Viral infections

Question 1

Sore and ulcerated mouth - important Qs to ask in history.

Answer 1

C/o - SOCRATES, where, when first noticed, painful - diffcult to eat, swallow
Any noticable cause, getting worse, any other part of body affected
Had similar ulcers before
Systemic complications - fever malaise, regional lymphadenopathy

Question 2

Labratory investigations for primary herpetic gingivostomatitis (HSV)

Answer 2

Swab, biopsy, immunofluorecence

HSV in saliva - PCR tissue cell culture

Question 3

Management of PHGS

Answer 3

Antipyretics, bed rest, reassurance, CHX mw, fluid intake

If immunocompromised - aciclovir 200mg tablets 1 tablet 5x daily for 5 days

Question 4

How can HSV present as a secondary infection (LATENT)

How can it be managed

Answer 4

Herpes labialis - crusting, blistering of lip (coldsore)
Its a latent infection of the dormant herpes simplex virus remaining in the trigeminal ganglion.

• Reassure, explain recurrence, fluid maintenance
  Aciclovir 5% cream 2g tube, apply yo lesion every 4hr 5x daily for 5 days

Question 5

what is shingles

• cause
• features
• treatment

Answer 5

Varicella zoster virus - reaction of latent virus in nerve
-pain/irritation of dermatome supply = severe burning, rash along dermatome develops and stomatitis, vesicles rupture and form crusting and scarring
ONLY TO MIDLINE

• shingles treatment pack
  aciclovir 800mg tablets, send 35
  take 1 tablet 5xdaily for 7 days