Herpes Simplex Virus (HSV) Flashcards
HSV causes these two kinds of herpes:
1
2
1 Cold Sores
2 Genital herpes
HSV-1 primarily causes:
Cold sores and Genital herpes
HSV-2 primarily causes:
Genital herpes
HSV is transferred by direct contact with _________ or mucosal surface
broken skin
True or False: HSV infections spread to sexual partners unknowingly
True, its called asymptomatic viral shedding
3 Stages of HSV
1
2
3
Primary Infection: FIRST EPISODE, with no antibodies for HSV present. Longer duration and more severe signs and symptoms
Non-primary infection: First episode in a patient who has antibodies for one type of HSV and acquires the other type. Less severe, shorter duration
Recurrent episode: Latent HSV reactivated, typically less severe than the other two. Prodrome symptoms: tingling, itching, pain prior to symptoms
Prodromal symptoms associated with a recurrent HSV episode include the following:
_____, ______, pain
tingling, itching
Risk factors for HSV include:
1. physical contact with someone shedding the virus
2.
3.
- # of sexual partner
- Female
This type of Herpes can cause neurological effects
Herpes Encephalitis
It takes __ to___ weeks for cold sores (herpes labialis) to fully resolve
1-2 weeks
True or False: There is no cure to treatment to eradicate herpes virus
True
A recurrent cold sore infection lasts about ___ to ___ days
8-10 days
List some non-drug options to help treat cold sores
1
2
3
1 clean area with mild soap and water
2 cool compress
3 sunscreen
Topical protectants to prevent from drying and cracking, avoid touching area, frequently wash hands
List some non prescription options to help treat cold sores:
Duration modifying
1.
Pain releif/protectants
1. Acetaminophen/nsaid
2. Benzocaine, Lidocaine/Prilocaine
can cause sensitization = pain worse after stopping
3. camphor menthol (feel good)
4. pramoxine (dec pain and less sensitization)
5. zinc sulfate/heparin sodium (helps with dryness)
- Abreva, docosanol
Patients that require referral for cold sore include the following:
1.
2 recurrent, persistent cold sores >/= ___ per year
3.
4. 5. secondary bacterial infection
- immunocompromised
- systemic symptoms
- lasts longer than 2 weeks
Systemic antivirals for the treatment of cold sores are most beneficial if started <___ hrs after symptom onset
24 hr
The three systemic antivirals for the treatment of recurrent cold sores are:
1
2
3
Acyclovir 400 mg 5x/day x 5-10d
Famiciclovir 750 mg BID or 1500 mg once
Valacyclovir 2g BID x 1 day
If oral treatment is refused, this topical antiviral can be used for five times per day for 4 days
Acyclovir 5% cream/ointment
True or False: Genital herpes increases the risk of contracting HIV
True
True or False: The rate of recurrence in genital herpes decreases with increasing age
True
Genital herpes of primary infection lesions heal in __ - __ weeks, with viral shedding lasting about 12 days
2-4 weeks
Signs of primary infection genital herpes includes:
1
2
3
4 lymphadenopathy (swollen glands)
5 fever, myalgia, malaise
1 painful lesions
2 local itching, tingling, pain
3 dysuria
True or false: Recurrent genital herpes infections are generally milder and have a LONGER duration than primary
FALSE, shorter duration
If the patient has > __ recurrences of genital herpes per year, then suppressive therapy should be considered
6
Lesions of recurrent genital herpes usually heal in __ to __ days
7-10
True or False: all patients with genital herpes should be treated with an antiviral
True
For patients with recurrent genital herpes:
Acyclovir should start within __ hrs of symptoms
Famiciclovir should start within __ hrs of symptoms
Valacyclovir should start within __ hrs of symptoms
12
6
12
Genital herpes in HIV infected/immunosuppressed patients should be treated for a longer course, consider IV ________
Acyclovir
HSV can be transferred to the neonate, suppressive antiviral management is recommended at ____ weeks
36
Acyclovir or Valacyclovir can be used
HSV encephalitis should be treated with IV ______
Acyclovir ONLY
