Herpes

Question 1

How many types of human herpesvirus are there?

Answer 1

8
Herpes Simplex Virus 1 (HSV1)
Herpes Simplex Virus 2 (HSV2)
Varicella Zoster Virus (VZV)
Epstein-Barr Virus (EBV)
Cytomegalovirus (CMV)
Human herpes virus type 6 (HHV6)
Human herpes virus type 7 (HHV7)
Human herpes virus type 8 (HHV8)

Question 2

Does herpes virus have latency?

Answer 2

Yes

Question 3

What is the primary site of HSV 1 infection?

Answer 3

Lips (80%)

Question 4

What is the primary site of HSV 2 infection?

Answer 4

Genitalia (80%)

Question 5

What are some of the pathologies associated with the herpes simplex virus?

Answer 5

• Vesicular eruption
• Encephalitis

Early inlusion:
- Cowdry type A inclusion body

Question 6

Where does HSV 1 persists lifelong (latent state)?

Answer 6

Trigeminal ganglia

Question 7

Name 3 infections caused by HSV1

Answer 7

1. Acute herpetic gingivostomatitis (esp in young children)
2. Herpes Labialis (cold sore)
3. Keratoconjunctivitis
4. Herpetic whitlow

Question 8

What is the commonest recurrent disease from reactivation of HSV in trigeminal ganglion?

Answer 8

Herpes Labialis (affect lips)

Question 9

What is the commonest primary disease of HSV1?

Answer 9

Acute herpetic gingivostomatitis

Question 10

How is Acute herpetic gingivostomatitis spread?

Answer 10

Kissing

Question 11

Characteristics of Acute herpetic gingivostomatitis

Answer 11

• Vessicals on buccal mucosa
• Gums ulcerate with grey slough
• fever

Question 12

What test can be done to diagnose acute necrotizing encephalitis?

Answer 12

PCR for HSV
CSF for lymphocytosis

Question 13

What infections does HSV 2 cause?

Answer 13

1. Herpes progenitalis
2. Neonatal herpes

Question 14

Where does HSV 2 latency stays in the body?

Answer 14

Lumbar and sacral ganglion

(think of lower body)

Question 15

What is a common STI caused by HSV 2?

Answer 15

Herpes progenitalis

Question 16

How is neonatal herpes transmitted?

Answer 16

From birth canal of mother

Question 17

How can neonatal herpes be prevented?

Answer 17

Offer caesarian delivery

Question 18

What is used to treat HSV and given as prohphylaxis in immunocompromised patients?

Answer 18

Acyclovir

Question 19

2 ways HSV is transmitted

Answer 19

Sexually and perinatally

Question 20

What is the virus that cause chickenpox?

Answer 20

(Varicella) Zoster Virus

Question 21

What is the virus that cause shingles?

Answer 21

Varicella (Zoster) Virus

Question 22

What is the incubation period of Varicella

Answer 22

2 to 3 weeks

Question 23

Symptoms of varicella

Answer 23

• Fever
• Crops of vesicles in waves more on trunk than limbs

(more severe in adult than children)

Question 24

Complications of Varicella

Answer 24

• Skin superinfection (staphylococci or streptococci)
• pneumonia

Question 25

Can varicella be pass form mother to neonate?

Answer 25

Yes, transplacental infection in early pregnancy. (RARE: Congenital Varicella)

Question 26

Does previous infection with varicella confers life-long immunity to zoster?

Answer 26

No

Question 27

What is given as prophylaxis in exposed high risk patients for varicella?

Answer 27

Varicella Zoster Immune globulin (VZIG)

Question 28

Characteristics of Zoster

Answer 28

Belt of roses Vesicles are more evenly distributed as it corresponds to one or more sensory root ganglia

Question 29

Treatment for Zoster

Answer 29

IV Acyclovir

Question 30

How to prevent zoster?

Answer 30

Herpes Zoster vaccine (Shingrix)

Question 31

Diagnosis of VZV

Answer 31

- Microscopy / Nucleic Acid Amplification Test - Serology - Culture

Question 32

Is Cytomegalovirus CMV a congenital infection?

Answer 32

Yes, fetal may be infected following maternal viraemia in any trimester of pregnancy

Question 33

What is CMV called when it becomes severe?

Answer 33

Cytomegalic inclusion disease

Question 34

One characteristics of Cytomegalic Inclusion disease

Answer 34

Enlarged cells with large intranuclear **"owl's eye"** inclusions

Question 35

How to diagnose CMV?

Answer 35

NAAT Blood smear

Question 36

How to treat CMV?

Answer 36

**Gangiclovir** CMVIG prophylaxis to organ recipients receiving from infected donors

Question 37

Where does EBV replicate?

Answer 37

B lymphocytes causing B cells proliferation

Question 38

What is EBV associated with?

Answer 38

EBV is a **oncovirus** and most common cause for infectious mononucleosis. May cause cancers like: - Burkitt Lymphoma - Nasopharyngeal carcinoma

Question 39

How to diagnose EBV?

Answer 39

- Blood smear - NAAT