viral infections

Question 1

which Herpes simplex is predominantly oral and which is predominantly genital?

Answer 1

HSV 1 oral

HSV 2 genital

Question 2

how is HSV transmitted?

Answer 2

direct contact

Question 3

what ganglion will the HSV 1 go to be latent?

Answer 3

trigeminal ganglion

Question 4

True or false?

HSV is neurotropic (meaning nerve loving)

Answer 4

true.

in oral leisions HSV 1 goes to trigeminal ganglion to be latent

Question 5

what is another name for primary herpes?

Answer 5

Herpetic Gingivostomatitis

Question 6

most people acquire their first incidence of primary herpes by what age?

Answer 6

at 5 years old

Question 7

shallow ulcerations with SERPENTINE borders

Answer 7

herpetic Ginivostomatis (primary herpes)

Question 8

Primary herpes can occur on any mucosal surface?

true or false

Answer 8

true

Question 9

red erythematous border with a yellowish surface in the middle is another characteristic along with the serpentine border for what

Answer 9

primary herpes (herpetic gingivostomatitis

Question 10

when can you see intact vesicles in patients with herpes?

Answer 10

first 24-48hrs. vesicles rupture after this

Question 11

what is the lay term for herpes labialis?

Answer 11

fever blister

Question 12

are the blisters in herpetic gingivostomatitis painful?

Answer 12

yes

Question 13

what is the differential diagnosis for primary herpes?

Answer 13

trench mouth (ANUG) which has punched out papillae where as primary herpes doesn’t and instead have ulceratoins with serpentine borders

Question 14

whats the best way to test primary herpes?

Answer 14

exfoliative cytology

Question 15

infected cells show mutinucleation and balooning degeneration of nuclei which is called viral cytopathic effect
and these cells are called Tzanck cells
what virus show this in biopsy?

Answer 15

primary herpes

Question 16

what is the med for primary herpes?

Answer 16

acyclovir or valacylovir

Question 17

when does the antiviral treatment work best for primary herpes?

Answer 17

if you catch the leision within the first 2-3 cays

Question 18

what is the symptomatic care for primary herpes?

Answer 18

popsicles can be soothing for pediatric patients.

topical anesthetics so patient can eat and drink - important to avoid dehydration

Question 19

what are the two forms of recurrent herpes?

Answer 19

recurrent herpes labialis

recurrent intraoral herpes

Question 20

whats another name for hepres labialis?

Answer 20

cold sore fever blister

Question 21

what the following clinical symptoms manifestation of?
prodromal itching, tingling, burning, erythema
triggered by UV light exposure or trauma

Answer 21

recurrent herpes labialis

Question 22

history of having cold sores right at the commissure,

Answer 22

recurrent herpes labialis

Question 23

what is the differential diagnosis with recurrrent herpes labialis?

Answer 23

impetigo.

while recurrent herpes labialis lesions recur many times, impetigo only occurs once.

Question 24

is it same medication for primary herpes and recurrent herpes labialis?

Answer 24

yes. valacyclovir has the best results

Question 25

which herpes is confined to onlym ucosa bound to periosteum (hard palate and attached gingiva)?

Answer 25

recurrent intraoral herpes

Question 26

cervical lymphoadenopathy

Answer 26

primary herpes (herpetic gingivostomatitis)

Question 27

how do you differentiate immunosuppressed patient from immunocompetent patients when they are affected with hepres?

Answer 27

manifestation of herpes in inmmunosuprressed patients is white raised scalloped borders around the leisions.

Question 28

treatment for immunosuppressed herpes is ?

Answer 28

IV acyclovir

Question 29

herpetic whitlow?

Answer 29

herpes infection contacted with hands

Question 30

is varicella zoster virus a the human herpes virus?

Answer 30

Yes, it is in the family of HHV (human herpes virus) so it has a lot of similarities to HSV.
there are about 8 Human herpes viruses

Question 31

how is variclla (chicken pox) zoster virus spread?

Answer 31

direct contact or air borne droplets

Question 32

intensily pruritic vesicles with dew droplets on rose petals type of leisions are clinical manifestatins of what?

Answer 32

varicella (chickenpox)

Question 33

clear vesicle sitting on an erythematous base leisions of what?

Answer 33

varicella

Question 34

a disease that lays dormant in spinal dorsal ganglion

Answer 34

varicella zoster

Question 35

is it same treatment for primary herpes, recurrent herpes and varicella zoster?

Answer 35

yes. acyclovir if detected with in 1 day.

Question 36

what is the difference between varicella zoster (chicken pox) and herpes zoster (shingles) in terms of clinical manifestations?

Answer 36

shingles are VERY PAINFUL.
shingles lesions stop at MIDLINE.
shingles lesions follow one dermatome that is innervated by single nerve

Question 37

when should you refer shingles to an opthomalogic emergency?

Answer 37

when the tip of the nose has leisions. because tip of the nose is innervated by nasociliary branch of CN V and that means CN V is also involved and that means opthalmic branch of CN V is also involved and will effect the eyes.

Question 38

is it same treatment as chicken pox?

Answer 38

yes but 5x dosage of chicken pox ( or HSV which is same med for chicken pos and HSV – acyclovir)

Question 39

true or false?
HSV = multiple recurrances
herpes zoster = one recurrence is typical.

Answer 39

true.

so if they have multiple outbreaks of herpes zoster. start considering immune problems

Question 40

cossackievirus A or B or echovirus

localized to posterior soft palate/ tonsillar pillar region

Answer 40

Herpangina

Question 41

what is CD4 number that is important?

Answer 41

200 cells /uL. if the count is less than that. HIV + patient’s blood constitues AIDS

Question 42

what lymph nodes are affected in persistent lymphadenopathy?

Answer 42

cervical lymph nodes are frequently affected including posteror cervical nodes.