Herpes simplex virus (VIRAL) Flashcards
Herpes simplex virus (HSV), known as herpes, is a common infection. How many different types of this infection are there?
1 - 2
2 - 4
3 - 6
4 - 9
1 - 2
- HSV-1 and HSV-2
- dsDNa virus
- part of the herpesviridae family
Is HSV-1 more likely to cause infections and symptoms above or below the waist?
- typically above, but can also cause below the waist as well
Is HSV-2 more likely to cause infections and symptoms above or below the waist?
- typically below, but can also cause above the waist as well
Typically how can HSV spread?
1 - skin to skin contact
2 - oral secretions
3 - genital secretions
4 - all of the above
4 - all of the above
What is the most common way HSV can be contracted?
1 - through food
2 - kissing
3 - skin to skin contact
4 - sex
3 - skin to skin contact
- typically enter through broken skin
Once a patient has been infected, HSV can replicate in epithelial cells, such as in the skin. What cells does it typically then infect?
1 - sensory neurons
2 - respiratory epithelial cells
3 - hair follicles
4 - subcutaneous fat
1 - sensory neurons
- travels to the neuronal cell body
When epithelial cells become infected with HSV, do they initially enter the latent phase or the lytic cycle?
- lytic cycle
- reproduction of viruses using a host cell
Once the HSV, reaches the neuronal cell bodies, does HSV enter the latent phase or the lytic cycle?
- latent phase
- lays dormant waiting for opportunity to re-infect the patient
The 2 most common places HSV infects is the face and the genitals. In the face where are the neuronal cell bodies present that typically become infected by HSV?
1 - olfactory nerve
2 - trigeminal nerve
3 - facial nerve
4 - vagus nerve
2 - trigeminal nerve
- once a patient is infected, they have the HSV here for life
The 2 most common places HSV infects is the face and the genitals. In the genital where are the neuronal cell bodies present that typically become infected by HSV?
1 - lumbar ganglia
2 - sciatic nerve
3 - sacral ganglia
4 - piriformis ganglia
3 - sacral ganglia
- once a patient is infected, they have the HSV here for life
When a patient is infected with HSV, the virus can remain dormant in the trigeminal or sacral ganglia neuronal cell bodies. If the virus becomes active and the trigeminal nerve is affected, do symptoms present on the ipsilateral or contralateral side?
- ipsilateral (same) side
If infected with HSV, is there a limit to how many times the HSV can become active and present with typical HSV lesions?
- no
- can re-occur over and over again in a patients life
- sometimes there are no symptoms
Which of the following are triggers that can lead to re-activation of HSV?
1 - skin irritation
2 - viral infection
3 - stress
4 - all of the above
4 - all of the above
When patients have a re-activation of their HSV, there is said to be a prodrome phase. Which 2 are the tell tail signs of this?
1 - tingling
2 - bleeding gums
3 - epistaxis (nose bleed)
4 - burning sensation
1 - tingling
4 - burning sensation
- typically occur 1-2 days before blisters appear
The primary infection in HSV is typically asymptomatic. However, it can present with skin lesions on all of the following EXCEPT which one?
1 - eyes
2 - gums/palate
3 - tongue
4 - lips
5 - facial area
1 - eyes
- lesions are commonly referred to as cold sores, which are fluid filled and ulcerate and ooze
- typically heal in a few weeks
The primary infection in HSV is typically asymptomatic. However, it can present with skin lesions on the
- gums/palate
- tongue
- lips
- facial area round mouth
Which of these is most common?
- facial area round mouth
- referred to as vermillion border
Does active HSV present more in children or adults?
- adults
In adults and children which of the following can occur in patients with active HSV?
1 - severe gingivostomatitis
2 - cold sores
3 - painful genital ulceration
4 - pharyngitis
5 - all of the above
5 - all of the above
In the genitals, active HSV can cause ulcers and pustules (small, pus-filled cutaneous lesion). In men with active HSV, where does the ulcers and pustules present?
1 - scrotum
2 - gland
3 - shaft of penis
4 - urethral opening
3 - shaft of penis
- blisters typically are most common that resolve in around a week
In the genitals, active HSV can cause ulcers and pustules (small, pus-filled cutaneous lesion). In women with active HSV, where does the ulcers and pustules present?
1 - labia minor and majora
2 - mons pubis
3 - cervix
4 - vaginal mucosa
5 - all of the above
5 - all of the above
- blisters typically are most common that resolve in around a week
Oral and genital areas are the most common locations that are infected by HSV. However, other parts can also be affected. What is the term used to describe if the finger has been exposed to an open blister and become infected?
1 - herpes gladiatorum
2 - herpetic whitlow
3 - eczema herpeticum
4 - keratoconjunctivitis
2 - herpetic whitlow
Oral and genital areas are the most common locations that are infected by HSV. However, other parts can also be affected. What is the term used to describe when large parts of the body have been exposed to open blisters?
1 - herpes gladiatorum
2 - herpetic whitlow
3 - eczema herpeticum
4 - keratoconjunctivitis
1 - herpes gladiatorum
- common in wrestlers due to the skin to skin contact
Oral and genital areas are the most common locations that are infected by HSV. However, other parts can also be affected. What is the term used to describe when parts of the body that are affected by skin conditions like atopic dermatitis called?
1 - herpes gladiatorum
2 - herpetic whitlow
3 - eczema herpeticum
4 - keratoconjunctivitis
3 - eczema herpeticum
- can worse eczema and cause herpes like presentation
- often treated with IV Aciclovir
Oral and genital areas are the most common locations that are infected by HSV. However, other parts can also be affected. What is the term used to describe when the eye is affected by HSV?
1 - herpes gladiatorum
2 - herpetic whitlow
3 - eczema herpeticum
4 - keratoconjunctivitis
4 - keratoconjunctivitis
- eye inflammation involving both the conjunctiva and the superficial cornea
Causes:
- pain and redness
- tearing
- photosensitivity
- blurred vision
- dendritic lesion
In pregnant women with active HSV, elective caesarean is advised when patient are past which week of gestation?
1 - >21 weeks
2 - >28 weeks
3 - >34 weeks
4 - >41 weeks
2 - >28 weeks
- women <28 weeks with recurrent herpes should be treated with suppressive therapy and be advised that the risk of transmission to their baby is low
Although rare HSV can infect the CNS. Which 2 common conditions has HSV been shown to cause if the CNS is affected?
1 - meningitis
2 - encephalitis
3 - multiple sclerosis
4 - epilepsy
1 - meningitis
2 - encephalitis
- HSV is most common cause of encephalitis
- specifically affects the temporal part of the brain
Although rare HSV can infect the CNS and cause meningitis and encephalitis. What is the best method to diagnose this?
1 - blood sample
2 - urinalysis
3 - lumbar puncture
4 - MRI
3 - lumbar puncture
Could show:
- high RBCs
- high WBCs
- high protein
Are immunocomprimisewd patients at a greater risk of HSV re-activation than normal people?
- yes
- lots more lesions as well
HSV can typically be diagnosed clinically, however, which of the following tests can also be useful?
1 - PCR for viral DNA
2 - positive viral antibodies
3 - culture growth for virus
4 - all of the above
4 - all of the above
Do all patients presenting with HSV symptoms need to be treated pharmacologically?
- no
- often resolves without treatment
In patients with more severe HSV symptoms, which of the following is typically prescribed?
1 - Aciclovir
2 - Amoxicillin
3 - Flucloxacillin
4 - Vancomycin
1 - Aciclovir
- all others are antibiotics, so useless on HSV
- aciclovir can be given orally to treat oral and genital HSV. Chlorhexidine mouthwash may be useful for oral as well
- topical aciclovir can be used on cold sores
