M29- HSV

Question 1

what are the 2 types of herpes simplex virus?

Answer 1

type 1 and 2

Question 2

Describe type 1 herpes simplex virus.

Answer 2

• Type 1 acquired in childhood
• HSV1 is cause of oral lesions
• 70% UK adults have been infected
• Infection through saliva contact

Question 3

What is primary gingivostomatitis due to HSV1?

Answer 3

• Disease of pre-school children
• Primary infection
• Systemic upset
• Lips, buccal mucosa, hard palate
• Vesicles 1-2mm
• Ulcers

Question 4

Describe the symptoms of primary gingivostomatitis due to HSV1.

Answer 4

Fever, local lymphadenopathy

Question 5

How long does primary gingivostomatitis take to recover?

Answer 5

up to 3 weeks to recover

Question 6

where can primary gingivostomatitis spread?

Answer 6

beyond mouth

Question 7

what is the treatment of primary gingivostomatitis?

Answer 7

aciclovir treatment

Question 8

Describe latency.

Answer 8

• Disappears clinically but virologically still virus in trigeminal ganglion
• After primary infection
• Inactive form of virus in sensory nerve cells
• Can reactivate to re-infect mucosal surfaces

Question 9

What is the cold sore?

Answer 9

• Reactivation from nerves causes active infection

- Various stimuli I.e UV light on skiing trip

Question 10

what is used to treat cold sores?

Answer 10

Aciclovir therapy or suppression

Question 11

Are all reactivations symptomatic?

Answer 11

no

Question 12

Can aciclovir prevent latency?

Answer 12

No

Question 13

Describe the recurrence of cold sores.

Answer 13

• Multiple cycles of latency and active infection possible
• Natural history is for decreasing frequency
• Only half of infected people get clinical recurrences
• Oral herpetic lesions usually HSV1
• Recurrent intra-oral lesions are rarely HSV

Question 14

What is an occupational hazard of dentistry?

Answer 14

• Herpetic whitlow

- Use of gloves essential in prevention

Question 15

What is a lab confirmation of HSV?

Answer 15

Swab of lesion in virus transport medium:

-detection of viral DNA by PCR

Question 16

what is an example of when herpes affects the brain?

Answer 16

-Herpes simplex encephalitis

virus inflames and kills off nerve cells

Question 17

What are symptoms of herpes simplex encephalitis?

Answer 17

abnormal mental state,chanhe in mental state and fever

Question 18

what is herpangina?

Answer 18

Vesicles/ulcers on soft palate
Enteroviruses
including coxsackie viruses (not HSV)

Question 19

What is the patient age range for herpangina?

Answer 19

Similar patient age range to 1ry HSV gingivostomatitis

Question 20

how is herpangina diagnosed?

Answer 20

Diagnosis clinically or by PCR test of swab in viral transport medium

Question 21

what island, foot and mouth disease due to?

Answer 21

enteroviruses -inxluding coxsackie viruses (not HSV)

Question 22

what outbreaks are common for hand, foot and mouth disease?

Answer 22

family outbreaks

Question 23

Describe aphthous ulcers.

Answer 23

-Non viral, self limiting
-Recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos:
>Confined to mouth
>Absence of systemic disease
>Begin in childhood, tend to abate in 3rd decade
>Each ulcer lasts less than 3 weeks

Question 24

Give examples of recurrent ulcers associated with systemic disease (non viral).

Answer 24

-Behçet's disease :
>Recurrent oral ulcers
>Genital ulcers
>Uveitis. 
>involve visceral organs such as the gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems

-Gluten-sensitive enteropathy or inflammatory bowel disease,
>Diarrhoea, weight loss

-Reiter’s disease
>Arthritis

-Drug reactions
-Skin diseases
>lichen planus, pemphigus, or pemphigoid

Question 25

what is a main symptom of primary syphilis?

Answer 25

Chancre

Question 26

What is a chancre?

Answer 26

• Painless indurated ulcer at site of entry of bacterium Treponema pallidum
• Most common site is genital, but oral lesions can be the site of entry

Question 27

What happens if a chancre goes left undiagnosed and untreated?

Answer 27

can progress to secondary and tertiary syphilis