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Dermatology > Viral skin infections > Flashcards

Viral skin infections Flashcards

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Dermatology Board Prep flashcards
1
Q

Chickenpox and shingles are both caused by which virus?

A

Varicella zoster

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2
Q

How does chickenpox present?

A

Typically in childhood the patient will present with a generalised itchy rash and fever

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3
Q

How does shingles present?

A

Dermosomal reactivation of the virus typically in old age

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4
Q

How does chickenpox become shingles?

A

The virus becomes latent after an episode of chicken pox and settles in the sensory nerve roots where it can reactivate at any time

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5
Q

What is the progression of the chickenpox rash?

A

Macules to papules to vesicles to scabs to recovery

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6
Q

How would you describe the chickenpox rash?

A

Inflamed erythematous polymorphic rash with centripetal distribution of varying density

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7
Q

What are the possible complications of chickenpox?

A

Secondary bacterial infection, VZ pneumonitis, hemorrhagic chickenpox, scarring, encephalitis

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8
Q

What are some predictors of the severity of chickenpox?

A

Extremes of age or immunosuppression

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9
Q

Neonatal chickenpox infection can occur when the mother is infected with the virus during pregnancy. T/F

A

True

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10
Q

How high is the mortality rate for neonatal chickenpox? How can it be prevented?

A

Very high. Immunoglobulin injections in susceptible woman

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11
Q

Who gets shingles the most?

A

Elderly and/or immunocompromised patients

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12
Q

What is the progression of the shingles rash?

A

Tingling/pain > erythema > vesicles > crusts

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13
Q

What type of pain does shingles give its victims?

A

Neuralgic

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14
Q

After four weeks of shingles related pain what is the pain then called?

A

Post herpetic neuralgia

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15
Q

How common is scarring of the skin from shingles?

A

Un

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16
Q

What are the three divisions of the trigeminal nerve called?

A

Ophthalmic, maxillary & mandibular

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17
Q

What department needs urgent referral if a patient present’s with ophthalmic shingles?

A

Ophthalmology

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18
Q

What complications can arise from ophthalmic shingles?

A

Optic scarring, red eyes, facial palsy

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19
Q

In what circumstances would children be more likely to get shingles?

A

Chickenpox in utero or immunocompromised

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20
Q

What is Ramsay-Hunt syndrome?

A

Vesicles and pain in the auditory canal and throat along with facial palsy and irritation of the eight cranial nerve causing deafness, vertigo and tinnitus

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21
Q

What is the other names for Ramsay-Hunt syndrome?

A

Geniculate or otic herpes zoster

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22
Q

What is Bell’s palsy?

A

Bell’s palsy is a condition that causes temporary weakness or paralysis of the muscles in one side of the face.

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23
Q

What type of vaccine is the chickenpox vaccine?

A

Live attenuated

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24
Q

What are the indications for chickenpox vaccine in the UK?

A

At risk health care workers

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25
Q

What are the indications for the shingles vaccine in the UK?

A

70>

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26
Q

What is the difference between the chickenpox vaccine and the shingles vaccine?

A

The shingles vaccine is just a higher titre preparation

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27
Q

What are the benefits of giving the shingles vaccine?

A

Reduces incidence of shingles and incidence of post herpetic neuralgia

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28
Q

How does herpes simplex virus present?

A

+ primary gingivostomatitis -extensive ulceration in and around mouth
+ recurrence - blistering rash at vermillion border

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29
Q

When does herpes simplex virus typically present and how long does it last?

A

Pre-school children. Lasts around a week

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30
Q

Where can herpes simplex virus be spread to?

A

Fingers (herpetic whitlow) and eczema (herpeticum)

31
Q

What are the two types of herpes simplex virus and what are the differences between them?

A

Type 1 - mainly oral lesions and half of all genital cases, can cause encephilitis
Type 2 - rarely causes oral lesions, half of all genital cases, encephalitis/disseminated infection (neonates)

32
Q

What is the treatment of varicella zoster virus and herpes simplex virus?

A

Aciclovir

33
Q

What is the mechanism of action of aciclovir? What is the drawback of it?

A

Selectively incorporated into viral DNA to prevent replication. Does not eliminate latent virus

34
Q

How can herpes simplex/varicella zoster be diagnosed?

A

Viral swab (skin/mucous membrane infections), antibody tests (virus infected site inaccessible)

35
Q

What is erythema multiforme?

A

Erythematous target lesions

36
Q

What can trigger erythema multiforme?

A

Multiple drugs, infections (e.g herpes simplex virus, mycoplasma pneumonia)

37
Q

What is molluscum contagiosum?

A

Small, fleshy, firm, umbilicated, pearlescent nodes. Self limiting but months in duration.

38
Q

Who gets molluscum contagiosum?

A

Children mostly

39
Q

Molluscum contagiosum can be sexually transmitted. T/F

A

True

40
Q

How can molluscum contagiosum be treated?

A

Application of liquid nitrogen

41
Q

What causes warts?

A

Human papilloma virus

42
Q

What group commonly gets warts?

A

Children

43
Q

How can warts be treated?

A

Self limiting but topical salicylic acid can be used to speed up removal

44
Q

What can be caused by HPV?

A

Warts, veruccas (type 1-4), genital warts (type 6 & 11), cervical cancer (type 16 & 18), head & neck cancer

45
Q

What strains of HPV does the current UK vaccine protect against?

A

Types 6, 11, 16 & 18 (gardasil)

46
Q

What is herpangina?

A

Self limiting blistering rash at the back of the mouth

47
Q

What organisms cause herpangina?

A

Enterovirus (coxsackie & echovirus)

48
Q

How can herpangina be diagnosed?

A

Swabs or stool for PCR

49
Q

What is hand, foot and mouth disease?

A

Non-itchy erythematous vesicles on hands & feet as well as painful mouth ulcers

50
Q

Where does the rash on hand, foot and mouth disease also develop?

A

Knees, elbows, buttocks & groins

51
Q

Which virus causes hand, foot and mouth?

A

Enteroviruses (coxsackie)

52
Q

Who typically gets hand, foot and mouth?

A

Children & their families

53
Q

What is a complication of hand, foot and mouth caused by enterovirus 71?

A

Brain stem encephalitis

54
Q

Name a viral cause of rash and acute arthritis. What does this look like?

A

Erythema infectiosum. Slapped cheek appearance > lacy macular rash on the body (children). No macular rash present but acute polyarthritis of the small joints (adults).

55
Q

What virus causes slapped cheek disease?

A

Parvovirus B19

56
Q

What are the possible complications of slapped cheek disease?

A

Foetal hydrops followed by spontaneous abortion, aplastic crises or chronic anaemia (in immunosupressed)

57
Q

What is an aplastic crises? Who may experience this?

A

Sudden drop in haemoglobin. Patients with conditions giving short red cell lifespan who contract parvovirus B19

58
Q

How is slapped cheek disease diagnosed?

A

Antibody testing (IgM test)

59
Q

How does rubella present?

A

Diffuse erythema that blanches on pressure. After rash disappears there are often oral lesions & petechial haemorrhages on the soft palate. Systemic symptoms also

60
Q

How is rubella diagnosed?

A

Antibody testing

61
Q

How is rubella prevented?

A

Vaccination in high risk areas

62
Q

How does orf present?

A

Firm, fleshy nodules on the hands

63
Q

How is orf diagnosed? How is it treated?

A

Clinically. Self-limiting

64
Q

How is orf contracted? Who usually gets it?

A

Sheep. Farmers

65
Q

How does primary syphillis present? How does secondary syphillis present? How does tertiary syphilis present?

A

Chancres (painless ulcers) at site of entry. Red rash all over the body & most prominent on palmer/planter surfaces as well as mucous membrane snail track ulcers. CNS, CVS, gummatous, etc symptoms.

66
Q

What is the cause of syphilis? How is it spread?

A

Treponeum pallidum (BACTERIA). Sexually

67
Q

How is syphilis diagnosed?

A

Bloods or chancre swab for PCR

68
Q

How is syphilis treated?

A

Penicillin injections

69
Q

How does lyme disease present?

A

Erythema migrans > heart block, nerve palsies & arthritis

70
Q

What is the cause of lyme disease?

A

Borrelia burgdorferi hosted inside ticks

71
Q

How is lyme disease diagnosed?

A

Clinical but in later stages antibody blood test

72
Q

How is lyme disease treated?

A

Doxycycline or amoxicillin

73
Q

Tick bites are treated with prophylactic antibiotics. T/F

A

False - asymptomatic bites are left alone

Dermatology (26 decks)

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