7.

A newly diagnosed HIV-infected male is being evaluated prior to

being placed on antiretroviral therapy.
What technique is used to determine the number of CD4+ cells in
his peripheral blood?
(A) Direct fl uorescent antibody test
(B) Enzyme-linked immunoassay
(C) Flow cytometry
(D) Immunoprecipitation
(E) Quantitative polymerase chain reaction

11. HIV can infect any cell expressing the appropriate

coreceptors but a productive infection occurs only in activated
cells. What is the most likely reason for this observation?
(A) Activated cells decrease their cell surface expression of the
coreceptors, so budding virions can easily escape to infect new host
cells
(B) Activated cells do not have the capacity to induce the antiviral
state
(C) Resting cells have sensitive TLR molecules which bind HIV RNA
molecules and activate the antiviral state, resulting in degradation
of the integrated HIV DNA
(D) Activated cells express transcription factors and polymerases
required for transcription of HIV genes
(E) Resting cells are resistant to HIV attachment and penetration due
to low expression of the HIV coreceptors

14 The CTL response to HIV infection is quite robust; however, these activated
CD8+ T cells have little
impact on viral clearance or inhibition of AIDS progression.
Which one of the following offers an explanation for this observation?
(A) HIV can directly infect CTL causing their lysis upon viral replication
(B) HIV infection of CTL results in insertion of viral DNA into areas of the host
genome critical for
cell function, thus, infected CTL are functionally impaired
(C) HIV peptides generated in infected cells do not fi t into the grooves of the host
cell class II MHC
molecules, thereby, inhibiting CTL recognition and killing
(D) HIV peptides have alterations which do notpermit efficient CTL TCR interactions
(E) HIV reverse transcriptase is highly efficient (not error prone) and thus protein
mutation is a rare
event

An HIV-infected man with a CD4 cell count of 400/cmm

develops a painful, vesicular rash as seen in the
accompanying photograph. What does this skin rash indicate
about his immune system?
(A) He can no longer produce anti-HIV antibodies
(B) His B cells can no longer control the agent causing the skin
infection
(C) His CD4 cells cannot activate CD8 cells
(D) His CD4 to CD8 ratio is increased
(E) His complement C5 to C9 is depleted

A 17-year-old girl presents with fever, stiff neck,

malaise, inguinal lymphadenopathy, vaginal discharge,
and vesicular lesions on her external genitalia.
A direct fl uorescent antibody stain of the genital
lesions showed nuclear fl uorescence. She admits to
being sexually active but has never had symptoms like
these before. How are recurrences of the infection in the
above
question best prevented?
(A) Antiviral medication
(B) A strong antiviral cell mediated immune response
(C) High levels of -interferon
(D) High titers of antiviral IgG
(E) Highly active natural killer cells

79 A 22-year-old woman is diagnosed with condyloma

acuminatum and treated with imiquimode. What is the
mechanism of action of this drug?
(A) Activates macrophages
(B) Acts as nucleoside analog to block DNA synthesis
(C) Induces secretion of interferon-
(D) Inhibits cyclooxygenases
(E) Inhibits neovascularization