Clinical Correlation

Question 1

Herpes Zoster

Answer 1

shingles

Question 2

Where does the varicella virus establish permanent latent infection?

Answer 2

dorsal root and cranial nerve ganglia

Question 3

What does Herpes Zoster outbreak cause?

Answer 3

vesicular rash in a dermatome region

Question 4

what is the risk of someone who already has varicella of getting HZ?

Answer 4

30%

Question 5

How many ganglia does the HZ infection hit?

Answer 5

NORMALLY one, sometimes more than one

Question 6

Prodrome of HZ

Answer 6

HA, photophobia, malaise, fever, abnormal skin sensations and pain (tingling)

Question 7

HZ rash

Answer 7

unilateral
only hits one side of the body
1-3 adjacent dermatome

Question 8

What dermatome is most common for HZ

Answer 8

thoracic, cranial, ophthalmic involvement

Question 9

What is the time that is critical to get help within for HZ

Answer 9

72 hours

Question 10

how long does it take for HZ to resolve?

Answer 10

2-4 weeks

Question 11

zoster sine herpetes

Answer 11

rash never forms

rare

Question 12

complications of HZ

Answer 12

PHN

Question 13

PHN

Answer 13

complication of HZ
pain for weeks/months/years
chance increases after age 50

Question 14

Herpes Zosters Ophthalmicus

Answer 14

• 15% of cases
• rash or vesicle on tip of nose means GREAT chance of hitting eye
• trigeminal area
• if untreated, 50-70% develop acute ocular complications

Question 15

Transmission of herpes zoster

Answer 15

from persons with zoster to persons with no history of varicella disease or fax and cause varicella

Question 16

pancoast tumors

Answer 16

located on apex of lungs

Question 17

How do pancoast tumors affect the eye?

Answer 17

• pinches superior cervical ganglion

- dilator papillae (sympathetic) does not get innervated and cannot dilate pupil

Question 18

Horner’s syndrome

Answer 18

causes unilateral miosis. can be associated with lid ptosis and facial hypohidrosis