Infections & Infestations

Question 1

Describe the progression of HSV?

Answer 1

1st exposure causes the first clinical episode or goes straight to latency.

Lies latent in your DRG

New episodes occur due to certain stimuli

Question 2

What can cause a flare up of HSV?

Answer 2

• Trauma
• Menstruation
• Sunlight
• Fever
• Stress
• random?

Question 3

What patients suffer badly with HSV?

Answer 3

Immunocompromised or atopic patients

Question 4

What conditions are caused by HZV?

Answer 4

Chickenpox on primary exposure

Shingles later

Question 5

How is Scabies transmitted?

Answer 5

Person to person.

Its slow, you have to hold someones body for around a minute for the mites to pass over. (so think loved ones)

Question 6

How do you treat scabies?

Answer 6

Liclear cream
Patient has to cover their whole body in it, wait 8 hours, wash it off and repeat in 1 wk

Ensure you treat all their contacts simulatenously to prevent re-infection

Question 7

What virus causes warts?

Answer 7

Human Papilloma Virus (HPV)

has a 4 month incubation period

Question 8

What are the types of Warts?

Answer 8

Common
Plantar
Genital
Other - Plane/filiform/mosaic

Question 9

How do we treat bacterial infections?

Answer 9

Antibiotics
IV for Erysipelas

Drain pus from a boil

Question 10

presentation of someone with HSV?

Answer 10

• Sore areas
• Vescicles follow
• Pustules and ulcers can also present

HSV-1 :

• 90% of cases in adults between the age of 20-40
• Usually asymptomatic in children

HSV-2:
-Genital infection

Question 11

How is VZV spread?

Answer 11

• Via airdroplets so by coughing and sneezing

- by bodily fluids

Question 12

Treatment for chicken pox?

Answer 12

• Symptomatics

- Calamine lotions

Question 13

Complications of shingles?

Answer 13

• post-herpetic neuralgia

- infection

Question 14

Treatment

Answer 14

• Pain relief

- Keep area clean to prevent infection

Question 15

Candida infections- predisposing factors

Answer 15

• DM
• Occlusion
• Immunosuppression
• Broad spectrum antibiotics

Question 16

Presentation of candida infections?

Answer 16

o Erythematous presentation
o Satellite pustules
o Intertriginous areas: areas where two areas of skin might touch e.g. between fingers, inguinal folds, sub-mammary

Question 17

Treatment for candida infections

Answer 17

• Remove pre-disposing causes

- topical antifungals and oral antifungals in some cases

Question 18

Presentation of scabies

Answer 18

• Itch
• Burrows of 0.5 to 1.5cm, grey
• Affects trunk and limbs but spares the scalp

Question 19

Treatment of scabies

Answer 19

• Antiscabetic topical cream which needs to be repeated after 1 week
• sometimes oral medicine is required

Question 20

What causes syphilis?

Answer 20

Treponema pallidum

Question 21

Presentation of primary, secondary and tertiary syphilis

Answer 21

Primary: Episodes of active disease followed by latent periods
o Usually presents as a single sore ulcer – initially an small red papule
o Usually where the infection has entered e.g. the genital area/ the mouth

Secondary: Rash and flu-like symptoms 
o	3 weeks to 3 months later 
o	Widespread 
o	Can be subtle or can rough red/ brown/ yellowish patches 
o	Usually on trunk, palms, soles 

Tertiary: if left untreated can effect brain, eyes , heart and bones
o Patient is infectious
o Granulomatous lesions= gummas on skin, mouth, throat

Question 22

Investigation for syphilis?

Answer 22

Serological tests turn positive after 5-6 weeks after infection
Non-specific treponemal test
Specific treponemal antibody test

Question 23

Treatment

Answer 23

Injection of penicillin depending on site