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Amy Somerville > INF2 - A. OTC ANTIVIRALS-COVERED > Flashcards

INF2 - A. OTC ANTIVIRALS-COVERED Flashcards

1
Q

what virus causes chickenpox in babies, children, young adults (primary)

A

varicella zoster

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2
Q

what virus causes shingles in adults (secondary)

A

herpes zoster

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3
Q

symptoms of chickenpox

A
  • flu-like symptoms
  • fever
  • itchy rash of red itchy spots that turn into fluid-filled blisters which crust over to form scabs which drop off
  • can appear anywhere on body
  • immune system produces a more severe reaction in adults
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4
Q

how can chickenpox be life-threatening

A

causes secondary pneumonia in immunocompromised

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5
Q

what happens after primary infection

A
  • virus dormant in nerves in everyone
  • VSV can reactivate in nerves when stressed, immunocompromised = shingles
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6
Q

treatment of chickenpox

A
  • intentional infection of children = pox party so children become immune (1-5 years old)
  • neonates (1st month) = parenteral antiviral
  • 1month - 12 years = paracetamol, calamine lotion on spots, stop scratching
  • NOT ibuprofen (NSAIDS) as they can make symptoms worse
  • adolescents/adults = antiviral Aciclovir within 24 hours (500mg 5x a day for 5/7 days)
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7
Q

how long are you infectious for with chickenpox

A
  • from 3-4 days before blisters appear to after scabs form
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8
Q

what is the vaccine for chickenpox (can be given on PGD)

A

varivax: injection either IM or deep SC
varilrix: deep SC injection in deltoid region or anterolateral thigh
- private vaccine in UK for most
- boots do for £200

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9
Q

what are some differential diagnosis’ for chickenpox

A
  • molluscum contagious: location similar to chickenpox but blisters aren’t fluid-filled
  • impetigo: crusty bacterial infection around mouth/nose
  • scarlet fever: red flat rash
  • hand, foot, mouth
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10
Q

who should be given pre-exposure vaccination

A
  • sero-negative HC worker at risk
  • lab staff
  • contacts of immunocompromised patients
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11
Q

who should be given post-exposure vaccination

A
  • unvaccinated HC workers
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12
Q

what is shingles

A
  • infection of a nerve and the area of skin around it
  • occurs at end of nerves ie - trigeminal nerve
  • specific line of rash along nerve
  • no fluid-filled blisters just red rash
  • caused by dormant VZV in nervous tissue
  • shingles can re-occur
  • can catch chickenpox from someone with shingles
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13
Q

what can cause reactivation

A
  • old age: risk and severity increases with age
  • immunosuppressant therapy
  • HIV infection
  • stress
  • if had colds and flu
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14
Q

symptoms of shingles

A
  • last 2-4 weeks, prodrome then pain followed by rash
  • localised pain, tender skin, lasts after rash gone
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15
Q

what is post-herpetic neuralgia

A

1 in 5 have
- constant or intermittent burning
- aching, throbbing, stabbing, shooting pain
- Amitriptyline if not pregnant

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16
Q

what is ophthalmic shingles

A
  • virus reactivated in trigeminal nerve (ophthalmic nerve is first division of trigeminal nerve)
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17
Q

what is Ramsay-hunt syndrome

A
  • occurs when shingles affects facial nerve near one of the ears
18
Q

management of herpes zoster

A
  • self care: rash clean, dry, loose clothing, cool compress, don’t share towels, cover painful red with cling film
  • antivirals: Aciclovir 800mg 5x day for 7-10 days
  • analgesia: paracetamol, NSAIDs, opioids, tricyclic antidepressants, gabapentin, pregabalin - anticonvulsants/antiepileptics (prevent nerve pain)
19
Q

who is the shingles vaccine for

A
  • 65-79 year olds
  • > 50 year old with compromised immune system
  • can be given on PGD
20
Q

which vaccine is now recommended

A
  • shingrix: recombinant vaccine
21
Q

what HSV causes coldsores

A

HSV-1: small blisters
highly contagious

22
Q

symptoms of cold-sores

A
  • tingling, itching or burning sensation around mouth
  • small fluid-filled sores then appear
  • remains dormant unless triggered
  • clears on own in 7-10 days
23
Q

treatment for coldsores

A
  • antiviral cream - Zovirax 2g for 5-7 days (P) reduces symptoms and length of symptoms
  • severe, oral Aciclovir prescribed by GP
  • apply as soon as tingling begins
24
Q

rare complications of coldsores

A
  • dehydration, Whitlows, keratoconjunctivitis, skin infections, encephalitis
25
Q

where can warts occur

A
  • anywhere on body: raised bumpy work
  • dark centre
  • like watery areas as skin softens and virus penetrates in
26
Q

where can verrucae occur

A
  • only on sole of foot: inverted (not raised) due to pressure
  • dark centre
  • like watery areas as skin softens and virus penetrates in
27
Q

what causes warts and verrucae

A

HPV

28
Q

symptoms of warts and verrucas

A
  • itching, pain, discomfort
29
Q

treatment for warts and verrucae

A
  • gels/paints (most contain salicylic acid 5/10%) eg - Bazuka
  • plasters (salicylic acid, up to 40%) eg - Wartie
  • freeze spray (Wartner cryo)
  • cryotherapy - see GP
  • treatment can take months
  • caution: diabetics as side effect of diabetes is peripheral neuropathy so need to make sure its not an ulcer caused by neuropathy
  • flip-flops
  • avoid sharing towels, shoes etc
30
Q

what type of infection is headlice, scabies, threadworms

A

parasitic

31
Q

diagnosis of headlice

A

combing hair with fine-toothed comb to find live lice of their eggs - nits (white dots)

32
Q

treatment of headlice

A

lotions and sprays
- dimeticone 4% eg - hedrin
- malathion 0.5% eg - derbac M
apply to whole scalp and leave for 8 hours and repeat in few weeks as eggs may still hatch

*children >6 months (if < GP for prescription) and avoid formulations with alcohol if asthmatic

33
Q

what is the wet combing method

A
  • wash hair with ordinary shampoo
  • apply lots of conditioner
  • comb whole head of hair from roots to ends
  • takes 10-30 minutes
  • do on days 1,5,9,13 to catch any newly hatched head lice
  • check again on day 17
34
Q

what mite causes scabies

A

sarcoptes scabiei

35
Q

how do scabies lay their eggs

A

feed using mouths and front legs to burrow into outer layer of skin and lay eggs so very itchy
after 3-4 days, baby mites (larvae) hatch and move to surface of skin where they mature into adults

36
Q

where do scabies like

A

warm places - skin folds (in between fingers), bedsheets

37
Q

treatment of scabies

A

permethrin 5% cream
malathion 0.5% lotion
need to use on whole body - apply and leave to dry for 24 hours
repeat 1 week layer to kill eggs that have hatched

38
Q

what causes pinworms/threadworms

A

enterobius vermicularis

39
Q

symptoms of threadworms

A
  • intense anal itching as eggs are here
  • long term infestation
40
Q

treatment of threadworms

A
  • scrupulous hygiene, hand washing, short nails, not sharing towels
  • mebendazole 100mg chewable tablet/suspension single dose
  • whole family needs treatment (>2 years = P, 6 months - 2 years = POM)

Amy Somerville (70 decks)

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