Varicella zoster

Question 1

define varicella zoster ?

Answer 1

primary infection is called chicken pox

secondary infection is shingles

Question 2

risk factors for shingles?

Answer 2

• Increased age
• HIV
• immunosuppression

Question 3

features of chicken pox?

Answer 3

o	Prodromal malaise  
o	Mild pyrexia  
o	Maculopapular rash 
o	Vesicles weep and crust over  
o	New vesicles appear

Question 4

features of shingles?

Answer 4

• Vesicular maculopapular rash with PAIN
o May occur after a period of stress
o Tingling/hyperaesthesia in a dermatomal distribution

Question 5

investigations?

Answer 5

CLINICAL diagnoses

Question 6

management for chickenpox?

Answer 6

o	SUPPORTIVE 
o	Children
-	Keep cool
-	Trim nails 
-	Calamine lotion

Question 7

management for shingles?

Answer 7

• Analgesia
  o 1. Paracetamol and NSAIDs
  o 2. Amitriptyline
• Anti-Virals
  o Antivirals within 72 hours for majority of patients
  o Acyclovir

Question 8

how to prevent chicken pox?

Answer 8

o Varicella Zoster vaccine

- in elderly, immunocompromised, and pregnant

Question 9

complications of chicken pox?

Answer 9

o Secondary bacterial infection of the lesions (B-haemolytic group A)
o Scarring
o Pneumonia
o Encephalitis

Question 10

main complication of shingles? and how is it reduced?

Answer 10

o Postherpetic neuralgia– reduced with anti-virals

Question 11

another significant complication of shingles?

Answer 11

o Ramsay-Hunt syndrome

• Auricular pain
• Facial nerve palsy
• Vesicular rash around the ear

Question 12

how is ramsay hunt syndrome managed?

Answer 12

• Managed with oral acyclovir and corticosteroids