The Global Picture

Question 1

What are the dianostic tests for imported fever?

Answer 1

• Malaria films
• FBC
• Liver function
• dip-stick urine
• cultures
• imaging: X-Ray Chest
• Serology… serial samples stored

Question 2

What is the type of mosquito that causes deadly malaria that is a medical emergency?

Answer 2

• P Falciparum

Question 3

What are the two different types of Herpes?

What is different about the presentations and location of infection?

Answer 3

HSV-1

Presentation: herpetic stomatitis (viral infection of the mouth that causes ulcers and inflammation), cold sores, keratoconjunctivitis (inflammation of the cornea and conjunctiva) and encephalitis(inflammation of the brain).

Location: mouth… usually transmitted through oral sex

HSV-2

Presentation: genital herpes and systemic infection in the immunocompromised host.. but also cause infections in the mouth (tho less common compared to HSV-1).

Location: genital

Question 4

Where is the site of latent for HSV-1 and 2?

Answer 4

• nerve cell body in the dorsal root ganglia

Question 5

What is the risk factor of HSV-2?

How is it transmitted?

Answer 5

• women > men
• in 16-24 years old
• transmission occurs from the mucous membrane of a person who is shedding HSV, many can be asymptomatic.
• Usually transmitted through genital contact

Question 7

What the primary reaction to HSV-1 infection?

Answer 7

• can go unnoticed
• produce a severe inflammatory reaction with vesicle formation… painful ulcers

Question 8

How can HSV-1 be reactivated?

• What is the name of the reactivated form?

Answer 8

• through stress and UV radiation
• from the trigeminal ganglion
• herpes labialis (cold sore)

Question 9

What are the symptoms of primary genital infection of HSV?

Answer 9

• multiple shallow ulcers
• tender inguinal lymphadenopathy
• Systemic symptoms of viraemia… fever, myalgia(muscle pain) and headache
• in women, external dysuria and vulval pain are the main symptoms
• ulcers can present on the cervix and can have the appearance of a malignancy
• rectal infection can lead to severe proctitis with pain and bleeding

Question 10

What is a non-primary genital infection?

Answer 10

• occurs in people with prev HSV-1 or 2 who then acqire the other type of genital HSV.
• due to some cross-protection from preious HSV infection, resulting in a milder illness than in primary infection.
• more likely to be asymtomatic

Question 11

What is chickenpox known as in medical terms?

What organism is it caused by?

Answer 11

• varicella zoster
• varicella zoster virus

Question 12

What are the group of people does varicella zoster usually occur on?

How is it transmitted?

Answer 12

• in childhood
• enters through the mucosa of the URT
• spread from the throat and from fresh skin lesions by air-borne transmission or direct contact

Question 13

How long is the incubation period of varicella-zoster?

How long is infectivity period?

Answer 13

• the incubation period for varicella is 14 to 16 days
• 2 days before rash appearance to skin lesions are all at crusting stage

Question 14

Wjere does varicella zoster remain latent in?

Answer 14

• dorsal root and cranial nerve ganaglia

Question 15

What are the clinical features of chicken pox?…symtoms, location

Answer 15

• after 14-21 days of getting virus…
• start with fever, malaise, headache
• followed by an eruption of chicken pox, from macules to papules to vesicles to pustules in a matter of hours
• occurs o the face,scalp, trunk and less extent on extremities.

Question 16

What are the complications of varicella-zoster?

Answer 16

• pneumonia ( more common in smoking adults)
• rarely acute truncal cerebellar ataxia
• can cause structural damage to the fetus in pregnant women

Question 17

What is shingles?

Answer 17

• arises from the reactivation of VZC latent within the dorsal root or cranial nerve ganglia…
• more common in elderly
• in dermatome distribution and pain