herpes

Question 1

herpes reactivation stimuli

Answer 1

fever
menstruation
sunlight 
stress
may be clinically asymptomatic or induce life threatening disease

Question 2

chicken pox development

Answer 2

fever 1-2 days before rash, lasts 4-5 days, abates once rash completely appears
groups of new lesions appear over 4-7d

Question 3

treatment of varicella/shingles

Answer 3

start within 24-48h of rash
acyclovir PO 800mg 5 times a day for 7d
valacyclovir PO 1g TDS 7d

Question 4

genital herpes diagnosis

Answer 4

patient history
presentation/symptoms
- classical painful multiple vesicular or ulcerative lesions
- local itching, pain, tender inguinal lymphadenopathy
- flu-like symptoms during first few days after appearance of lesions
virologic tests
type-specific serologic tests

Question 5

treatment for 1st episode of genital herpes

Answer 5

acyclovir PO 400mg TDS 7-10d
acyclovir IV 5-10mg/kg Q8h 2-7d complete with PO for total 10d
valacyclovir PO 1g BD for 7-10d

extend treatment if healing incomplete after 10d

Question 6

chronic suppressive therapy for genital herpes

Answer 6

acyclovir PO 400mg BD

valacyclovir PO 500mg OD or 1g OD

Question 7

episodic therapy for genital herpes

Answer 7

acyclovir PO 800mg BD 5d or TDS 2d

valacyclovir PO 500mg BD 3d or 1g OD 5d