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Dermatology > Viral infections of the skin > Flashcards

Viral infections of the skin Flashcards

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Dermatology Board Prep flashcards
1
Q

What virus causes shingles and chicken pox?

A

Varicella zoster virus

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2
Q

What pattern is shingles seen in?

A

Dermatomal pattern

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3
Q

What is the developmental pattern of chickenpox lesions?

A

Macules to papules to vesicles to scabs to recover

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4
Q

What symptoms may occur with chicken pox?

A

Fever

itch

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5
Q

What complications can occur with chickenpox?

A

Secondary bacterial Pneumonitis
Haemorrhagic
Scarring
Encephalitis

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6
Q

What are the predictors of severity with chicken pox?

A

Extremes of the

Decreased cell mediated immnunity

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7
Q

What is neonatal VZV?

A

Secondary to chickenpox in mother in late pregnancy

Higher mortality

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8
Q

What can prevent neonatal VZV?

A

Varicella zoster immune globulin in susceptible women in contact

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9
Q

What is the pattern of development of shingles?

A

TIngling/pain to erythema to vesicles to crusts

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10
Q

Describe zoster associated pain?

A

Neuralgic in character

beyond 4 week known as post herpetic neuralgia

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11
Q

What is ophthalmic zoster?

A

Ophthalmic division of trigeminal nerve affected, urgent opthalmic referral indicated

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12
Q

What is seen in late ophthalmic zoster?

A

Scarring and red eye, facial palsy

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13
Q

When can ophthalmic zoster occur in children?

A

If chickenpox in utero or if they become immunocompromised

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14
Q

What is ramsay hunt syndrome?

A

Vesicles and pain in auditory canal and throat

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15
Q

What causes facial palsy?

A

7th nerve palsy

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16
Q

What does irritation of the 8th cranial nerve cause?

A

Deafness
Vertigo
Tinnitus

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17
Q

What is available for chickenpox prevention?

A

Live attenuated vaccine is available

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18
Q

What is available for shingles prevention?

A

Same attenuated vaccine used in chickenpox can be used in high titre preparation in elder to reduce impact of shingles

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19
Q

What does herpes simplex virus present as in pre-school children?

A

Primary gingivostomatitis

Extensive ulceration in and around mouth

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20
Q

How long does herpes simplex virus last in pre-school children?

A

around a week

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21
Q

What happens in later life in HSV?

A

Recurrence

Blistering rash at the vermillion border

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22
Q

How can HSV be spread?

A

Can be spread to finger (herpetic whitlow) or to the patients eczema (eczema herpeticum)

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23
Q

What HSV is the main cause of oral lesions?

A

HSV 1

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24
Q

HSV1/HSV2 ratio in genital lesions?

A

50/50

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25
Q

Which HSV causes encephalitis?

A

Both

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26
Q

What is used in therapy of VZV and HSV?

A

Aciclovir

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27
Q

How does Aciclovir work?

A

Selectively incorporated into viral DNA inhibiting replication

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28
Q

What is the problem with aciclovir?

A

Doesn’t eliminate latent virus

29
Q

How is HSV/ VSV confirmed?

A

Swab with viral transport medium or antibody tests

30
Q

What can trigger erythema multiforme reactions?

A

Drug reactions and some infections

  • HSV
  • mycoplasma pneumoniae
31
Q

What is seen in molluscum contagiosum?

A

Fleshy, firm, umbilicated, pearlescent nodule

1-2mm diameter

32
Q

What is done for molluscum contagiosum?

A

Self limiting

Can be treated with local application of liquid nitrogen

33
Q

How can molluscum contagiosum be transferred?

A

Between children or sexual transmission

34
Q

What virus causes warts?

A

Human Papilloma Virus

35
Q

Who is HPV commonest in?

A

Children

36
Q

What is done in the treatment of HPV?

A

Self limiting, topical salicylic acid

May present as verrucas on feet

37
Q

How many types of HPV are there?

A

> 80

38
Q

Which types of HPV are most common in warts/verruca?

A

1-4

39
Q

Which HPV viruses causes genital warts?

A

6 & 11

40
Q

Which HPV viruses causes cervical cancer?

A

16 & 18

41
Q

What cancer can HPV cause?

A

Head and neck

Cervical

42
Q

What is herpangina?

A

Blistering rash of back of mouth caused by enteroviruses

  • coxsackie virus
  • echovirus
43
Q

What is done for herpangina?

A

Self-Limiting

-swab of lesion, sample of stool for enterovirus PCR

44
Q

Who gets hand foot and mouth disease?

A

Typically children and family outbreaks

45
Q

Which viruses cause hand foot and mouth?

A

Enteroviruses (especially coxsackie)

46
Q

What can complicate hand foot and mouth disease?

A

Enterovirus 71 can cause fatality due to pulmonary oedema of neurogenic origin

47
Q

What is erythema infectious and its presentation?

A

Slapped cheek effect
Caused by erythrovirus
(parvovirus B19)
As rash on face fades may develop into a lacy macular rash on the body
In adults arthritis may be more prevalent than rash

48
Q

What are the complications of parvovirus?

A

Spontaneous abortion
Aplastic crises
Chronic anaemia

49
Q

How is parvovirus confirmed in the lab?

A

Antibody testing B19 IgM test

50
Q

What is Orf?

A

Virus of sheep ‘scabby mouth’

51
Q

What is seen in Orf?

A

Firm, fleshy nodules on hands of farmers

Constitutional symptoms are rare

Self limiting

Clinical diagnosis, lab confirmation not used

52
Q

What is noticed in primary syphilis infection?

A

Chancre

-painless ulcers at infection site

53
Q

What is noticed in secondary phase of syphilis infection?

A

Red rash over body
Prominent on soles of feet and palms of hands
Mucous membrane ‘snail track’ ulcers

54
Q

What is seen in tertiary syphilis infection?

A

CNS, cardiovascular, gummatous (benign granuloma) changes

55
Q

What causes syphilis?

A

Sexually transmitted infection with bacterium treponema pallidum

56
Q

How is syphilis diagnosed?

A

Blood test or swab of chancre for PCR

57
Q

What is syphilis treated with?

A

Injections of penicillin

58
Q

What is the vector for lyme disease?

A

Ticks

59
Q

What bacteria causes lime disease?

A

Borrelia burgdorferi

60
Q

How does lyme disease present?

A

Early: erythema migrans
Late: heart block, nerve palsies, arthritis

61
Q

What is the treatment for lyme disease?

A

Doxycyline or amoxicillin

62
Q

How is lyme disease confirmed in the lab?

A

Blood test for antibodies

63
Q

How long does a tick need to be attached for an infection to occur?

A

24 hrs

64
Q

Describe the time progression of Zika virus

A

Symptom onset: 3-12 days

Symptom resolution: 2-7 days

65
Q

What are the symptoms of Zika virus?

A 
Mild fever
Rash (maculopapular)
Headaches
Arthralgia
Myalgia 
Non-purulent conjunctivitis
66
Q

What is the presentation of Zika similar to ?

A

Chikungunya infection

67
Q

What is Zika spread by?

A

mosquito aedes aegypti or by sexual transmissions

68
Q

What are the complications of Zika infection?

A

Microcephaly and guillan barre syndrome

Dermatology (15 decks)

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