Varicella

Question 1

90% of cases occur in what pop

Answer 1

children below 10 yo.

highest age spec incidence in age 1-4 yo unvaccinated children.

Question 2

incu period

Answer 2

10-21 days usually 14-15 days

Question 3

infectious days, or when is it communicable

Answer 3

5 days before eruption

most infectious 1-2 days before rash.

Question 4

days or secondary viremia

Answer 4

day 11-20

Question 5

days for infection of RES

Answer 5

bet day 4-6

Question 6

mortality rate in children

Answer 6

1.4 in 100,000 cases
adults: 30.9 in 100,000 cases.
preg women 5x greater risk of an adverse outcome

Question 7

vesicles char as

Answer 7

tear drop vesicles on an erythemtous base

Question 8

most common complicarion of varicella

Answer 8

sec infec w s aureaus and strep

Question 9

most comm neuro complications

Answer 9

Cerebellar ataxia
encephalitis

Vari- CE

Question 10

skde effect if using aspirin in varicella

Answer 10

Reye syndrome
hepatitis
acute enceph.

Varicella/ Asp/ ReAcHe

Question 11

drug contraindicated in vari

Answer 11

Aspirin

Question 12

dx

Answer 12

tzanck smear from a vesicle . show
multinucleate giant cells.

DFA can confirm the infection and type the virus.

Question 13

tx

Answer 13

acyclovir w in 24 hours of eruption.

aspirin is 20mg/kg max 800 mg per dose 4x a day for 5 days.

Question 14

tx for severe fulminant cutaneous disease and visceral complications

Answer 14

IV acyclovir 10mg/kg every 8 hours adj for crea clearance

Question 15

if maternal infection occurs before 28 weeks Aog and slex before 20 wks a small bubsig risk of infection of fetus called

Answer 15

congential varicella syndrome

Hypoplastic limbs
Cutaneous scars
Ocular and CNS disease.

female >male fetus

0.4 % overall risk

highest risk in varicella occ at weeks 25-36 w AOG.

Question 16

risk of spont abortion by 20 weeks

Answer 16

3%

fetal death occurs after 20 wks.

Question 17

severe vari and vari pneumo or disseminated dx in preg tx

Answer 17

IV acyclovir

Question 18

all varicella in preg tx

Answer 18

oral acyclovir 800mg 5x a day for 7 days. adj renal func.

Question 19

tx for all women past 35 wks of gestation or w inc risk of premature labor;

Answer 19

admission and IV acyclovir 10mg/kg 3x a day.

Question 20

when is VZIG given

Answer 20

not in pregnant women who has dev varicella.

given for significant exposures within the first 72-96 hours

Question 21

congenital varicella syndrom anmalies

Answer 21

hupoplastic limbs usually unilateral and lower ext
cutaneous scars
ocular and cns disease.

Question 22

highest risk in maternal varicella congenital syndrom

Answer 22

2% from maternal varicella bet weeks 13 and 20.

overall risk for congential varicella syndrome- 0.4%

Question 23

how many days before and after delivery that pxs has varicella that has the possibility of having neonatal varicella

Answer 23

5 days before and 2 days after delivery

Question 24

HIV tx for varicella

Answer 24

Valacyclovir 1g 3x a day
famciclovir 500mg 3x a day
acyclovir 800mg 5x a day.

if no visceral complications

valacyclovir and famciclovir may be preferable to acyclovir bec of enhanced oral bioavailability.

Question 25

among 3 drugs tx who has mire bioavailability and more preferred

Answer 25

Vala and fam

Question 26

how long are antibirals guveb

Answer 26

atleast 10 days

Question 27

acyclovir resistant varixella tx with

Answer 27

Foscarnet ir in nin resposhve pxs cidofovir

Question 28

of mortger dev varicella bet 5 days before and 2 days after delivery

Answer 28

neonatal varicells can occur and may be severe bec of inadequate transplacental deliver of antivaricella antibody.
they dev varicella 5-10 days of age.

VZIG warranted.
IV acyclovir therapy should be considered.

Question 29

What is modified varicella like syndrome. MVLS.

Answer 29

children immunized w attenuated varicella vaccine may develop varicella of reduced severity on exposure to natural varicella. MVPS.

ave 15 days post exposure to varicella.

30-50 lesions instead of 300.

fewer than 5 days. afebrile

Question 30

high risk significant exposure

Answer 30

household contact
face to face for atleast 5 minutes
Contact indoors for more than 1 hour. in an adjacent bed or in the same open ward.

Question 31

when is vaccination safe after chemotx

Answer 31

after more than 1 year from induction of chemo.

Chemo is halter about the time of vaccination.

lymphocyte count is higher than 700/mm.

Question 32

tx immunossuppressed children

Answer 32

iv acyclovir 10 mg/kg three times daily (500mg/m in children) given as soon as dx of varicella is suspected.