Herpes Virus

Question 1

Where is viral envelop derived from?

Answer 1

Host cell nuclear membrane

Question 2

Which is tegument?

Answer 2

A structural protein btw envelop and capsid

Question 3

Types of herpes virus?

Answer 3

HSV 1$2
Varicella zoster virus
Epstein Barr virus
Cytomegalovirus 
Human herpes virus 678

Question 4

Class of herpes virus?

Answer 4

Alpha (HSV $ VZV)- sensory ganglia inf
Beta (CMV)- salivary gland $ organ inf
Gamma ( EBV)- B $ T cell inf

Question 5

Types of Herpes simplex virus

Answer 5

Type 1$2

Question 6

HSV 1?

Answer 6

Mouth inf
Spread by direct contact 
Infection above waist
Virus remains latent in ganglia 
Trigeminal nerve- nerve of the face

Question 7

HSV 2?

Answer 7

Genitalia inf
Spread by venereal- sex
Inf below waist
Sacral nerves

Question 8

Envelop of HSV contains?

Answer 8

Glycoproteins B D H

B$D- absorption and penetration into host cell

H- release of the virus

Question 9

Pathogenesis of HSV?

Answer 9

Virus enter through defects skin/ mucous
Multiply locally
Enters the cutenous nerve fibers
Replication in ganglia
Migration to skin/ mucosa. 

Causes cutenous and mucosa lesion.

Question 10

Clinical manifestation of HSV?

Answer 10

Depends on site of inf, age, immune status of host, antigenic type of virus

Question 11

Lesion on buttocks of infant?

Answer 11

( napkin rash)

Question 12

Cutenous inf of HSV looks like?

Answer 12

Thin walled vesicle
A ballooning
Degeneration of intra epithelial cells

The underlying basal layer is usually intact with the vesicle

The base of vesicle contains multi nuclear cells (Tzanck cells) with eosinophillic inclusion bodies

Question 13

The base of the vesicle in HSV contains?

Answer 13

Tzanck cells with eosinophilic inclusion bodies

Question 14

What happens when the vesicle of HSV cutenous lesion breaks down?

Answer 14

Ulcer forms in the mucous $ non-keratinizing epithelia

Question 15

The lesion in fever blister/ herpes fibrils is caused by?

Answer 15

Virus deactivation in febrile ( showing sign of fever) patient

Question 16

Occupational cutenous herpes?

Answer 16

Hermetic whitlow seen in doctors, dentist and nurses

Question 17

Eczema herpeticum (kaposi varicelliform) of cutenous inf of HSV?

Answer 17

Eruption caused by herpes inf in children with eczema

Arises from pre-existing skin disease usually atopic dermatitis

Question 18

Mucosal inf of cutenous inf in HSV?

Answer 18

Buccal mucosa is the most common site
Gangivostomatittis
Pharyngitis - most frequent in primary $ recurrent inf

Question 19

Opthalamic inf of cutenous inf in HSV?

Answer 19

Acute keratoconjuctivitis ( itself or by extension from facial herpes)

Most common cause of corneal blindness

Question 20

Follicular conjunctivitis in Cutenous inf of HSV

Answer 20

Vesicle on eyelids

Cornea may be involved with typical branching dendritic ulcers

Question 21

Nervous system inf of HSV?

Answer 21

HSV encephalitis- acute onset with fever
Focal neurological symptoms

HSV meningitis- self limiting disease usually leave in a week

Rarely transverse myelitis or Gillian barre syndrome

Question 22

What causes sacral autonomic dysfunction

Answer 22

Nervous system inf of HSV

Question 23

What can cause bell’s palsy

Answer 23

HSV ( nervous inf)

Question 24

Visceral inf ofHSV?

Answer 24

HSV esophagitis causes dysphagia, substernal pain, weight loss

Respiratory tract inf causing tracheobronchitis, pneumonitis

Erythema multiforme

Question 25

Genitalia inf of HSV?

Answer 25

Lesion on penis, urethra, cervix, vulva, perineum Primary inf is usually more serious Fever and malaise Vesicular-ulcerated lesion may be painful

Question 26

Congenital inf of HSV

Answer 26

Transplacental inf - congenital malformation If mother has HSV1- fetus multi organ involvement with or without encephalitis Mortality rate is high If mother has HSV 2- post neonatal inf common in eye , mouth and skin Caserian section may prevent inf to the neonate

Question 27

Diagnosis of HSV?

Answer 27

Tzanck cell smear with Toluidine blue o or giemsa stain FAT PCR Isolation from amnion cell, embryonic kidney cell, chick embryo ELISA NEUTRALIZATION TEST COMPLEMENT FIXATION TEST CHEMOTHERAPHY - idoxyuridine ( topical use for skin and eye inf) Acyclovir$ vidarabine- management of deep and systemic inf Acyclovir - to avoid encephalitis Valaciclovir $ famiciclovir are more effective as oral agents