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Dermatology > Microbiology 3 > Flashcards

Microbiology 3 Flashcards

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Dermatology Board Prep flashcards
1
Q

Chickenpox and shingles are both due to infection with what?

A

Varicella-Zoster

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2
Q

What part of the Varicella-Zoster virus causes chickenpox?

A

Varicella

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3
Q

How does chickenpox present?

A

A generalised itchy rash with fever

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4
Q

How does the rash of chickenpox progress?

A

Red macular, papular, vesicular

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5
Q

What are some complications of chickenpox?

A

Secondary bacterial infection Pneumonitis Haemorrhage Scarring Encephalitis

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6
Q

What are risk factors for more severe chickenpox?

A

Extremes of age and depressed cell mediated immunity

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7
Q

What causes neonatal VZV?

A

If the mother has chickenpox in late pregnancy

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8
Q

How is neonatal VZV prevented?

A

VZ immune globulin is given to pregnant mothers at risk of this

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9
Q

What type of vaccine is the chickenpox vaccine?

A

Live attenuated vaccine

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10
Q

Who is the chickenpox vaccine given to?

A

Susceptible healthcare workers

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11
Q

What happens to the VZV once a patient has recovered from chickenpox?

A

It establishes latency in the dorsal (sensory) nerve root ganglia in the spine

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12
Q

What part of the VZV causes shingles?

A

Zoster

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13
Q

An adult presents with a rash, pulmonary nodules and no other organ involvement. He has a child with chickenpox but he has never had the virus himself. What is this most likely to be?

A

Varicella pneumonia

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14
Q

How do you treat varicella pneumonia?

A

IV acyclovir

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15
Q

Late in life the chickenpox virus may reactivate as what?

A

Shingles

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16
Q

Where does shingles affect?

A

A single dermatome

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17
Q

What are two groups that have increased incidence and increased severity of shingles?

A

Elderly and immunocompromised

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18
Q

What occurs before any skin symptoms begin to show in shingles?

A

Pain/tingling along the affected dermatome

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19
Q

What type of pain does shingles cause? How does this feel?

A

Neuropathic pain- feels sharp

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20
Q

The pain from shingles tends to increase as the patient gets what?

A

Older

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21
Q

What is post-herpetic neuralgia?

A

Pain from shingles which continues for 4 weeks + after the rash has disappeared

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22
Q

Who is post-herpetic neuralgia most likely to occur in?

A

Elderly Those with shingles associated with the trigeminal nerve (head and neck)

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23
Q

Is scarring common in shingles?

A

Not really

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24
Q

What is ophthalmic Zoster? What should be done if this is suspected?

A

Shingles affected the ophthalmic division of the trigeminal nerve- urgent ophthalmic referral

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25
Q

What can ophthalmic Zoster leave?

A

Scarring and eye redness

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26
Q

Ophthalmic Zoster can occur in children. What makes this more likely?

A
  • Infected in utero - Immunocompromised
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27
Q

Which regions are adults most likely to be affected by shingles in?

A

Thoracic and lumbar

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28
Q

Which regions are children most likely to be affected by shingles in?

A

Cervical and sacral

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29
Q

What virus can cause shingles in a child who has been vaccinated against VZV?

A

Herpes Zoster

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30
Q

What is Ramsay-Hunt syndrome?

A

VZ affecting the 7th cranial nerve which causes facial nerve palsy, vesicles and pain in the auditory canal and throat

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31
Q

What is Bell’s palsy?

A

Idiopathic facial nerve palsy

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32
Q

Which has a worse prognosis, Ramsay-Hunt Syndrome or Bell’s palsy?

A

Ramsay Hunt Syndrome

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33
Q

Ramsay-Hunt Syndrome can irritate what other cranial nerve? What symptoms can this cause?

A

8th cranial nerve- deafness, vertigo, tinnitus

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34
Q

When is a vaccine used for shingles?

A

Routinely in 70 year olds to reduce impact of the disease

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35
Q

Is the chickenpox vaccine the same as the shingles vaccine?

A

Yes

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36
Q

What virus causes primary gingivostomatitis?

A

Herpes Simplex Virus

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37
Q

Who does primary gingivostomatitis occur in?

A

About half of pre-school children

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38
Q

Does infection with herpes simplex always cause symptoms?

A

No, most people get an infection without symptoms

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39
Q

If children infected with HSV get symptoms, what will these be?

A

Excessive ulceration around the mouth lasting about a month. The child may be reluctant to eat and drink.

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40
Q

Some patients with HSV go to hospital for treatment, what is this for?

A

Rehydration

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41
Q

Where does the HSV remain latent?

A

Dorsal root ganglia

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42
Q

What are some things that the HSV can cause when it reactivates?

A

Cold sores, herpetic whitlow, eczema herpeticum

43
Q

What does Type 1 HSV cause?

A
  • Main cause of oral lesions - Half of genital herpes - Encephalitis
44
Q

What does Type 2 HSV cause?

A
  • Rarely oral lesions - Half of genital herpes - Encephalitis/disseminated infection in neonates
45
Q

What are VZV and HSV treated with?

A

Acyclovir

46
Q

What is acyclovir an analogue of?

A

Guanosine

47
Q

How does acyclovir work?

A

Incorporated into viral DNA and inhibits replication

48
Q

Does acyclovir eliminate the latent virus?

A

No

49
Q

How do you test for a virus on skin/mucosal membrane infections?

A

Swabs with viral transport medium

50
Q

How do you test for a virus in areas unable to be swabbed?

A

Antibody tests

51
Q

How does erythema multiforme present?

A

Target lesions with erythema

52
Q

What are some causes of erythema multiforme?

A
  • Drug reactions - HSV - Mycoplasma pneumoniae
53
Q

Who does molluscum contagiosum normally appear in?

A

Children

54
Q

How does molluscum contagiosum infect adults?

A

Sexually transmitted

55
Q

How will the lesions of molluscum contagiosum look?

A

Fleshy, firm, pearlescent nodules 1-2mm diameter

56
Q

How is molluscum contagiosum treated?

A

Self limiting, but can take months If very symptomatic can treat with liquid nitrogen

57
Q

What virus causes warts?

A

HPV (types 1-4)

58
Q

Viral warts are most common in children. How are they treated?

A
  • Self-limiting - Can be frozen with liquid nitrogen - Topical salicylic acid
59
Q

What are some other diseases caused by HPV?

A

Genital warts (6+11), cervical cancer (16+18), head and neck cancers

60
Q

What is herpangina?

A

A blistering, ulcerating disease at the back of the mouth

61
Q

What causes herpangina?

A

Enterovirus (coxackie virus, echovirus)

62
Q

How do you test for herpangina? How is it treated?

A

Swabs, stool sample for enterovirus PCR Self-limiting

63
Q

What is hand, foot and moth disease? What is it caused by?

A

Similar to herpangina but with blisters on the hands, feet and sometimes buttocks. Caused by enterovirus (mostly coxsackie)

64
Q

Who does hand, foot and mouth disease tend to affect?

A

Children, can cause family outbreaks

65
Q

What are very rare complications of hand, foot and mouth disease?

A

Viral meningitis or encephalitis

66
Q

What is erythema infectiosum also known as?

A

Slap cheek disease

67
Q

How does slap cheek disease present?

A

The child looks and feels well but has a rash on the face, once this fades it can occur all over the body

68
Q

What is another symptom that slap cheek disease can cause when it occurs in adults?

A

Acute arthritis (small bones of hands and feet)

69
Q

What causes slap cheek disease?

A

Parvovirus (erythrovirus) B19

70
Q

What are some complications of slap cheek disease?

A

Spontaneous abortion, aplastic crisis, chronic anaemia if immunosuppressed

71
Q

How is parvovirus B19 tested for?

A

Parvovirus B19 IgM testing

72
Q

What is a virus which occurs in people who work with sheep?

A

Orf

73
Q

How does orf present?

A

Firm, fleshy nodule on the hands of farmers

74
Q

How do you test and treat orf?

A

Test- clinical diagnosis Treat- self-limiting

75
Q

What will a primary infection of syphilis show?

A

Painless ulcers at the site of entry

76
Q

What will a secondary infection of syphilis show?

A

Red rash all over the body, prominent on the soles and palms, mucus membrane ulcers

77
Q

What will a tertiary infection of syphilis show?

A

CNS and CV effects, formation of a gumma

78
Q

What causes syphilis?

A

A bacterium- Treponema Pallidum

79
Q

How is syphilis diagnosed and treated?

A

Blood test or swabs for PCR Treat with IM penicillin injections

80
Q

Which sex is syphilis most common in?

A

Males

81
Q

What does Borrelia Burgdoferi (bacteria) cause?

A

Lyme Disease

82
Q

What are the early and later presentations of Lyme disease?

A

Early- erythema migrant (diagnostic) Late- heart block, nerve palsies, arthritis

83
Q

What can you treat Lyme disease with?

A

Doxycycline or amoxicilline

84
Q

What is the lab test for late presentations of Lyme disease?

A

Blood test for antibodies to the organism

85
Q

Do asymptomatic tick bites need prophylaxis?

A

No

86
Q

How can Zika virus be transferred?

A

Through mosquitoes or sexually transmitted

87
Q

How many people infected by Zika will become ill? How many days after exposure will symptoms occur? How many days after symptoms start will they resolve?

A

1/5 3-12 2-7

88
Q

What are some symptoms of Zika?

A

Fever, rash, headaches, arthralgia, myalgia, conjunctivitis

89
Q

What are some complications of Zika?

A

Guillain Barre syndrome Microcephaly CNS problems in foetus

90
Q

What disease may cause fever, sore throat, arthralgia, rash and a diffuse blanching erythema over the upper body?

A

Rubella

91
Q

What is the test for rubella?

A

Rubella IgM

92
Q

Who is rubella most common in?

A

Middle aged men

93
Q

Who should be vaccinated against rubella as a priority?

A

Women of child bearing age and their partners

94
Q

What does this man have?

A

Chickenpox

95
Q

What does this man have?

A

Shingles

96
Q

What does this lady have?

A

Ophthalmic Zoster

97
Q

This lady has shingles affecting where?

A

The maxillary division of the trigeminal nerve

98
Q

This lady has shingles affecting where?

A

Mandibular division of the trigeminal nerve

99
Q

What does this child have?

What virus caused it?

A

Primary gingivostomatitis

HSV

100
Q

What does this man have?

A

Erythema multiforme

101
Q

What does this person have?

A

Molluscum contagiosum

102
Q

What does this person have?

A

Orf

103
Q

When is this rash seen?

A

Secondary syphilis

104
Q

What is this rash known as?

What is it diagnostic of?

A

Erythema migrans

Lyme Disease

Dermatology (15 decks)

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