16.4

Question 1

mostly associated with orofacial disease,

Answer 1

HSV Type 1 (HSV-1)

Question 2

usually being associated with genital infection.

Answer 2

HSV Type 2 (HSV-2)

Question 3

is increasingly becoming a more common cause of genital mucosal infections in young women i

Answer 3

HSV-1

Question 4

greatest during childhood

HSV 1 or 2?

Answer 4

1

Question 5

Rates of infection with HSV-1 increase with __ and __

Answer 5

age and reduced socioeco- nomic status.

Question 6

t/f

infected with HSV-1 or HSV-2 are asymptomatic, they still can transmit the virus.

Answer 6

T

Question 7

the rate of acquisition of HSV-2 infection is higher for

women or men?

Answer 7

women

Question 8

genital HSV infec- tions significantly increase the risk for acquisition and transmission of __

Answer 8

HIV

Question 9

Primary infections with HSV, namely those that develop in persons without preexisting immunity to either HSV-1 or HSV-2, are usually more __

Answer 9

severe, frequently involve systemic signs and symptoms,

Question 10

___are most commonly associated with a primary HSV-1

Answer 10

Herpetic gingivostomatitis and pharyngitis

Question 11

perioral facial area, mainly the lips, with the ___ being the most commonly affected area

Answer 11

outer one-third of the lower lip

Question 12

Two-thirds of labial lesions involve the____and the rest occur at the junction of the border with the skin

Answer 12

vermilion border

Question 13

Prodromal symptoms precede herpes labialis in __ to __% of episodes. Patients experience___

Answer 13

45 to 60%

pain, burning, or itching at the site of the subsequent eruption

Question 14

The progression of classical herpes orofacial lesions has been divided according to the following stages based on their features:__, __ and __

Answer 14

the developmental stage (disease stage) (resolution stage)

Question 15

the developmental stage

Answer 15

prodromal, erythema, and papule

Question 16

(disease stage)

Answer 16

vesicle, ulcer, and hard crust

Question 17

resolution stage

Answer 17

dry flaking and residual swelling

Question 18

HSV lesions usu- ally resolve within __

Answer 18

5 to 15 days.

Question 19

Triggers for oral herpes recurrences include

Answer 19

emotional stress, illness, exposure to sun, trauma, fatigue, menses, chapped lips, and the season of the year

Question 20

___ 120 times less likely to reactivate

HSV1 or HSV2?

Answer 20

HSV2

Question 21

HSV 2, In males, lesions commonly occur on the in females, lesions may involve the vulva, perineum, buttocks, vagina, or cervix.

Answer 21

glans penis or the penile shaft;

Question 22

HSV 2, in females, lesions may involve the

Answer 22

vulva, perineum, buttocks, vagina, or cervix.

Question 23

occurs in more than 80% of women with primary infection. It can pres- ent as purulent or bloody vaginal discharge;

Answer 23

HSV cervicitis

Question 24

Without treatment, the genital lesions usually heal in .

Answer 24

6 to 10 days

Question 25

__ and __ are antimicrobial peptides that inhibit HSV replication.

Answer 25

Cathelicidin and beta-defensins

Question 26

results from widespread infection follow- ing inoculation of virus to skin damaged by eczema.

Answer 26

Eczema herpeticum (Kaposi varicelliform eruption)

Question 27

Recurrences are usually far__ than the first infec- tion.

Answer 27

milder

Question 28

Eczema herpeticum of the young infant is a __ and early treatment with__ can prove lifesaving.

Answer 28

medical emergency, acyclovir

Question 29

Recurrent HSV infection is the most common pre- cipitating event in cases of recurrent ___

Answer 29

erythema mul- tiforme

Question 30

account for more than 50% of cases of neonatal herpes

Answer 30

The encephalitic and disseminated disease forms

Question 31

is the most commonly identified acute, sporadic viral encephalitis

Answer 31

HSV encephalitis

Question 32

AIDS or transplantation recipients, are at particular risk for

Answer 32

progressive mucocutaneous or visceral infections

Question 33

For patients with active lesions, virus can be isolated in cell culture. In culture, HSV causes typical cytopathic effects, and most specimens will prove positive within __ hours after inocula- tion.

Answer 33

48 to 96

Question 34

solation of virus is most successful when lesions are cultured during the ___ and when specimens are taken from __ or __

Answer 34

vesicular stage immunocompromised patients or from patients suffer- ing from a primary infection.

Question 35

is more sensitive than viral isolation and has become the preferred method for diagnosis

Answer 35

PCR

Question 36

A giant, multinucleated keratino- cyte on a ___stained smear obtained from a vesicle base.

Answer 36

Giemsa smear for Tzanck cells.

Question 37

pathology

Answer 37

. Multinucleated cells with intranuclear eosinophilic inclusion bodies can be seen.

Question 38

Patients with genital herpes should be counseled to refrain from sexual intercourse during outbreaks and for__days after

Answer 38

1 to 2

Question 39

risk of transmit- ting herpes to the baby during childbirth is extremely (low/high)

Answer 39

low

Question 40

primary HSV infec- tion during pregnancy should be treated with

Answer 40

antiviral therapy.

Question 41

prophylactic therapy with __for infants born to mothers with primary infection;

Answer 41

intravenous acyclovir

Question 42

Treatment is warranted for infections that are

Answer 42

likely to prove protracted, highly symptomatic, or complicated.

Question 43

is approved by the FDA for nonprescription treatment of recurrent herpes labialis.

Answer 43

Docosanol 10% cream

Question 44

For disseminated or severe herpes infections, the treatment of choice remains __

Answer 44

intravenous acyclovir 10 to 15 mg/kg every 8 hours.

Question 45

The dose of intravenous acyclovir for neonatal herpes is

Answer 45

20 mg/kg per dose given every 8 hours.

Question 46

Antiviral treat- ment of initial herpes episodes (does/ does not) decrease subsequent recurrences,

Answer 46

does not

Question 47

Treatment of recurrent episodes of genital herpes reduces the time of healing from approximately__ days, time of cessation of viral shedding from 4 to 2 days, and duration of symptoms from 4 to 3 days

Answer 47

7 to 5

Question 48

HSV gingivostomatitis should be treated with

Answer 48

oral acyclovir.

Question 49

pediatric dose of acyclovir

Answer 49

is 15 mg/kg of acyclo- vir suspension orally 5 times a day for 7 days

Question 50

not currently approved for use in children.

Answer 50

Valacyclovir and famciclovir

Question 51

stage susceptible for treatment in oral herpes. what is the treatment?

Answer 51

prodromal/erythema penciclovir 1% cream q2 hours x 4days or docosanol 10% cream 5x a day, oral acyclovir 400mg 5x x 5 days

Question 52

are not beneficial in recurrent herpes labialis.

Answer 52

Creams and ointments containing 5% and 10% acyclovir

Question 53

Both perioperative ___ and ___ appeared to reduce the recurrence of orofacial HSV in patients undergoing facial laser resurfacing.

Answer 53

famciclovir (125 or 250 mg orally twice daily given 1 to 2 days before to 5 days after the procedure) and valacyclovir (500 mg twice daily for 14 days, starting either a day before or the day of the procedure)

Question 54

are effective in shortening the duration of dendritic and geographic keratitis

Answer 54

topical + oral antivirals

Question 55

does not require activation by HSV thymidine kinase and is usually effective in the treatment of acyclovir-resistant HSV. mode of delivery

Answer 55

Foscarnet and cidofovir IV

Question 56

Foscarnet, SE

Answer 56

nephrotoxicity, electrolyte disturbances, anemia, and seizures.

Question 57

Intravenous cidofovir is associated with considerable nephrotoxicity and requires the coadministration of ___ and ___

Answer 57

saline hydration and probenecid

Question 58

. A few patients with acyclovir-resistant genital herpes have responded to ____causes severe inflammation in some pat

Answer 58

imiquimod 5% cream.

Question 59

HSV infection can be prevented by ___, ___ and ___

Answer 59

total abstinence, Condoms and Male circumcision

Question 60

was effective in reducing the transmission of HSV-2

Answer 60

Valacyclovir 500 mg once daily

Question 61

showed a 50% reduction in HSV-2 genital shedding after vaccination.

Answer 61

HSV-2 gD2 and ICP4 protein