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Dermatology > Viral infections of the skin > Flashcards

Viral infections of the skin 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
Which HSV causes encephalitis?
Both
26
What is used in therapy of VZV and HSV?
Aciclovir
27
How does Aciclovir work?
Selectively incorporated into viral DNA inhibiting replication
28
What is the problem with aciclovir?
Doesn't eliminate latent virus
29
How is HSV/ VSV confirmed?
Swab with viral transport medium or antibody tests
30
What can trigger erythema multiforme reactions?
Drug reactions and some infections - HSV - mycoplasma pneumoniae
31
What is seen in molluscum contagiosum?
Fleshy, firm, umbilicated, pearlescent nodule | 1-2mm diameter
32
What is done for molluscum contagiosum?
Self limiting | Can be treated with local application of liquid nitrogen
33
How can molluscum contagiosum be transferred?
Between children or sexual transmission
34
What virus causes warts?
Human Papilloma Virus
35
Who is HPV commonest in?
Children
36
What is done in the treatment of HPV?
Self limiting, topical salicylic acid | May present as verrucas on feet
37
How many types of HPV are there?
>80
38
Which types of HPV are most common in warts/verruca?
1-4
39
Which HPV viruses causes genital warts?
6 & 11
40
Which HPV viruses causes cervical cancer?
16 & 18
41
What cancer can HPV cause?
Head and neck | Cervical
42
What is herpangina?
Blistering rash of back of mouth caused by enteroviruses - coxsackie virus - echovirus
43
What is done for herpangina?
Self-Limiting | -swab of lesion, sample of stool for enterovirus PCR
44
Who gets hand foot and mouth disease?
Typically children and family outbreaks
45
Which viruses cause hand foot and mouth?
Enteroviruses (especially coxsackie)
46
What can complicate hand foot and mouth disease?
Enterovirus 71 can cause fatality due to pulmonary oedema of neurogenic origin
47
What is erythema infectious and its presentation?
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
What are the complications of parvovirus?
Spontaneous abortion Aplastic crises Chronic anaemia
49
How is parvovirus confirmed in the lab?
Antibody testing B19 IgM test
50
What is Orf?
Virus of sheep 'scabby mouth'
51
What is seen in Orf?
Firm, fleshy nodules on hands of farmers Constitutional symptoms are rare Self limiting Clinical diagnosis, lab confirmation not used
52
What is noticed in primary syphilis infection?
Chancre | -painless ulcers at infection site
53
What is noticed in secondary phase of syphilis infection?
Red rash over body Prominent on soles of feet and palms of hands Mucous membrane 'snail track' ulcers
54
What is seen in tertiary syphilis infection?
CNS, cardiovascular, gummatous (benign granuloma) changes
55
What causes syphilis?
Sexually transmitted infection with bacterium treponema pallidum
56
How is syphilis diagnosed?
Blood test or swab of chancre for PCR
57
What is syphilis treated with?
Injections of penicillin
58
What is the vector for lyme disease?
Ticks
59
What bacteria causes lime disease?
Borrelia burgdorferi
60
How does lyme disease present?
Early: erythema migrans Late: heart block, nerve palsies, arthritis
61
What is the treatment for lyme disease?
Doxycyline or amoxicillin
62
How is lyme disease confirmed in the lab?
Blood test for antibodies
63
How long does a tick need to be attached for an infection to occur?
24 hrs
64
Describe the time progression of Zika virus
Symptom onset: 3-12 days | Symptom resolution: 2-7 days
65
What are the symptoms of Zika virus?
``` Mild fever Rash (maculopapular) Headaches Arthralgia Myalgia Non-purulent conjunctivitis ```
66
What is the presentation of Zika similar to ?
Chikungunya infection
67
What is Zika spread by?
mosquito aedes aegypti or by sexual transmissions
68
What are the complications of Zika infection?
Microcephaly and guillan barre syndrome

Dermatology (15 decks)

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