Viral Skin Infections - Wright Flashcards

1
Q

HSV-1: where does it cause lesions?

A

perioral, lips, oral cavity

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2
Q

HSV-2: where does it cause lesions?

A

genital area

It takes two to get an STD

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3
Q

How is HSV transmitted?

A

Direct contact

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4
Q

History of primary HSV infection?

A

Pain, burning, and tingling in the area. Possible fever, malaise, LAD

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5
Q

What happens symptomatically as HSV recurs?

A

The symptoms tend to get milder

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6
Q

Appearance of HSV infection?

A

clusters of monomorphous vesicles with an erythematous base; “punched out” lesions and crusted papules

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7
Q

What petry dish technique is used to dx HSV?

A

Tzanck smear, you will see multinucleate giant cells

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8
Q

Should you culture/PCR HSV?

A

Yes

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9
Q

What is herpes zoster commonly known as?

A

Shingles

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10
Q

What increases your chances of VZV reactivation?

A

Age over 60, immunosuppression

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11
Q

Where does VZV lay dormant?

A

Dorsal root ganglia

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12
Q

What are some triggers for VZV reactivation?

A

Trauma, stress, fever, radiation, immunosuppression

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13
Q

Clinical appearance of VZV?

A

grouped vesicles following a DERMATOME; most commonly on the trunk

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14
Q

What is positive Hutchinson’s sign? What does this mean (THIS IS ON THE TEST)?

A

Vesicles at the tip/side of the nose; indicates the nasociliary branch of V1 is involved

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15
Q

Why is a positive Hutchinson’s sign a bad thing?

A

It increases the patient’s risk of blindness

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16
Q

What is a common complication of VZV after it resolves?

A

Postherpetic neuralgia (continued nerve pain) in 5-20% of patients, typically over 40

17
Q

Differentiating between HSV and VZV on history and physical alone?

A

HSV is not as painful, doesn’t follow a dermatome

18
Q

Is there a vaccine for VZV? Who should get it?

A

Yes, Zostavax; those 60 and older

19
Q

What is molluscum contagiosum?

A

Cutaneous infection caused by the pox virus

20
Q

What is the course of molluscum contagiosum? What will it leave behind?

A

Resolves spontaneously in months to years; can leave behind a depressed scar

21
Q

Clinical manifestation of mollscum contagiosum?

A

pink to skin-colored, 2-10 mm, dome-shaped, waxy papules, commonly with CENTRAL UMBILICATION

22
Q

Where does molluscum contagiosum commonly present?

A

Face, upper chest, extremities

23
Q

Treatment of molluscum contagiosum?

A

No clear evidence to support any one therapy.

She did talk about a drug called Cantharidin. MOA is to essentially cause blister of molluscum, dries up then falls of

24
Q

What causes warts (verrucae)

25
What are the oncogenic strains of HPV? (she said to know this)
16, 18, 31, 33
26
What do common warts look like? Where are they most common?
Single/multiple skin-colored, hyperkeratotic papules or plaques, might have black dots; most common on the HANDS (but can be anywhere)
27
What are the "black dots" you see in warts?
Thrombosed capillaries
28
What are filliform warts?
Warts that look like fingers; commonly around the eye or mouth
29
Describe flat warts. Where are they most common?
Smooth, skin-colored to slightly tan/pink flat-topped thin papules (3-5mm); legs (most common), face, arms, neck
30
What facilitates the spread of flat warts?
Shaving
31
Where are plantar warts found?
Plantar foot, toes
32
What is commonly seen in the plantar wart?
The black dots
33
What is characteristic of the appearance of anogenital warts?
Can form large masses resembling cauliflower
34
What is the best treatment for warts? Patients don't like this answer
Over the counter therapies
35
What are the 2 HPV vaccines?
Gardasil (16, 18, 6, 11) and Cervarix (16 and 18)