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446- ID and transplant > HSV 1 and 2 > Flashcards

HSV 1 and 2 Flashcards

1
Q

HSV 1 is predominantly associated with

A

oral lesions

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2
Q

HSV 2 is predominantly associated with

A

genital lesions

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3
Q

transmission of HSV requires _________ and can happen when ____________

A

close contact
active outbreak or asymtpomatic

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4
Q

HSV is transmitted through inoculation of the virus onto ______

A

susceptible mucosal surface

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5
Q

HSV 1 is transmitted through

A

oral-to-oral contact (virus in saliva, sores, and surfaces in and around the mouth)

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6
Q

HSV 2 is transmitted via

A

sexual activity (oral-genital, genital-genital)

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7
Q

T or F: mother can transmit HSV to infant

A

T

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8
Q

cold sores are contagious from ______________ and are most contagious when _________

A

prodrome until lesion completely healed
blister bursts or leaks fluid

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9
Q

T or F: <50% of genital herpes are transmitted asymptomatically

A

F- up to 70% transmitted by asymp viral shedding

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10
Q

T or F: Asymptomatic shedding occurs in almost all patients with HSV-2

A

T

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11
Q

in initial infection with HSV, it replicates in cells of the _____ and infects ________

A

epithelium
nerve endings

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12
Q

HSV 1 stays in the _____ ganglia and HSV 2 in ______ ganglia

A

trigeminal
sacral

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13
Q

in HSV recurrence, viral replication is ________________, and spreads to mucosal surfaces through ________

A

reactivated in ganglion
peripheral sensory nerves

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14
Q

list 3 factors that may trigger HSV 1 recurrence

A

psychological stress, fatigue, viral illness (ex-cold/ influenza), exposure to UV light, local skin trauma, dental tx, menstruation, immune suppression

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15
Q

list 3 factors that may trigger HSV 2 recurrence

A

psychological stress, menstruation, local friction, surgery, immune suppression

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16
Q

most Gingivostomatitis infections are

A

subclinical

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17
Q

in first cases of HSV1, if you have sx, they are often

A

worse- multiple painful vesicles/ blisters and ulcerative erosions involving lips, oral cavity, pharynx, and perioral skin

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18
Q

healing from primary HSV1 takes

A

days to 2-3wks

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19
Q

first episode of HSV 1 is ______ severe than HSV 2

A

less severe

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20
Q

incubation of first episode genital herpes is ____ while lesions last _____

A

6d
11-12d

21
Q

sx of 1st episode genital herpes

A

severe burning pain, itching, dysuria, vaginal or urethral discharge

22
Q

describe the sx felt in prodromal epriod

A

tingling, discomfort, burning, itching 2-24hrs before appearance of the vesicle in location of the eruption

23
Q

which type of HSV have higher % recurrence? HSV 1 or 2

A

2- 90% with sx primary HSV 2 can experience reactivation

24
Q

recurrence of HSV 2 is often __ severe and ___ duration compared to primary episode

A

less severe, shorter duration

25
Q

prodrome for HSV 1 usually ____ before lesions appear

A

2-24h

26
Q

list 3 differential dx for HSV 1

A

Recurrent aphthous stomatitis (canker sores)
Chicken pox
Shingles (herpes zoster)
Oral cancers (basal cell carcinoma)
Angular cheilitis
Impetigo
Syphilis

27
Q

refer for HSV 1 if

A

<12yrs,
lesions presents for >!4 days,
lesion appears infected (excessively swollen, red, or pus),
sx of systemic illness (fever, swollen glands),
compromised immune system d/t meds or disease,
frequent recurrences >6x/yr

28
Q

tx for intermittent herpes labialis

A

topical or oral tx

29
Q

choric suppressive tx for HSV 1 is appropriate for

A

appropriate for pts who are psychologically distressed (freq episodes or severe disease)
May be used to ↓ transmission to uninfected partners
Oral tx only

30
Q

PO analgesics for mod-sevre HSV 1 pain

A

acetaminophen, ibuprofen, naproxen

31
Q

topical analgesics for mild pain for HSV 1

A

benzocaine, camphor/ menthol/ phenol, lidocaine, pramoxine

32
Q

how do protectants help in HSV 1

A

(Ex- petrolatum, zinc oxide, cocoa butter, allantoin, or calamine)- prevents cracking and excess drying of lips and lesion

33
Q

T or F: astringents are recommended in cold sores

A

F- not rec due to excessive drying = cracking, fissuring, possible bacterial superinfection

34
Q

zinc action in HSV may prevent ____________ but is known to be ______________

A

virus attachment to cells, not well studied
irritating and drying

35
Q

heparin MOA for HSV 1

A

reduces binding of virus to cellular target in cell lines tested in lab- no published evidence for safety/ efficacy

36
Q

propolis is a

A

resinous substances bees collect from plant sources

37
Q

how to use coldsore-Fx

A

apply topically 4-6x/d until healed

38
Q

what is the evidence for lysine in cold sores

A

may or may nor be effective, not much harm

39
Q

Xerese decreases healing time and pain duration by

A

~0.5d

40
Q

acyclovir ____ is not as effective as ____

A

ointment < cream

41
Q

docosanol decreases healing time by ______ and pain duration by _________

A

0.5-1d
0.5d

42
Q

which is false about docosanol
1. may help abort attacks
2. topical is more effective than oral docosanol
3. must be applied 5x/d
5. best chance of success if start at prodrome

A

2

43
Q

which antivirals may be used in oral HSV

A

acyclovir, valacyclovir, famciclovir

44
Q

evidence suggests using antivirals in primary HSV infections can

A

decrease disease duration + period of infectivity in children

45
Q

which doses are expected to be higher for antivirals- in primary or recurrent HSV episodes

A

primary

46
Q

intermittent suppressive tx for HSV is used when

A

outbreaks can be anticipated

47
Q

T or F: the optimal dose and agent for intermittentsuppressive tx for HSV 1 is acyclovir 400mg BID 12-24hrs before exposure + continue through intense exposure

A

F- Optimal dose and pref antiviral agent unknown

48
Q

intermittent suppressive tx for HSV may not impact lesions that

A

develop within 48hrs of UV exposure

49
Q

which antiviral has the most data in pregancy

A

acyclovir

446- ID and transplant (18 decks)

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