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Virus ID - Clinical Medicine > Varicella-Zoster > Flashcards

Varicella-Zoster Flashcards

1
Q

What is primary varicella presentation?

A

chickenpox

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2
Q

What is the latent reactivation of varicella?

A

herpes zoster

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3
Q

How is varicella spread?

A

droplets and aerosols or contact with lesions

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4
Q

How does varicella present?

A

fever then rash after 2 days

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5
Q

How is the rash present in chicken pox?

A

pruritic, start on head and spread to trunk, vesicles and pustules

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6
Q

When does crusting take place in chicken pox?

A

crusting

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7
Q

When are chickenpox pt infectious?

A

2 days prior to rash and until all crusting

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8
Q

What is the key presentation of chicken pox?

A

dew drop on rose pedal

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9
Q

What are complications of chicken pox?

A

cellulitis due to group A strep or s. aureus
Hepatitis
Thrombocytopenia
Cerebellar ataxis

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10
Q

What happens in preg pt exposed to varicella in first trimester?

A

fetal varicella syndrome

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11
Q

What two different exposure causes of chicken pox?

A

exposure to chickenpox or zoster

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12
Q

How do you tx chicken pox?

A

acetaminophen for fever

oatmeal bath or lotion

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13
Q

Who do you tx with viral meds in chicken pox?

A

immunocompromised, children with chronic lung or skin, newborn mothers, pt w/ complications

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14
Q

What is the viral meds for chicken pox?

A

valcyclovir for 2-18 yo

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15
Q

How does the rash in zoster present?

A

feels before present, pain, burning, tingling

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16
Q

When does rash appear?

A

1-2 days after exposure

17
Q

Does the rash cross the midline?

A

no, dermatomal pattern

18
Q

When does zoster reach the crusting stage?

A

10 days after exposure, no longer contagious

19
Q

What can herpes zoster cause?

A

herpes zoster ophthalmicus

20
Q

How do you treat HZO?

A

refer!!!!!

21
Q

What is a key sign in HZO?

A

Hutchinson’s sign - vesicle on nose

22
Q

What is pain persiting long after herpes zoster resolved?

A

post-herpetic neuralgia

23
Q

Who gets PHN?

A

over 50 yo

24
Q

What is the complications of zoster (2 more)?

A

bacterial infection and meningitis

25
Q

When is treatment best for zoster?

A

within 3 days of rash appeance

26
Q

What are the drugs for acute HZ?

A

Valacyclovir 1000 mg PO tid
Famciclovir 500 mg PO tid
Acyclovir 800 mg PO 5x/d

FOR 7-10 days

27
Q

What is the tx for extensive HZ?

A

acyclovir 10-14 days

28
Q

What do you give for acyclovir resistant HZ?

A

hoscarnet 14-28 days

29
Q

What can you combine with antivirals for HZ?

A

60 mg/day taper 21 days

Hydrocodone or oxy

30
Q

How do you treat PHN?

A

gabapentin 300 mg qhs
pregabalin 75 mg qhs
Capsaicin, lidocaine patches

Virus ID - Clinical Medicine (14 decks)

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