oral med

Question 1

• VZV causes two different diseases

Answer 1

chicken pox and herpes zoster”shingles”

Question 2

what is the primary infection of vzv

Answer 2

chicken pox

Question 3

where does vzv stay latent in?

Answer 3

spinal cord ganglia and cranial nerves

Question 4

how reactivation occurs?

Answer 4

predisposing factors trigger the latent virus so it spreads from ganglion to specific dermatome

Question 5

manifestations of chicken pox

Answer 5

vesicular rash
ulcers
fever
oral painless lesions(lips and palate)

Question 6

ttt of chicken pox

Answer 6

self limiting*****
varivax vaccine

Question 7

secondary infection o vsv

Answer 7

shingles

Question 8

predisposing factors of vzv causing shingles as a reactivation

Answer 8

trauma to spinal cord
malignancy
immunodeficiency
old age(>45yrs)
immunocompromised

Question 9

specific prodrome of shingles

Answer 9

unilateral tenderness along the involved nerve(ophthalmic/maxillary/mandibular)

Question 10

specific signs of shingles

Answer 10

unilateral severe itching and severe burning pain
dermatomal rash
ulcers that leave crust when ruptured and scarring occurs

Question 11

what causes trigeminal shingles

Answer 11

occurs when reactivation uccurs within trigeminal ganglion

Question 12

vesicles of trigeminal shingles are?

Answer 12

neuralgic extreme pain
unilateral
dermatomic distribution
rupture leaving ulcers tha scars

Question 13

reactivation of vzv affecting facial nerve via geniculate ganglion

Answer 13

ramsay hunt syndrome

Question 14

which ganglion is the normal shingles?

Answer 14

spinal cord ganglion

Question 15

hamsay hunt ganglion name?

Answer 15

geniculate ganglion

Question 16

specific prodrome to ramsay hunt

Answer 16

pain localized to ear or radiating to jaw and neck

Question 17

ramsay hunt main signs

Answer 17

herpetic oticus
facial palsy
ant 2/3 of tongue affected
unilateral localized pain followed by vesicles then ulcers

Question 18

most common complication of shingles

Answer 18

post herpetic neuralgia

Question 19

signs of post herpetic neuralgia

Answer 19

Pain or dysesthesia persisting for 3 or more months after rash resolves.
* Pain is due to inflammation and fibrosis of the affected nerve.
* Localized, acute episodic and sharp pain.

Question 20

ttt of neuralgia

Answer 20

gabapentin
capsaicin cream 0.075
lidocaine patch

Question 21

if pt with scars and then get neuralgic pain expect what?

Answer 21

ppst herpetic neuralgia after shingles

Question 22

ttt of shingles

Answer 22

acyclovoir 800mg 5 times for 10 days