S50(3) VZV

Question 1

VZV has two clinical disease

Answer 1

1) Chicken pox

2) Shingles

Question 2

Chickenpox (primary infection)

Answer 2

Most common in childhood

Mortality increases by 15 fold for adults

Question 3

Shingles (reactivation)

Answer 3

Most common in the elderly

Only occurs in people who had chickenpox

Question 4

VZV Infectious period:

Answer 4

48 hrs before vesical formation though 4-5 days after vesicles crust over

Question 5

shingles

Answer 5

Virus infects dorsal root ganglia where it lies dormant

Question 6

Signs and Symptoms

Zoster

Answer 6

Unilateral vesicular eruption with dermatomal distribution

Question 7

Varicella

Signs and Symptoms

Answer 7

Maculopapules -> vesicles -> scabs

Crusts fall off in 1-2 weeks

Question 8

VZV Prevention

Answer 8

Avoid contact until 4-5 days after lesions heal

Question 9

Shingrix (RZV)

Answer 9

Adults ≥ 50 yo

Dosing: 0.5 mL IM x 2 doses 2-6 months apart

Question 10

Adults who previously received ZVL -> wait 2 months -> RZV x 2 doses
Adults ≥ 60 yo can receive either RZV or ZVL

Answer 10

True

Question 11

Counsel on side effects

Answer 11

More side effects in patients 50-69
Duration median 2-3 days
Headache, shivering, and myalgia were more common after the 2nd dose
Caution patients with gout

Question 12

Typicasl ADR’s

Answer 12

Pain 78%
Myalgia 44.6%
Fatigue  44.5%
Redness  38.1%
Headache 37%
Shivering 26.8%
Swelling  25.9%
Fever  20.5%
GI symptoms 17.3%