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5th - OD - Infections > Viral Infections > Flashcards

Viral Infections Flashcards

1
Q

Name the four viruses of importance?

A

Herpes
Coxsackie
Paramyxovirus
Human papilloma

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2
Q

What is the herpes virus?

A

Double stranded DNA - icosahedral capsid surrounding dsDNA

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3
Q

What gives herpes virus specificity?

A

Glycoproteins

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4
Q

What is life cycle of herpes?

A

Virus binds specific cell surface receptor
Docking allows uncoating of virus and entry
DNA inserted into cell as protein uncoated
dsDNA moves into nucleus and interact host cell protein
Polymerase transcribes viral proteins = mRNA
mRNA translated into viral proteins
Viral DNA inserted into capsid
Cell becomes full and bursts = release viral particles

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5
Q

What is difference between herpes type 1 and 2

A

Type 1 - skin and oral mucous membranes

2 - genital mucosa

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6
Q

Where does virus live in type I simplex?

A

Virus enter trigeminal sensory neurones and migrate to ganglion

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7
Q

How is simplex type I reactivated?

A

Reactivation caused by UV, stress, illness, immunosuppression

Virus migrates to peripheral nerve endings and it shed

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8
Q

Why are infants at increased risk of primary infection?

A

Have passive immunity from maternal antibodies - these deplete very quickly

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9
Q

Are primary HSV symptomatic?

A

No 90% are asymptomatic

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10
Q

Who do you seen primary herpetic gingivostomatitis in?

A

Children and young adults

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11
Q

What is incubation period of PHG?

A

5 days

Heal 10-14 days

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12
Q

What is issue with treating patient with primary herpetic gingivostomatisis?

A

Risk of herpetic whitlow

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13
Q

Signs and symptoms of primary herpetic gingivostomatisis?

A

Malaise and fever
Vesicles which rupture
Erythematous gingivitis
Crusting lesions

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14
Q

Pathogenesis of primary herpetic gingivostomatisis?

A

Herpes virus replicates epithelial cells

Epithelial destruction and ballooning cells = intra-epithelial vesicles

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15
Q

Management of primary herpetic gingivostomatisis?

A 
Supportive = fluids, analgesics, soft diet, chlorhexidine 
Medication = acyclovir 5 days
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16
Q

When should acyclovir be given in primary herpetic gingivostomatisis?

A

Early infections

Immunosupressed pt

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17
Q

What is herpes labials often referred as

A

Cold sores

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18
Q

What are clinical features of a cold sore?

A

Prodromal tingling before vesicles
Vesicles at mucocutaneous junction - ulcerate and crust
Last 7-10 days

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19
Q

Treatment of herpes labials?

A

Acyclovir - only effective prodromal stages

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20
Q

What can herpes labials be confused with?

A

Erythema multiforme

21
Q

What is type 3 HSV?

A

Varicella zoster virus?

22
Q

Difference between primary and secondary varicella zoster virus?

A

Primary = chicken pox

Secondary (herpes zoster) = shingles

23
Q

Where does shingles affect?

A

One of division of trigeminal nerve?

24
Q

3 phases of varicella zoster virus?

A

Pre-herpetc - pain in affected division
Rash phase
Post-herpetic neuralgia - burning pain

25
Q

What see is rash phase of VZV?

A

Unilateral vesicles - follow trigeminal division

26
Q

Management of shingles?

A

Tx w/ anti-viral - acyclovir/ valaciclovir
Supportive measure
Ophthalmology if eye involvement

27
Q

How manage post-herpetic neuralgia in shingles?

A

Neuropathic pain drugs - gabapentin/ antidepressants

28
Q

What is HSV4?

A

Epstein barr virus

29
Q

What see in Epstein Barr virus?

A

Infectious mononucleosis - glandular fever

Petechiae soft palate/ tonsils

30
Q

What other things are related to epstien-barr virus?

A

Burkitts lymphoma
Nasopharyngeal carcinoma
Hairy leukoplakia

31
Q

How does oral hairy leukoplakia present?

A

White patchs bilateral on lateral border of tongue

32
Q

What pt often present with oral hairy leukoplakia?

A

HIV

33
Q

What are the 5 different types HSV?

A 
I -skin and oral
II - gential
III- varicella zoster
IV - epstein barr
V - cytomegalovirus
34
Q

What is HSV 5?

A

Cytomegalovirus

35
Q

Where does HSV5 lay dormant?

A

Dormant in lymphocytes

36
Q

Issue w/ HSV5?

A

Rarely cause problem healthy indiviudals

Issue if immunocompromised/ new-born

37
Q

How does cytomegalovirus present immuno-suppreswed?

A

Salivary gland swellings

38
Q

What virus do you see herpangina in?

A

Coxsackie - type 4

39
Q

What see in herpangina?

A

Vesicles and ulcers on soft palate - last a few day

40
Q

What causes hand, foot and mouth?

A

Coxsackie virus - type 16

41
Q

What see in hand, foot and mouth

A

Mild systemic upset
Rash/ vesicles palms of hands and sole of feet
Intra-oral vesicles

42
Q

What causes mumps/meaasles?

A

Paramyxovirus - negative strand mRNA virus

43
Q

What see is measles?

A

Systemic upset

Koplik’s spots - papule buccal and palatal mucosa

44
Q

What are kopliks spots seen in measles?

A

In prodromal phase

45
Q

What is HPV?

A

Circular dsDNA

46
Q

What cancer can HPV be related to?

A

HPV16 and 18 oncogenic
HP16 = oropharyngeal
HPV18 = cervical

47
Q

What to HPV 6 and 11 cause?

A

warts

48
Q

What does HPV infect?

A

Basal keratinocytes - can’t penetrate intact mucosa needs epithelial damage

49
Q

How can HPV present orally?

A

Squamous cell papilloma
Verucca vulgaris
Focal epithelial hyperplasia

5th - OD - Infections (5 decks)

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