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From Flashcardlet > Cornea: 4b. Viral Infections > Flashcards

Cornea: 4b. Viral Infections Flashcards

0
Q

linear double-stranded DNA

A

describe the genome of the herpesviridae

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1
Q

10 minutes

A

tonometer tips exposed to adenovirus need to be submerged in dilute bleach for this period of time

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2
Q

icosahedral protein capsid, protein tegument, envelope with viral glycoproteins

A

describe the three layers of the herpesviridae covering

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3
Q

33%

A

percentage of humans that suffer from recurrent herpes infections

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4
Q

40-80%

A

percentage range of people in industrialized countries with antibodies to herpesviridae

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5
Q

true

A

TRUE OR FALSE: Herpes is most commonly transmitted by asymptomatic shedders

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6
Q

0.15%

A

percentage of the US population with a history of external ocular HSV infection

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7
Q

follicular blepharoconjunctivitis with vesicles, ulcers, and lymphadenopathy

A

describe primary ocular HSV infection

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8
Q

false

A

TRUE or FALSE: epithelial keratitis, stromal keratitis, and uveitis are never seen in primary herpes ocular infection

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9
Q

8id x 10 days

A

describe the dosing of trifluridine 1% (Viroptic)

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10
Q

5id until epithelium heals, then tid x 7 days

A

describe the dosing of ganciclovir 0.15% ung (Zirgan)

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11
Q

false

A

TRUE or FALSE: Herpes blepharoconjunctivitis in the absence of epithelial keratitis is specific to primary ocular infection

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12
Q

iridocyclitis

A

this manifestation of herpetic reactivation is usually seen when the virus establishes latency in the ciliary ganglion or superior cervical ganglion

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13
Q

focal SPK

A

initial sign of herpes keratitis

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14
Q

glycoproteins

A

loss of these allows rose bengal to stain corneal epithelial cells in HSK (hint: herpes needs to get rid of these before it can establish its own)

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15
Q

VZV, adenovirus, EBV, Acanthamoeba

A

name four infectious agents that can produce dendritiform epithelial lesions similar to herpes simplex

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16
Q

2 weeks

A

topical antivirals should NOT be continued beyond this period of time

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17
Q

immunocompromised, HUS/TTP

A

Valacyclovir (Valtrex) should not be used in THESE patients due to risk of causing THIS

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18
Q

HSV stromal keratitis

A

the most common cause of infectious corneal blindness in the US

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19
Q

interstitial, disciform

A

two forms of nonnecrotizing stromal keratitis due to HSV

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20
Q

herpetic interstitial keratitis

A

this form of herpes infection is often difficult to distinguish from an old scar in the absence of cornea edema or conjunctival injection

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21
Q

Cogan syndrome

A

the only major noninfectious item on the differential for herpetic interstitial keratitis

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22
Q

interstitial

A

Which of the forms of herpetic stromal keratitis truly involves only one layer of the cornea

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23
Q

true

A

TRUE or FALSE: Disciform keratitis due to HSV versus VZV is indistinguishable

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24
Q

herpetic disciform keratitis

A

which form of herpetic stromal keratitis does NOT involve the stroma primarily and in fact involves all three corneal layers

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25
Q

necrotizing herpetic stromal keratitis

A

form of herpes infection that is most difficult to distinguish from bacterial infection

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26
Q

herpetic stromal keratitis

A

The HEDS trial primarily shed light on treatment for this condition

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27
Q

nonnecrotizing herpetic stromal keratitis

A

In the HEDS trial, the addition of oral acyclovir to topical steroids and Viroptic in the treatment of this condition showed no benefit in shortening disease duration or lowering risk of recurrence

28
Q

PF 1% Q2H, Viroptic qid

A

initial treatment strategy of visually significant herpetic interstitial keratitis

29
Q

acyclovir 400 mg bid, valacyclovir 500 mg qd

A

two po alternatives to provide antiviral cover when treating herpetic interstitial keratitis

30
Q

disciform, necrotizing

A

two forms of herpetic keratitis for which Viroptic is a poor choice (for different reasons)

31
Q

false

A

TRUE or FALSE: Necrotizing herpetic stromal keratitis tends to be relatively resistant to topical steroids and typically requires high doses

32
Q

necrotizing herpetic stromal keratitis

A

granulomatous or nongranulomatous iridocyclitis may commonly accompany this form of herpetic keratitis

33
Q

acyclovir 400 mg 5id

A

In addition to topical steroids, the HEDS trial showed a trend towards statistical significance in the treatment of herpetic iridocyclitis with this strategy

34
Q

herpetic disciform keratitis

A

form of HSV disease that is most likely to result in persistent bullous keratopathy

35
Q

80%

A

success rate of optical PK approaches this in eyes without active herpetic inflammation for the prior 6 months

36
Q

tectonic PK

A

surgical intervention that may be indicated in impending or frank perforation secondary to herpetic disease (usually necrotizing or neurotrophic ulceration)

37
Q

20%

A

incidence of VZV reactivation over a lifetime

38
Q

15%

A

percentage of zoster cases represented by HZO

39
Q

vesicular dermatoblepharitis

A

usual pattern of HZO without ocular infection

40
Q

T3 to L3

A

most common thoracic dermatomes affected in zoster

41
Q

patchy

A

pattern of iris atrophy in herpes simplex

42
Q

sectoral

A

pattern of iris atrophy in herpes zoster

43
Q

70%

A

incidence of ocular involvement in patients with HZO

44
Q

false

A

TRUE or FALSE: HZO is rarely bilateral

45
Q

VZV

A

HSV or VZV: associated with episcleritis and scleritis

46
Q

HSV

A

HSV or VZV: prominent central ulceration in keratitis

47
Q

nummular

A

only form of keratitis said to be specific to VZV

48
Q

VZV

A

In which group does neurotrophic keratitis tend to be more problematic, HSV or VZV?

49
Q

33%

A

Cranial nerve palsies occur in up to this percentage of cases of HZO

50
Q

25%

A

Upper limit of incidence of systemic zoster in patients who are immunosuppressed

51
Q

72 hours

A

oral antiviral therapy needs to be started before this time period passes to limit the incidence and duration of postherpetic neuralgia in HZO

52
Q

50 years

A

the herpes zoster vaccination is available to immunocompetent adults aver this age

53
Q

7-10 days

A

duration of PO antiviral therapy in HZO

54
Q

1 g tid

A

dose of valacyclovir (Valtrex) in HZO

55
Q

500 mg tid

A

dose of famciclovir (Famvir) in HZO

56
Q

800 mg 5id

A

dose of acyclovir (Zovirax) in HZO

57
Q

10 mg/kg IV Q8H

A

treatment and dose of therapy for HZO in immunosuppressed patients

58
Q

epithelial keratitis

A

only indication for topical antivirals in HZO

59
Q

EBV

A

most common cause of acute dacryoadenitis

60
Q

EKC

A

type 1 EBV stromal keratitis most resembles this

61
Q

type 2

A

which type of EBV stromal keratitis is described here: multifocal, blotchy, pleomorphic infiltrates with active inflammation or granular ring-shaped opacities in anterior to midstream

62
Q

syphilitic interstitial keratitis

A

type 3 EBV stromal keratitis most resembles this

63
Q

EBNA

A

serological scar in EBV infection

64
Q

topical steroids

A

treatment for EBV stromal keratitis

65
Q

myeloid progenitor cells

A

where does CMV establish latency?

66
Q

CMV

A

apart from lack of sectoral or patchy atrophy anterior uveitis due to this virus may appear identical to VZV or HSV (including uveitic ocular hypertension)

67
Q

valganciclovir 900 mg bid

A

treatment of CMV anterior uveitis

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