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Herpes Simplex (w1) Flashcards

1
Q

Macule

A
  1. Flat
  2. circumscribed
  3. discolored area
  4. less than 1 cm
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2
Q

Patch

A
  1. Flat
  2. Circumscribed
  3. discolored area
  4. more than 1 cm
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3
Q

lesions that are raised from surface

A
  1. papule

2. plaque

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4
Q

Papule

A
  1. raised from surface
  2. circumscribed
  3. flat top
  4. less than 1 cm
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5
Q

Plaque

A
  1. raised from surface
  2. circumscribed
  3. flat top
  4. more than 1 cm
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6
Q

Lesions that contain fluid

A
  1. vesicle

2. bulla

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7
Q

What kind of fluids lesions contain

A

Fluid
Blood
Pus (pustule either small or large)

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8
Q

Why is the extraoral papule brown and what is the white coloration

A

Brown- melanin

White- keratin

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9
Q

What does rupture of vesicle or bulla lead to

A

Ulcer or erosion

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10
Q

What determines if the rupture of a vesicle/bulla is an ulcer or an erosion

A

According to depth

Ulcer: complete loss of epithelium (l7ad abl el ct)

Erosion: partial loss of epithelium

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11
Q

Why do we call an ulcer secondary

A

Because it happened after rupture of vesicle/bulla

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12
Q

Which lesions are mass of tissue

A

Nodule

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13
Q

What is an intraepithelial vesicle

A

Erosion

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14
Q

What is a subepithelial vesicle

A

Ulcer

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15
Q

What is the classification of ulcers

A

Primary and secondary

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16
Q

Primary and recurrent herpes simplex types

A 
Type 1 (above waist)
Type 2 (below waist)
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17
Q

List secondary vesiculobullous infective disease

A
  1. Primary & recurrent herpes simplex lesions
  2. Herpes zoster & chickenpox
  3. Hand - foot & mouth disease
  4. Herpangina
18
Q

Herpes viruses

A
  1. Herpes simplex type 1 & 2
  2. Human herpes 6
  3. Cytomegalovirus
  4. Varicella zoster virus
  5. Epstein barr virus
19
Q

What does herpes simplex type 1 cause

A
  1. Oral & pharyngeal inflammations
  2. Meningeo-encephalitis
  3. Dermatitis
    Above the waist
20
Q

What does herpes simplex type 2 cause

A
  1. Genital infection
  2. Dermatitis
    Below the waist
21
Q

Primary infections are …..

A

Subclinical

22
Q

What form does a recurrent infection take?

A
  1. Herpes labialis (cold sores or herpes blisters)

2. Recurrent intraoral herpes

23
Q

Transmission of herpes is through…

A

Close contact

24
Q

Most commonly affected are…

A

Children from 2 to 10 years

Immunocompromised adults

25
Q

Who’s not expected to get a primary infection and why

A

Infants below 6 months

Because they have maternal antibodies (IgG)

26
Q

What are the clinical features of herpes simplex

A
  1. Prodrome
  2. Early lesions
  3. Gingivostomatitis
  4. Excessive salivation
  5. Self limiting
27
Q

Prodrome

A

Manifestations that appear before the oral vesicles by 1 or 2 days

28
Q

What is the prodrome of herpes simplex

A

Headache, fever
Nausea, vomiting
Malaise, lymphadenitits

Fever and malaise may be severe especially in adults

29
Q

Early lesions

A
  1. Dome shaped
  2. 2-3 mm in size
  3. On hard palate & dorsum of tongue
  4. Painful
  5. They rupture and leave circular, sharply defined, shallow ulcers
    Yellowish/ greyish floors
    Red margins
30
Q

Gingival margins in herpes simplex

A

Swollen and red especially in children

31
Q

How long do they take to be treated

A

They resolve on their own within 7-10 days (self limiting)

32
Q

What is the pathology of herpes simplex type 1?

A
  1. Intraepithelial vesicles
  2. Ballooning degeneration
  3. Multinucleated cells
  4. Lipschutz bidies (intranuclear inclusion bodies)
33
Q

What are the steps of diagnosis

A

History
Clinical picture
Lab test

34
Q

What is the history of herpes simplex

A
  1. Prodrome 1-2 days before lesion
  2. -ve history of recurrent herpes labialis
  3. +ve history of being in contact with patient with recurrent lesion
35
Q

What are the required lab investigations of herpes simplex

A

Smear showing virus or damaged cells
Raising titre of antibodies reaching peak after 2-3 weeks
(Provides absolute but retrospective confirmation of diagnosis)

36
Q

How is herpes simplex treated

A

Supportive measures

Acyclovir

37
Q

What are the supporting measures taken to help herpes regress

A
  1. Bed rest
  2. Antipyretic
  3. Non irritating diet
  4. Fluids for hydration and electrolyte balance
  5. No aspirin for childern
38
Q

When is acyclovir taken

A

Lethal herpetic encephalitis

Disseminated infection

39
Q

What does acyclovir do?

A

Inhibits DNA replication of herpes

40
Q

Acyclovir dose

A

200 mg, 5 times per day (5 days) - adults

100 mg, 5 times per day (5 days) - children

Oral Medicine (3 decks)

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