HSV questions/scenarios Flashcards
36 yr old man has attended your clinic. He has a 10yr history of HSV with 4-6 recurrences/yr. These are still troubling him and he wants to try something other than antivirals.
a. lysine
b. vitamin C
c. echinacea
d. elagan
e. Skinner vaccine
Discuss Bo5
45 yr old woman attends your herpes clinic. Recurrent vulval erythema and pain. She has had recurrent candida diagnosed by a local GUM clinic and monthly fluconazole has helped symptoms of itching and discharge but the pain and erythema continue.
Discuss
25 yr old man attends your clinic. He has recurrent hsv and is in a new relationship. He has NOT informed his partner about his diagnosis. He asks your advice as to what he should do?
Discuss
A heterosexual couple is referred to your herpes clinic. They have been together 2 years. He has a history of genital herpes predating the relationship. He has 5 recurrences/yr and is on no therapy. She is asymptomatic and has never had symptoms suggestive of HSV. They would like to plan a pregnancy. She is on the oral contraceptive and plans to stop the pill soon. They currently use condoms consistently.
Discuss
The occupational health physician has contacted your clinic to ask your advice concerning a member of staff. this individual has recurrent whitlow and works in a maternity unit as a midwife. What is your advice?
Discuss
You have been asked to provide a medical expert opinion for a court concerning the following. A 12 yr old girl in care has recently contracted genital herpes. It is type 2. She has informed the police that a carer has sexually assaulted her. He is known to have type 2 HSV.
Discuss
30 yr old woman diagnosed as having HSV at GUM clinic. She has been started on aciclovir some 4 days ago. No new lesions have appeared but she is having increasingly difficulty passing urine. She has no dysuria but has noticed that she only passes small volumes. She feels her abdomen is swollen and her trousers are tight. Her legs feel tired and her muscles generally ache.
Discuss
A gay couple request your advice. They have been together 4 weeks and are serodiscordant for HIV. The HIV positive partner has a long-standing confirmed history of genital herpes and is not on HAART. The HIV negative partner was diagnosed with genital HSV 2 some 3 months ago. He has had 2 mild recurrences with perianal lesions since diagnosis.
They ask your advice on HSV management/HIV transmission.
Discuss/counsel
A patient is concerned he may acquire HSV from his girlfriend. She has a history of recurrent disease with 4 episodes per year. They use condoms and avoid sex when she has episodes of genital herpes. He is becoming increasingly anxious that he will acquire HSV during asymptomatic episodes in his partner.
They attend together for your advice.
Discuss/counsel
25 yr old woman is seeing you in your herpes clinic. She acquired HSV2 6 months ago (PCR confirmed) in a previous relationship this has ended acrimoniously. She has had one mild recurrent episode since diagnosis. She is in a new relationship with a partner she is very fond of. She has not started having sex with her new partner.
Her new partner has indicated strong negative views concerning STIs
She is concerned that if she discloses her diagnosis he will leave her
She feels emotionally drained
She asks your advice regarding the need for disclosure
Discuss/counsel
