Viral infections

Question 1

WHat are the Most common Herpes viruses?

Answer 1

HSV

Question 2

What is the pathogenesis of Herpes Simplex virus infection?

Answer 2

Viral seeds a ganglion

Spreads via peripheral nerves

Question 3

What is caused by HSV-1?

Answer 3

Herpes Labialis

Immcomp: Genital, liver, lung, eye, CNS

Question 4

What is caused by HSV-2?

Answer 4

75-80% of recurrent genital herpes infections.

Question 5

What is charicteristic of Primary vs Reactivation of HSV infection?

Answer 5

Primary: Sudden, Asymptomatic, painful lesions
Reactivation: Systemic S and S, Local Lymphadenopathy
Prodromal Symptoms: Pain, burning, tingling, pruritis

Question 6

What are the opthalmologic manifestations of HSV?

Answer 6

Necrotizing Retinitis

HSV Keratitis

Question 7

What are the CNS Manifestations of Herpes?

Answer 7

Herpes Simplex Encephalitis (temporal lobe)
Aseptic Meningitis
Molaret Syndrome:(recurrent meningitis associated with reactivation of HSV)
Transverse myelitis/Sacral autonomic Dysfunction
Bell’s Palsy

Question 8

What are the visceral infections of HSV?

Answer 8

HSV Esophagitis
HSV Tracheitis
Pneumonitis, Hepatitis rare

Question 9

What is seen in HSV infection of immunocomprimized?

Answer 9

More frequent recurrence
Disseminated infection
Visceral infection = High mortality

Question 10

How is HSV diagnosed?

Answer 10

Clinical Diagnosis
Culture/PCR
Tzanck Smear (multinucleated giant cells)

Question 11

What is the Tx of HSV?

Answer 11

Acyclovir
Foscarnet, Gancyclovir
Eye infections- Topical antivirals

Question 12

What are the traits of Varicella Zoster infection?

Answer 12

Highly COntageous
More serious in adults
Aerosolized droplets from nasopharynx or direct contact from vesicle fluid

Question 13

How do you know that someone with Varicella Zoster is no longer contageous?

Answer 13

All their Sores are crusted over

Question 14

What are the risk factors for Varicella Pneumonia?

Answer 14

Smoking, pregnanacy, immuosupression

Question 15

What is the Tx of Varicella?

Answer 15

VZV less suceptible to Acyclovir than HSV but still first line

Question 16

WHo should recieve the VZV vaccine?

Answer 16

Ongoing risk of exposure
immsupressed Pts in household
Women of Childbearing age
Post exposure prophylaxis in non-immune Pts of children with pox
Outbreaks with intense exposure

Question 17

WHat are the different manifestations of Herpes Zoster infection?

Answer 17

Cutaneous
Acute Neuritis and Post-Herpetic Neuralgia
Ocular: Acute retinal necrosis
Oticus(ears)
CNS
Pneumonitis
Hepatitis

Question 18

What is the Tx for Zoster?

Answer 18

Acyclovir #1
Valacyclovir
Famcyclovir

Vaccine to avoid shingles

Question 19

What will happen if you give aspirin to a Zoster patient?

Answer 19

Reye’s Syndrome

Question 20

What is the manifestation of EBV in adolescents and adults ?

Children?

Answer 20

Infectious Mononucleosis

Subclinical

Question 21

What are the malignancies associated with EBV?

Answer 21

Lymphoproliferative disorders
Duncan Syndrome
Burkitt's Lymphoma
Nasopharyngeal CA
Hodgkin's dis
T-cell lymphoma
Nasal Lymphoma

Question 22

What is the the Tx of EBV?

Answer 22

Supportive Care
Avoid Contact sports
Steroids when there’s airway obs, aplastic anemia, fulminant hepatitis

Question 23

What is seen on microscopy of CMV?

Answer 23

Owl Eye inclusions