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Oral Path Exam 2 > 7: Viral Infections > Flashcards

7: Viral Infections Flashcards

1
Q

What are six members of the herpetoviridae family?

A

HSV-1, HSV-2, Varicella Zoster (HSV-3), EBV (HSV-4), CMV, Kaposi Sarcoma

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2
Q

Which is oral herpes? Genital?

A

HSV-1; HSV-2

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3
Q

T/F. Most of those with primary herpetic gingivostomatitis show signs.

A

F. Only ~12% are symptomatic

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4
Q

Other than the oral lesions, what are five other signs of primary herpetic gingivostomatitis?

A

Fever (103-105F), nausea, anorexia, irritability, cervical lymphadenopathy

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5
Q

What are two ways HSV-1 is spread?

A

Infected saliva or active perioral lesions

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6
Q

When is the only time HSV-1 presents on the lips and gums?

A

Primary infection

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7
Q

What is the only thing that has been proven to induce herpetic lesions after infection?

A

UV light

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8
Q

What are six general things that can reactivate HSV-1?

A

UV light, emotional stress, trauma, respiratory illness, systemic disease, malignancy

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9
Q

What is the primary HSV-1 infection age range?

A

Young (6mo-5yr) with the highest incidence in 2-3 year olds due to day care

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10
Q

What are four characteristics of the mouth lesions in primary HSV-1 infection?

A

Distinctive punched-out erosions, enlarged gingival, erythematous, can be anywhere in the mouth (almost always on lip)

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11
Q

Where does secondary HSV-1 infection most commonly present and what is it called?

A

Vermillion border and adjacent skin of lips; herpes labials (aka cold sore/fever blister)

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12
Q

What are four herpes labials symptoms?

A

Pain, burning, itching, local warmth

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13
Q

What is the herpes labialis course?

A

6-24 hrs: Prodromal stage
2+ Days: Vesicles rupture and crust
7-10 days: healing

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14
Q

What pathology may have cases that are preceded by a symptomatic recurrence of HSV?

A

Erythema multiforme (3-10 days earlier)

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15
Q

What are three characteristics of HSV-1 and 2 histology?

A

Ballooning degeneration, Tzanck cells, multinucleate giant cells

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16
Q

What are three topical anti-virals for HSV-1? Three systemic?

A

1: Acyclovir, docosonal, penciclovir

2. Acyclovir (200mg), Famciclovir (125mg), Valcyclovir (500mg)

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17
Q

What is the holistic approach for HSV-1 tx?

A

L-lysine 500mg

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18
Q

T/F. You can only give treatment during prodromal stage.

A

T. If given during vesicle rupture, you are too late and anti-virals will not help healing.

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19
Q

When is HSV-2 most dangerous?

A

During the delivery of a baby

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20
Q

Why do women have more risks of getting an STD?

A

Anatomy

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21
Q

When is the primary infection of chicken pox? Its other name? Adult reactivation’s name?

A

5-9yo, Varicella Zoster (HSV-3); shingles

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22
Q

How long is the incubation period for varicella zoster and where does the rash typically begin?

A

10-21 days; face and trunk

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23
Q

How long is a person contagious with chicken pox?

A

2 days before exanthema and until all the pustules crust

24
Q

What is the classic findings of reactivated loser and in what age?

A

Pt over 60, pain along nerve from back to front, then get lesions that scab in the area that look like shingles

25
Q

Where does Herpes Zoster remain latent (dormant)? HSV-1 dormancy?

A

Dorsal spinal ganglion (transported up sensory nerves); trigeminal nerve

26
Q

What is the histology of HSV-1? Describe

A

Tzanck cells: free floating epithelial cell in any intraepithelial vesicle

27
Q

What is the vaccine for Herpes Zoster? Other tx?

A

Live attenuated varicella zoster virus for adults; capsaicin may provide relief

28
Q

Is Herpes Zoster painful? Unilateral or bilateral?

A

Painful and unilateral

29
Q

Syndrome associated with Herpes Zoster (Shingles) that is a combination of cutaneous lesions of the external auditory canal and involvement of the ipsilateral facial and auditory nerves leading to facial paralysis, hearing defects, vertigo?

A

Ramsay-Hunt Syndrome

30
Q

Symptomatic disease form exposure to Epstein-Barr Virus (HHV-4)

A

Infectious mononucleosis

31
Q

When is Epstein Barr Virus (HHV-4) symptomatic: children or young adults?

A

Young adults; children do not display symptoms

32
Q

Infectious Mononucleosis (Epstein Barr Virus/HHV- 4) symptoms (6)?

A

Fever, Lymphadenopathy, Tonsilitis, Pharyngitis

Hepatosplenomegaly & rash (less frequent)

33
Q

2 tests that confirm Epstein Barr Virus?

A

Paul-Bunnell heterophil antibody & Indirectimmunofluorescent test for EBV-specific
antibodies

34
Q

2 tx’s for Epstein Barr Virus? Prognosis?

A

Non-aspirin antinpyretics and NSAIDS & No contact sports if enlarged spleen; good- will usually resolve itself in 4-6 weeks

35
Q

What virus can reside latently in salivary gland cells, endothelium, macrophages, and lymphocytes? What % of pt have symptoms?

A

CMV (HHV-5); 10%

36
Q

What are 3 Enteroviruses of dental significance?

A

Herpangina, hand-foot-and-mouth disease, Acute Lymphonodular pharyngitis

37
Q

Most well-known enterovirus infection?

A

Hand-foot-and-mouth disease

38
Q

What enterovirus does not have skin lesions but pt may have a sore throat, dysphagia or fever? Why the sore throat?

A

Herpangina; ulcerated lesions occur on posterior oropharnyx

39
Q

What is the course of herpangina?

A

Red macules that ulcerate into 2-4mm ulcer; 2-6 oral lesions of soft palate and tonsillar pillar that heal in 7-10 days

40
Q

How is HFM disease different from herpangina?

A

Will have oral lesions, but HFM will also have skin rash and oral lesions ass’d with flu-like symptoms; also the oral lesions in HFM will be numerous and can be anywhere in the oral cavity

41
Q

In HFM diease, which comes first, the oral lesions or skin lesions?

A

Oral lesions

42
Q

What Enterovirus is characterized by 1-5 yellow to dark pink nodules on the soft palate and tonsillar pillars representing hyperplastic lymphoid tissue?

A

Acute Lymphonodular pharyngitis

43
Q

Does ALP ulcerate?

A

No

44
Q

How do we diagnose enteroviruses?

A

Clinical presentation

45
Q

Treatment of Enteroviruses?

A

Self-limiting, so direct therapy toward symptomatic relief w/ non-aspirin anti-pyretics and topical anesthetics

46
Q

)Infection produced by a paramyxovirus that has largely been controlled with vaccines

A

Measles/rubeola

47
Q

What is the most distinctive oral manifestion of Rubeola/Measels in its initial stage? Define.

A

Koplik’s spots: mucosal erythema w/ numerous small blue-white macules within

48
Q

What are the Pathoneumonic histologic cells for Measels?

A

Warthin Finkeldey Giant Cells

49
Q

This sounds like the virus that causes normal measles, but this is a mild viral illness produced by a Togavirus, and has capacity to cause birth defects

A

Rubella/ German Measles

50
Q

What is the classic triad of congenital rubella syndrome?

A

Deafness, heart disease, and cataracts

51
Q

What virus is spread via respiratory droplets and infectious from 2 days before symptoms until 4 days after appearance of rash?

A

Measles/Rubeola

52
Q

This is a virus also caused by a Paramyxovirus, but this causes a diffuse disease of exocrine glands. Which gland does it most commonly affect?

A

Mumps/endemic parotitis; the Parotic salivary glands being the best known site of involvement

53
Q

What is a clinical symptom of Mumps/Endemic Parotitis?

A

Pain during initial parotid enlargement, then pain w/ chewing and salivation

54
Q

What is the 2nd most common place, beside the Parotid, that can swell due to Mumps/Endemic Parotitis?

A

Testicles (Epididymoorchitis)

55
Q

What are oral infections associated with Human immunodeficiency Virus (HIV)?

A

Candidiasis, HIV ass’dKaposi’sSarcoma, and HIV ass’d Oral Hairy Leukoplakia

56
Q

WhatdoesHIV-associatedKaposi’sSarcoma look like?

A

Multiple lesions of skin and oral mucosa. Brown or reddish purple that do no blanch under pressure

57
Q

What are the common oral areas for HIV associated Kaposi’sSarcoma?

A

Hard palate, gingiva and tongue

Oral Path Exam 2 (8 decks)

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