Virology USMLE Step 1 Practice Question
A 28-year-old man bitten on the hand by a stray bat while camping does not seek immediate medical care. Three weeks later, he presents with fever (38.5°C), anxiety, hydrophobia, and pharyngeal spasms. Vital signs show HR 110/min, RR 22/min, BP 128/82 mmHg. CSF analysis reveals lymphocytic pleocytosis with normal glucose. He denies recent travel outside the region. Which of the following best describes how the virus reached the central nervous system?
Answer choices
- ASpread through infected CD4 T lymphocytes
- BTransplacental spread through syncytiotrophoblasts
- CDirect extension through the cribriform plate
- DRetrograde axonal transport from the peripheral inoculation siteCorrect answer
- EHematogenous spread inside neutrophils
- FTranscytosis across the blood-brain barrier via infected endothelial cells
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