Virology

Question 1

what virus causes both chicken pox and shingles

Answer 1

varicella zoster virus

Question 2

what is caused by varicella

Answer 2

chickenpox

Question 3

describe chickenpox

Answer 3

primary infection typically in childhood generalised rash, itch and fever, virus establishes latency in sensory nerve roots

Question 4

what is shingles

Answer 4

dermatomal rash due to the reactivation of zoster or herpes zoster (typically in old age/ immunocompromised)

Question 5

describe the chicken pox rash

Answer 5

macules to papules to vesicles to scabs to recovery- centripetal, density varies, inflamed skin

Question 6

what are the possible complications of chickenpox

Answer 6

secondary bacterial, pneumonitis, haemorrhagic rash, scarring, enecphalitis

Question 7

what are the predictors of severity of chicken pox

Answer 7

extermes of age, depressed cell mediated immunity

Question 8

what causes neonatal chickenpox

Answer 8

secondary to chickenpox in mother in later pregnancy

Question 9

how can neonatal chicken pox be prevented

Answer 9

varicella zoster immune globulin injection in susceptible women

Question 10

describe the shingles rash

Answer 10

dermatomal unilateral distrubution, tingling pain to erythema to vesicles to crusts

Question 11

describe zoster associated pain

Answer 11

neuralgic, gets worse with increasing age

Question 12

what is post herpetic neuralgia

Answer 12

when pain persists beyond week four

Question 13

what is opthalmic zoster

Answer 13

zoster infection of opthalmic division of trigemial nerve

Question 14

which type of shingles requires urgent referral to opthamology

Answer 14

opthalmic zorster

Question 15

why can children develop opthalmic zoster

Answer 15

if they get chicken pox in utero or become immunocompressed

Question 16

what is ramsay hunt syndrome

Answer 16

vesicles and pain in auditory canal and throat, facial pasley (7th nrve), irritation of 8th cranial nerve (deafness, vertigo, tinnitus)

Question 17

who is the vaccine (live attenuated) for chickenpox used on in the uk

Answer 17

only susceptible health care workers

Question 18

is there a vaccine for shingles

Answer 18

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

Question 19

what virus causes primary gingivostomatitis and extensive ulceration in and around mouth in pre school children

Answer 19

herpes simplex virus

Question 20

descibe the recurrence of HSV in adults

Answer 20

blistering rash that can be spread to finger or eczema (eczema herpeticum)

Question 21

what are the two types of HSV

Answer 21

type 1- main cause of oral lesions, 1/2 genital herpes, causes encephalitis

type 2- rare oral lesions, 1/2 genital, causes encephalitis and disseminated infection (esp. in neonates)

Question 22

what is the treatment for HSV and how does it work

Answer 22

aciclovir- analouge of guanosine, incorporated into viral DNA inhibiting replication (doesnt eliminate latent virus)

Question 23

what to test for lab confirmation of virus

Answer 23

swap (with viral transport medium) or antibody test if site inaccessible

Question 24

what is erythema multiforme

Answer 24

target leions with erythema, triggers inc drugs and some infections (HSV, mycoplasma pneumoniae bacterium)

Question 25

what is molluscum contagiosum

Answer 25

fleshy, firm, umbilicated pearlescent nodules (1 to 2mm diameter) self limiting, may take months to go common in children, can be sexually transmitted

Question 26

how can you treat molluscum contagiosum

Answer 26

mostly self limiting but can with liquid nitrogen

Question 27

what virus causes warts and verucas

Answer 27

human papilloma virus

Question 28

what other diseases are caused by HPV

Answer 28

genital warts, cervical cancer, head and neck cancer

Question 29

what is herpangina and what causes it

Answer 29

blistering rash on back of mouth cause by enterovirus coxsackie, echovirus) self limiting (swab lesion of sample stool for PCR)

Question 30

what is hand foot and mouth disease

Answer 30

caused by enteroviruses (esp. coxsackie) typically in children, family outbreaks

Question 31

what are possible complications of HFMD

Answer 31

death- pulmonary oedema of neurogenic origin

Question 32

what is a viral cause of rash and acute athritis

Answer 32

parovirus B19 causing erythema infectiosum (slapped cheek disease)

Question 33

what does centripetal mean

Answer 33

densest in the middle

Question 34

inflamed skin is affected worse by chicken pox true or false

Answer 34

true (e.g sunburn)

Question 35

why do you get encephalitis due to chickenpox

Answer 35

if virus spreads to nervous system

Question 36

what can chicken pox in pregnancy cause

Answer 36

foetal varicella syndrome

Question 37

what is erythema multiforme

Answer 37

autoimmune reaction triggered by infection

Question 38

what is the most common symptom of parovirus 19 infection in children

Answer 38

florid red rash

Question 39

what are possible complications of parovirus B19

Answer 39

spontaneous abortion apalstic clisis (sudden drop in haemoglobin) chronic anaemia(in immunosuppressed)

Question 40

how does the lab confirm parovirus B19

Answer 40

antibody IgM test

Question 41

list symptoms of rubella

Answer 41

fever, sore throat, arthalgia, rash, diffue erythema, pain in oral cavity (haemorrhages)

Question 42

what is ORF

Answer 42

virus of sheep than can cause firm fleshy nodule on hands of farmers

Question 43

what is the presentation of primary syphilis infection

Answer 43

chancre (painless ulcers at site of entry)

Question 44

what is the presentation of the secondary phase of syphilis infection

Answer 44

red rash over body- coppery discolouration prominent on soles of feet and palms mucous membrane 'snail track' ulcers

Question 45

what does the tertiary syphilis infection affect

Answer 45

CNS, cardiovascular, gummatous etc possible to have aneursym on aorta causing pulsatile chest swelling

Question 46

what organism causes syphilis

Answer 46

bacterium trepnoema pallidum

Question 47

how do you diagnose syphilis

Answer 47

blood test, swap of chancre for PCR

Question 48

how is syphilis infected

Answer 48

injections of penicillin

Question 49

is syphilis more common in men or women

Answer 49

men

Question 50

what is erythema migrans

Answer 50

rash seen in early stages of lyme disease- has a raised palpable edge

Question 51

what is the vector and causative organism of lyme disease

Answer 51

ticks | bacteria- borrelia burgdorferi

Question 52

how does lyme disease present

Answer 52

early- erythema migrans late- heart block, nerve palsies, arthritis

Question 53

how long does tick need to be attached to infect

Answer 53

24hrs

Question 54

how do you diagnose lyme disease

Answer 54

erythema migrans diagnostic or if late antibody blood test

Question 55

describe the symptom onset and resolution of zika

Answer 55

onset 3-12 hours after exposure resolution 2-7 days after onset

Question 56

what are the symptoms of zika

Answer 56

mild fever, rash (mostly macropapular), headaches, arthralgia, myalgia, non purulent conjunctivitis

Question 57

what spreads zika

Answer 57

mosquito (aedes aegypti), sex

Question 58

what are the complications of zika

Answer 58

microcephaly and guillain barre syndrome

Question 59

what types of HPV cause viral warts

Answer 59

types 1-4

Question 60

what happens if viral warts are left intreated

Answer 60

may get worse initially but ultimately regress and disappear

Question 61

what are the treatments for viral warts

Answer 61

cryotherapy (liquid nitrogen) surgery topical salicylic acid formealdehyde

Question 62

what type of HPV cause viral warts and are they cancerous

Answer 62

6-11 not cancerous

Question 63

what antiviral for shingle

Answer 63

aciclovir

Question 64

what type of HSV causes eczema herpeticum

Answer 64

HSP1

Question 65

what are features of parovirus B19

Answer 65

in urtero can cause spontaneous abortion infection children often look and feel well it causes erythema infectiosum

Question 66

what virsues cause herpangina (blistering rash at back of mouth)

Answer 66

coxsackie ad echo virsues

Question 67

what causes orf and what is the presentation

Answer 67

caused by a sheep virus, firm fleshy nodules on the hands of mostly farmers

Question 68

what is slapped cheek syndrome

Answer 68

erythema infectiosum- viral infection caused by parovirus B19, giving (mainly children) the appearance of red inflamed cheeks