture

C) PCR

D) Serology

E) Electron microscopy

Options for questions 15-16

A) Hepatitis B

B) Herpes simplex

C) Varicella zoster

D) Human papilloma virus

E) Parvovirus B 19

15) Terratogenic virus

16) Virus typically associated with fetal hydrops

17) Chicken pox

A) Is caused by an RNA virus

B) Has an incubation period of 5-10 days

C) Is no longer contagious once the rash appears

D) Is more severe in pregnant compared to non-pregnant women

E) In pregnancy is not associated with congenital anomalies

18) With respect to varicella zoster infection in pregnancy

A) Infection cannot be contracted following contact with shingles

B) 15% of pregnant women in the UK are immune

C) Neonatal disease is unlikely if the mother develops symptoms 4 days after giving birth

D) Infection can be treated with acyclovir

E) Passive immunisation results in life-long immunity

19) A healthy 32 year old woman phones the maternity assessment unit because her 5 year old son has developed chickenpox and the woman is 16 weeks pregnant

A) She should be reassured

B) She should be reassured if she has had chickenpox in the past

C) She should be reassured and tested for immunity if she has had chickenpox in the past

D) She should be treated with immune globulin

E) She should be treated with acyclovir

20) Which statement regarding cytomegalovirus is not true?

A) Is a DNA virus

B) Infection in pregnancy causes congenital anomalies

C) Recurrent infection does not cause congenital anomalies

D) Is a sexually transmitted infection

E) Virus is excreted in urine of infected neonates

21) Human papilloma virus

A) Is a DNA virus

B) Is terratogenic

C) Infection in pregnancy is treated with ganciclovir

D) Primary infection at term is an indication for caesarean section

E) Infection always results in a chronic carrier state

22) A doctor has suffered a needle-stick injury during caesarean section and the patient is known to be HIV positive. The risk of the doctor becoming infected is

A) < 1%

B) 2-5%

C) 5-10%

D) 10-15%

E) 15-20%

23) The risk of HIV infection following a single episode of unprotected intercourse with an HIV positive partner is

A) < 1%

B) 2-5%

C) 5-10%

D) 10-15%

E) 15-20%

24) With respect to screening for HIV infection in pregnancy in the UK, which statement is not true?

A) HIV testing is offered to all pregnant women routinely

B) If a woman declines HIV testing, this should be documented in her antenatal notes

C) The HIV test results of HIV positive women should not be documented in their hand-held notes

D) HIV tests detect both the HIV antibody and the p24 HIV antigen

E) HIV test can be undertaken using buccal swab

25) With respect to HIV infection in pregnancy

A) There is a 3-6 months window between HIV infection and the development of HIV antibodies

B) Women booking after 28 weeks should not be offered HIV testing

C) Women presenting in labour with unknown HIV status should not be offered HIV testing

D) There is an increased risk of congenital anomalies with HIV infection in the first trimester

E) There is an increased risk of congenital anomalies with use of anti-retroviral drugs in the first trimester

26) The risk of vertical transmission of HIV in untreated non-breastfeeding women in Europe is

A) 1-2%

B) 5-10%

C) 15-20%

D) 20-25%

E) 30-35%

27) Vertical transmission of HIV infection mostly occurs

A) In the first trimester

B) In the second trimester

C) In the third trimester

D) During labour and delivery

E) In the neonatal period through breastfeeding

28) The risk of vertical transmission of HIV infection in adequately treated women in Europe is

A) < 2%

B) 2-5%

C) 5-7%

D) 7-10%

E) 10-15%

29) In HIV positive women treated with highly active anti-retroviral therapy, vaginal birth may be offered if the viral load is

A) < 5 copies /ml

B) < 50 copies / ml

C) < 100 copies / ml

D) < 200 copies / ml

E) < 300 copies / ml

30) In HIV positive women treated with highly active anti-retroviral therapy, which one is not associated with an increased risk of vertical transmission?

A) High viral load

B) Birth before 32 weeks gestation

C) Birth after 39 weeks gestation

D) Short duration of anti-retroviral therapy

E) Advanced maternal HIV disease