Chapter 165 - Varicella and Herpes Zoster

Question 1

Lesions in varicella are usually present at all stages at the same time.
True or False

Answer 1

True

Question 2

Important manifestation of herpes zoster

Answer 2

Pain

Question 3

The most common debilitating complication

Answer 3

Chronic neuropathic pain/ postherpetic neuralgia

Question 4

In temperate climates, 90% of cases occurred in children ___

Answer 4

X<10 years old

Question 5

The risk of hospitalization and death in infants and children was much higher than in adults.
True or False

Answer 5

False, infants and adults mortality is higher

Question 6

In temperate climates, the mean age of varicella is higher and susceptibility among adults is significantly greater than in tropical climates.
True or False

Answer 6

False, in tropical climates

Question 7

The decline in varicella-related morbidity is greatest among children aged ___, who were targeted for vaccination

Answer 7

1-4 years old

Question 8

A typical patient is infectious for ___ before the exanthem appears, and for ___ therafter

Answer 8

1-2 days

4-5 days

Question 9

Type of varicella which occurs early in infancy in presence of maternal antibody or following postexposure prophylaxis with varicella zoster immune globulin or varicella vaccine

Answer 9

Modified varicella

Question 10

Occurs when vaccinated individuals are reinfected ff exposure to wildtype VZV

Answer 10

Breakthrough varicella

Question 11

Major risk factors for herpes zoster (2)

Answer 11

Age

Decrease VZV- specific cell-mediated immunity

Question 12

Clinically significant pain or discomfort persisting for >/= ___ days after rash onset

Answer 12

30

Question 13

Second episode of herpes zoster almost always involve a ___ dermatome as involved in the first episode

Answer 13

Different

Question 14

Patients with varicella are more contagious than patients with herpes zoster.
True or False

Answer 14

True

Question 15

Characteristic feature of varicella

Answer 15

Rapid progression

Question 16

2-3 mm superficial vesicle, elliptical, long axis // to skin folds, surrounded by irregular erythema

Answer 16

Dewdrop on a rose petal

Question 17

Most distressing symptom of varicella

Answer 17

Pruritus

Question 18

Distinctive feature of varicella

Answer 18

Simultaneous presence

Question 19

Breakthrough varicella is predominantly maculopapular and more contagious and more severe than in natural varicella.
True or False

Answer 19

False, less severe, less contagious

Question 20

The most common complication of varicella

Answer 20

Secondary bacterial infection

Question 21

Major severe complication of varicella in adults

Answer 21

Varicella pneumonia

Question 22

The overall risk of congenital varicella syndrome is highest when maternal varicella occurs between ___ weeks

Answer 22

13-20

Question 23

Use of salicylates is contraindicated in children with fever as they may develop

Answer 23

Varicella-associated Reye syndrome

Question 24

Most common neurologic complication of varicella

Answer 24

Acute cerebellar ataxia

Question 25

Acute segmental neuralgia without ever developing a cutaneous eruption

Answer 25

Zoster sine herpete

Question 26

Most distinctive feature of herpes zoster

Answer 26

Localization and distribution of rash

Question 27

If only supratrochlear and supraorbital branches of trigeminal nerve are involved, the eyes are uninvolved.
True or False

Answer 27

True

Question 28

Involvement of the tip and sides of nose by VZV with direct access to intraocular structures leading to

Answer 28

Hutchinson sign

Question 29

Facial palsy in combination with herpes zoster of ear with or without tinnitus, vertigo, and deafness

Answer 29

Ramsay Hunt syndrome

Question 30

Cardinal symptom of herpes zoster

Answer 30

Pain

Question 31

Prominent and distressing symptom of herpes zoster

Answer 31

Itching

Question 32

PHN can be delayed up to 6 months.

True or False

Answer 32

True