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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}} {{Alison}}
|QuestionAuthor={{YD}} (Reviewed by {{YD}} and {{AJL}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Microbiology
|MainCategory=Microbiology
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|MainCategory=Microbiology
|MainCategory=Microbiology
|SubCategory=Genitourinary
|SubCategory=Genitourinary
|MainCategory=Microbiology
|MainCategory=Microbiology
|MainCategory=Microbiology
|MainCategory=Microbiology
|MainCategory=Microbiology
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|MainCategory=Microbiology
|MainCategory=Microbiology
|SubCategory=Genitourinary
|SubCategory=Genitourinary
|Prompt=A 60-year-old female presents to the physician’s office with post-coital bleeding. Upon appropriate work-up, the patient's pathology findings are illustrated below. You explain to the patient that her condition is most likely a sexually transmitted virus. Which of the following characteristics best describes the virus implicated in this patient's pathology?
|Prompt=A 60-year-old woman presents to the physician’s office with post-coital bleeding. A cervical smear is performed, and the patient's pathological findings are shown in the image below. The physician then explains to the patient that her condition is most likely caused by a sexually transmitted virus. Which of the following characteristics best describes the virus responsible for this patient's condition?<br>
 
[[Image:ThinPrep Pap smear HPV.jpeg|350px]]
|Explanation=The patient presents with an abnormal pap-smear that displays the presence of [[koilocytes]], abnormal cells infected by the [[human papilloma virus]] ([[HPV]]).  The image illustrated above depicts a normal cervical cell on the left, and a [[koilocyte]] on the right side, which contains a characteristic large nuclei with a [[perinuclear halo]].
 
HPV is a [[sexually transmitted infection]] (STI).  The virus is a double-stranded, non-envolved DNA virus.  Among the most significant HPV types are HPV type 16, 18, 31, 33, and 45, which predispose to [[cervical cancer]], and 6, 11, 42, 43, and 44 which frequently result in [[genital warts]].
 
|EducationalObjectives= [[Koilocyte]]s, with characteristic enlarged nuclei with perinuclear halos, are cells infected with HPV.  HPV is a sexually transmitted virus manifesting in over 100 forms, some of which predispose to cervical cancer and others to genital warts.
|References= First Aid 2014 page 158


[[Image:ThinPrep Pap smear HPV.jpeg|500px]]
|Explanation=The patient presents with an abnormal pap-smear that displays the presence of [[koilocytes]], which are abnormal cells infected by the [[human papilloma virus]] ([[HPV]]). The image illustrated above depicts a normal cervical cell on the left, and a [[koilocyte]] on the right. Characteristically, koilocytes contain large nuclei with a [[perinuclear halo]]. HPV is a sexually transmitted, double-stranded, non-enveloped DNA virus. Among the most significant HPV types are HPV types 16, 18, 31, 33, and 45, which predispose to the development of [[cervical cancer]]. In contrast, HPV types 6, 11, 42, 43, and 44 frequently result in [[genital warts]] and HPV types 1 and 4 are associated with development of skin warts.
|AnswerA=Double-stranded, non-enveloped DNA virus
|AnswerA=Double-stranded, non-enveloped DNA virus
|AnswerAExp=The human papilloma virus (HPV) is a double-stranded, non-enveloped DNA virus.
|AnswerAExp=The human papilloma virus (HPV) is a double-stranded, non-enveloped DNA virus.
|AnswerB=Double-stranded, enveloped DNA virus  
|AnswerB=Double-stranded, enveloped DNA virus
|AnswerBExp=HPV is a non-enveloped virus.
|AnswerBExp=Herpesviruses, adenoviruses, and poxviruses are double-stranded, enveloped DNA viruses.
|AnswerC=Single-stranded, non-enveloped DNA virus
|AnswerC=Single-stranded, non-enveloped DNA virus
|AnswerCExp=HPV is a double-stranded virus.
|AnswerCExp=Parvoviruses are single-stranded, non-enveloped DNA viruses.
|AnswerD=Single-stranded, enveloped RNA virus.
|AnswerD=Single-stranded, enveloped RNA virus.
|AnswerDExp=HPV is a double-stranded, non-enveloped DNA virus.
|AnswerDExp=flaviviruses, togaviruses, retroviruses, coronaviruses, orthomyxoviruses, paramyxoviruses, rhabdoviruses, filoviruses, arenaviruses, bunyaviruses, and delta virus are all examples of single-stranded, enveloped RNA viruses.
|AnswerE=Double-stranded, non-enveloped RNA virus
|AnswerE=Double-stranded, non-enveloped RNA virus
|AnswerEExp=HPV is a DNA virus.
|AnswerEExp=Reoviruses are double-stranded, non-enveloped RNA viruses.
|EducationalObjectives=[[Koilocyte]]s, with characteristic enlarged nuclei with perinuclear halos, are cells infected with HPV.  HPV is a sexually transmitted virus manifesting in over 100 forms, some of which predispose to cervical cancer and others to genital warts.
|References=First Aid 2014 page 158
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=double stranded, DNA, non-enveloped, HPV, human papilloma virus, genital warts, cervical cancer, sexually transmitted, gentiles
|WBRKeyword=Koilocytes, Pap smear, Papsmear, Cervical smear, DNA virus, HPV, Papilloma virus, Papillomavirus
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 22:53, 21 October 2014
Author [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D. and Alison Leibowitz [1])]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::Genitourinary
Prompt [[Prompt::A 60-year-old woman presents to the physician’s office with post-coital bleeding. A cervical smear is performed, and the patient's pathological findings are shown in the image below. The physician then explains to the patient that her condition is most likely caused by a sexually transmitted virus. Which of the following characteristics best describes the virus responsible for this patient's condition?

]]

Answer A AnswerA::Double-stranded, non-enveloped DNA virus
Answer A Explanation AnswerAExp::The human papilloma virus (HPV) is a double-stranded, non-enveloped DNA virus.
Answer B AnswerB::Double-stranded, enveloped DNA virus
Answer B Explanation AnswerBExp::Herpesviruses, adenoviruses, and poxviruses are double-stranded, enveloped DNA viruses.
Answer C AnswerC::Single-stranded, non-enveloped DNA virus
Answer C Explanation AnswerCExp::Parvoviruses are single-stranded, non-enveloped DNA viruses.
Answer D AnswerD::Single-stranded, enveloped RNA virus.
Answer D Explanation AnswerDExp::flaviviruses, togaviruses, retroviruses, coronaviruses, orthomyxoviruses, paramyxoviruses, rhabdoviruses, filoviruses, arenaviruses, bunyaviruses, and delta virus are all examples of single-stranded, enveloped RNA viruses.
Answer E AnswerE::Double-stranded, non-enveloped RNA virus
Answer E Explanation AnswerEExp::Reoviruses are double-stranded, non-enveloped RNA viruses.
Right Answer RightAnswer::A
Explanation [[Explanation::The patient presents with an abnormal pap-smear that displays the presence of koilocytes, which are abnormal cells infected by the human papilloma virus (HPV). The image illustrated above depicts a normal cervical cell on the left, and a koilocyte on the right. Characteristically, koilocytes contain large nuclei with a perinuclear halo. HPV is a sexually transmitted, double-stranded, non-enveloped DNA virus. Among the most significant HPV types are HPV types 16, 18, 31, 33, and 45, which predispose to the development of cervical cancer. In contrast, HPV types 6, 11, 42, 43, and 44 frequently result in genital warts and HPV types 1 and 4 are associated with development of skin warts.

Educational Objective: Koilocytes, with characteristic enlarged nuclei with perinuclear halos, are cells infected with HPV. HPV is a sexually transmitted virus manifesting in over 100 forms, some of which predispose to cervical cancer and others to genital warts.
References: First Aid 2014 page 158]]

Approved Approved::Yes
Keyword WBRKeyword::Koilocytes, WBRKeyword::Pap smear, WBRKeyword::Papsmear, WBRKeyword::Cervical smear, WBRKeyword::DNA virus, WBRKeyword::HPV, WBRKeyword::Papilloma virus, WBRKeyword::Papillomavirus
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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