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Dermatology > Viral Skin Infections > Flashcards

Viral Skin Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

What virus cause chickenpox and shingles?

A

Varicella zoster virus

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2
Q

What causes chickenpox?

A

Varicella-primary infection in childhood, generalised rash and fever, virus establishes latency, sensory nerve roots

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3
Q

What causes shingles?

A

Zoster/herpes zoster-reactivation (typically old age), dermatomal

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4
Q

What is the progression of chickenpox?

A

Macules, papules, vesicles, scabs, recovery (centripetal, density varies, inflamed skin)

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5
Q

What symptoms accompany the rash in chickenpox?

A

Fever, itch

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6
Q

What are some complications of chickenpox?

A

Secondary bacterial pneumonitis, haemorrhagic, scarring, encephalitis

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7
Q

What are some predictors for the severity of chickenpox?

A

Extremes of age, depressed cell mediated immunity

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8
Q

What are some features of the chickenpox vaccine?

A

Live attenuated vaccine, widely used but not routine in UK, used in susceptible health workers

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9
Q

How does Neonatal VZV occur?

A

Secondary to chickenpox in mother in late pregnancy (higher mortality)

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10
Q

How can Neonatal VZV be prevented?

A

Prevention with Varicella Zoster Immune Globulin or Aciclovir in women exposed late in pregnancy

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11
Q

How is shingles distributed?

A

It follows the dermatomes

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12
Q

Who gets shingles?

A

Elderly, immunocompromised

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13
Q

What is the progression of shingles?

A

Tingling/pain, erythema, vesicles, crusts

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14
Q

What character does zoster associated pain have?

A

Neuralgic

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15
Q

What does zoster associated pain become known as if it persists beyond 4 weeks?

A

Post herpetic neuralgia (in elderly and those with route of trigeminal nerve affected)

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16
Q

Is scarring common in shingles?

A

No

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17
Q

What vaccine is used to prevent shingles?

A

Same attenuated VZV used in chickenpox vaccine can be used in high titre preparations in elderly to reduce impact of disease (reduces incidence and post herpetic neuralgia)

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18
Q

How does Ophthalmic Zoster arise?

A

When shingles affects the trigeminal nerve, can happen in children especially if chickenpox in utero/immunocompromised

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19
Q

What is Ramsay-Hunt Syndrome?

A

Vesicles and pain in auditory canal and throat, also known as geniculate or otic herpes zoster

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20
Q

What nerves can be affected in Ramsay-Hunt Syndromes?

A

7th nerve-facial palsy (better prognosis than Bell’s palsy)

8th cranial nerve-irritation causing deafness, vertigo and tinnitus

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21
Q

What is another name for Herpes simplex virus?

A

Primary gingivostomatitis

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22
Q

What occurs in Herpes simplex infection and who commonly gets it?

A

Extensive ulceration in and around the mouth which lasts around a week; pre-school children

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23
Q

What does the recurrence of Herpes simplex virus look like?

A

Blistering rash at vermillion border

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24
Q

Where can Herpes simplex spread to?

A

The finger or to eczema-causes herpetic whitlow and eczema herpeticum (life threatening)

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25
Q

What are the characteristics of Herpes simplex type 1?

A

Main cause of oral lesions, cause of 50% of genital herpes, cause of encephalitis

26
Q

What are the characteristics of Herpes simplex type 2?

A

Rare cause of oral lesions, cause of 50% of genital herpes, encephalitis/disseminated infection (particularly in neonates)

27
Q

What is an example of an antiviral used to treat varicella zoster and herpes simplex viruses?

A

Aciclovir-analogue of guanosine, selectively incorporated into viral DNA inhibiting replication, does not eliminate latent virus

28
Q

How can varicella zoster and herpes simplex be confirmed in the lab?

A

Swab with viral transport medium (preferred for viral skin/mucous membrane inflections), antibody tests (yellow top vacutainer, used where virus infected site is inaccessible or as adjunct to swab)

29
Q

What causes Erythema multiforme, and what does the condition look like?

A

Herpes simplex virus, Mycoplasma pneumoniae bacterium, some drug reactions; target lesions with erythema

30
Q

What is Molluscum conatgiosum?

A

Fleshy, firm, umbilicated pearlescent lesions (1-2mm diameter), self limiting but take months to disappear, common in children, also sexually transmitted, can be treated with local application of liquid nitrogen

31
Q

What are warts?

A

Caused by Human papilloma virus, commonest in children, self limited and uncomplicated, called verrucas if on feet, treat with topical salicylic acid

32
Q

What types of HPV are associated with warts and verrucas?

A

Types 1-4

33
Q

What type of HPV causes genital warts?

A

Types 6 and 11 are most associated

34
Q

What cancers are linked to HPV?

A

Cervical (especially types 6 and 11), head and neck cancer

35
Q

What types of HPV does the new Gardasil vaccine protect against?

A

6, 11, 16 and 18

36
Q

What types of HPV does the old Cervatrix vaccine protect against?

A

16 and 18

37
Q

What is herpangina?

A

Blistering rash at back of mouth, caused by enterovirus (coxsackie virus, echovirus), self limiting

38
Q

How do you test for herpangina?

A

Swab of lesion or stool sample for enterovirus PCR

39
Q

What causes hand, foot and mouth disease?

A

Enteroviruses (especially coxsackie), typically children and family outbreaks, not same virus as animal disease of the same name

40
Q

What is the other name for Erythema infectiosum and what causes it?

A

Slapped cheek disease; caused by parovirus B19

41
Q

What occurs in Erythema infectiosum?

A

Acute arthritis (especially in the wrists) is commonly seen, especially as the rash fades in adults

42
Q

What are some complications of Erythema infectiosum?

A

Spontaneous abortion (fetal hydrops as precursor), aplastic crises (sudden drop in haemoglobin, seen in patients with short red cell life span e.g thalassaemia), chronic anaemia (in immunocompromised)

43
Q

How is Erythema infectiosum confirmed in the lab?

A

Antibody testing-parovirus B19 IgM test

44
Q

What are some features of orf?

A

Virus of sheep (scabby mouth), fleshy, firm nodules on hands of farmers, constitutional symptoms rare, self limiting, lab diagnosis not used so clinical diagnosis

45
Q

What occurs in the primary phase of syphilis infection?

A

Chancre (painless ulcers at site of entry)

46
Q

What occurs in the secondary phase of syphilis infection?

A

Red rash over body, prominent on soles of feet and palms of hands, erosions of tongue/hard and soft palate/tonsils, mucous membrane “snail track” ulcers

47
Q

What occurs in the tertiary phase of syphilis?

A

CNS and cardiovascular involvement, becomes gummatous (small soft swellings form on connective tissue of heart etc)

48
Q

What causes syphilis?

A

Sexually transmitted infection with Treponema pallidum bacterium

49
Q

What is the diagnosis and treatment of syphilis?

A

Diagnosed by blood test or swab of chancre for PCR; treated with penicillin injections

50
Q

What is the causative bacteria and vector in Lyme disease?

A

Caused by Borrelia burgdorferi and transferred by ticks

51
Q

What are the early and late presentations of Lyme disease?

A

Early=erythema migrans

Late=heart block, nerve palsies, arthritis

52
Q

How is Lyme disease treated?

A

Doxycycline or amoxicillin

53
Q

How is Lyme disease confirmed in the lab?

A

Blood test for antibody of organism, mainly fir late presentations

54
Q

How many people infected with zika virus become ill?

A

1 in 5

55
Q

When do symptoms for zika virus appear, and how long does it take for them to resolve?

A

Onset 3-12 days after exposure; resolve after 2-7 days after onset

56
Q

What are the symptoms of zika virus?

A

Mild fever, rash (mostly maculopapular), headaches, arthralgia, myalgia, non-purulent conjunctivitis

57
Q

What other disease have a similar presentation to zika virus?

A

Dengue and Chikungunya infection

58
Q

How is zika virus spread?

A

By the mosquito Aedes aegypti (endemic to dozens of tropical countries), sexually transmitted from person to person

59
Q

Is severe disease requiring hospitalisation common in zika virus?

A

No-fatalities also rare

60
Q

What are some complications of zika virus?

A

Microcephaly, Guillan-Barre syndrome

Dermatology (31 decks)

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