Herpes - MedEd

Question 1

How many human herpes viruses are there?

Answer 1

8

Question 2

List the names of all 8 HHV

Answer 2

1 - HSV 1 
2 - HSV 2
3 - Varicella zoster 
4 - EBV
5 - CMV 
6 + 7 - HHV 6+7
8 - HHV8 (kaposi)

How hens vary every chosen Haribo has (baffled me like) kaposi

Question 3

Is HSV DNA or RNA

Answer 3

DNA virus

Question 4

Presentation of HSV 1

Answer 4

Gingivostomatitis 
Temporal lobe encephalitis
Herpes labialis (on lips)
Keratoconjunctivitis 
Herpetic whitlow
Eczema herpeticum

Question 5

What is the name for vesicles of herpes on fingers?

Answer 5

Herpetic whitlow

Question 6

What is the name for herpes cold sores on the mouth?

Answer 6

Herpes labialis (on lips)

Question 7

Presentation of HSV 2

Answer 7

Painful vesicular lesions on genitals
Discharge
Urethral discharge
Dysuria (painful urination)
Fever and malaise

Question 8

Is HSV2 acute or chronic?

Answer 8

Chronic

Question 9

What are the two phases of HSV

Answer 9

Latent and lytic phase

Question 10

Where does the HSV rest during latent phase?

Answer 10

Latent phase - dormant phase where HSV travels to trigeminal root ganglia or sacral root ganglia

Question 11

What happens during the lytic phase of HSV and what triggers this?

Answer 11

Virus travels back to skin and replicates, triggered by stress or immunocompromise

Question 12

Treatment of HSV

Answer 12

Topical, oral or IV acyclovir

Question 13

When is VSZ contagious?

Answer 13

48 hr before vesicles

Until vesicles have crusted over (1 wk)

Question 14

How long does shingles take to improve?

Answer 14

2 w

Question 15

What precedes the dermatomal rash in shingles?

Answer 15

Tingling

Question 16

Treatment for chicken pox in children

Answer 16

Calamine lotion
Analgesia
Antihistamines

Question 17

Treatment for chicken pox in adults

Answer 17

Aciclovir if within 24 hr of rash

Question 18

Treatment for shingles

Answer 18

Valaciclovir or famciclovir

Aciclovir if within 72hr of appearance of rash for 7 days

Question 19

Who is eligible for the varicella vaccine?

Answer 19

Immunosuppressed patients

Pregnant women

Question 20

Shingles epidemiology

Answer 20

Over 50s if stressed and immunocompromised

Question 21

What do you call the pain in shingles?

Answer 21

Postherpetic neuralgia

Question 22

Presentation of infectious mononucleosis

Answer 22

Pharyngitis
Lymphadenopathy of posterior cervical nodes 
Splenomegaly and jaundice
Fever
Atypical lymphocytes

Question 23

Epidemiology of EBV

Answer 23

Affects most people

Spready by saliva/resp droplets

Question 24

Which cells does EBV affect?

Answer 24

B lymphocytes - in cooperates viral DNA into host DNA

Question 25

Investigations for EBV

Answer 25

Atypical lymphocytosis Heterophile antibodies - monospot test (but not specific) EBV specific antibodies (more specific) Real time PCR for EBV DNA detection

Question 26

Management of EBV

Answer 26

Paracetamol/ibuprofen | Steroids if severe

Question 27

What do you NOT give in EBV and why?

Answer 27

Amoxicillin, or ampicillin as it causes a widespread maculopapular rash

Question 28

What counts as 'severe' EBV?

Answer 28

Haemolytic anaemia Severe tonsillar swelling Obstructive pharyngitis

Question 29

What are the two types of EBV antigens?

Answer 29

EBV Viral capsid antigen | EB nuclear antigen

Question 30

Outline the order of antibody production for EBV

Answer 30

EBV Viral capsid IgM (acute infection) EBV VC IgG (past infection or infection that's been there for a while) EBNA IgG (past infection)

Question 31

Compare EBV with strep pyogenes

Answer 31

No splenomegaly in strep pyogenes | Anterior cervical chain lymphadenopathy in strep pyogenes whereas posterior in EBV

Question 32

How does karposi's sarcoma present?

Answer 32

Purple rash

Question 33

Which lung infection can people with AIDS get?

Answer 33

Pneumocystis pneumonia

Question 34

Ring enhancing lesions on CT head - what's the organism?

Answer 34

Toxoplasma gondii

Question 35

Bacterial vs viral tonsillitis

Answer 35

Bacterial - symptoms more severe

Question 36

Most common cause of sneezing and runny nose

Answer 36

Rhinoviruses