Viral STI continued

Question 1

When are neonates at highest risk for contracting HSV?

Answer 1

Neonates are at highest risk at birth from infected mothers when compared to after birth.

Question 2

What are three compliations with dermal neonatal herpes infections?

Answer 2

Blindness
Microcephaly
Spastic quadriplegia

Question 3

What percentage of neonates will develop encephalitis?

Answer 3

1/3 of neonate infections will develop into encephalitis often causing neurological impairment. Has 50% mortality in untreated patients.

Question 4

What percentage of neonates with visceral HSV will undergo mortality?

Answer 4

80% in untreated, when treated the rate dissipates to 20%.

Question 5

What are some of the complications with disseminated HSV?

Answer 5

HSV pneumotis and Disseminated intravascular coagulation.

Question 6

What treatment are neonates of HSV infected mothers given following birth?

Answer 6

IV administration of antivirals for all neonate herpes cases.

Question 7

What sort of virus is HSV?

Answer 7

HSV is an enveloped dsDNA virus that encodes many of its own enzymes including HSV polymerase.

Question 8

What sort of neurons does HSV like to hide in?

Answer 8

Sensory type neurons.

Question 9

HSV1 is most common with

Where as HSV2 is more common with….

Answer 9

HSV1 is more common with oral lesions where as HSV2 is most common with genital lesions.

Question 10

What sort of smear is important for diagnosis of HSV?

Answer 10

Tzanck smear.

Question 11

What can be used to determine between HSV1 and HSV2?

Answer 11

PCR can be used to detect the genome where as immunocytochemistry is used to detect antigens.

Question 12

Primary Genital herpes is treated with what?

Answer 12

Oral antiviral treatment.

Question 13

Recurrent genital herpes is treated with what?

Answer 13

Treated with long term oral antiviral treatment.

Question 14

What are the treatment goals of Anti-herpetic drugs?

Answer 14

Shorten time to lesion healing and increase time between outbreaks.

Question 15

Acyclovir and famciclovir work to treat what condition?

Answer 15

These work through similar mechanisms to treat HSV acting as nucleoside analogues for interuption of viral thymidine kinase.

Question 16

What is Foscarnet and how does it work?

Answer 16

Foscarnet is a nonnucleoside inhibitor of HSV used in acyclovir resistant HSV infections.
It acts by blocking viral DNA polymerases.

Question 17

What family is HPV a family member of?

Answer 17

Papovaviridae

Question 18

What type of virus is Human papillomavirus?

Answer 18

Non enveloped ds DNA genome

Question 19

Which two HPV strains increase risk of cervical cancer the most?

Answer 19

HPV-16 and HPV-18

Question 20

Upregulation of E6 and E7 are most closely tied to what infection?

Answer 20

HPV

If E6 and E7 go unchecked by E2 it can lead to excessive protein production leading to cancer.

Question 21

What does HPV E7 and HPV E6 block specifically?

Answer 21

HPV E6 blocks P53
HPV E7 blocks Rb
Both Rb and P53 normally stop the cell from entering S phase from G1.
Rising levels of E6 and E7 indicate risk of cancer.

Question 22

Appearance of Koilocytes in a pap smear are indicative of what pathology?

Answer 22

Koilocytes are seen in HPV infections and can help in the diagnosis of HPV.
Koilocytes are enlarged keratinocytes containing hyperchromatic nuclei surrounded by characteristic halo.

Question 23

At what age should YSPSTF HPV testing start and how often should the tests be done/ when should you stop?

Answer 23

The patient should be tested first at 21 years old.

Q3y paps costesting when older than 30 years old.

Stop at 65 if adequate prior screens.

Question 24

What sort of cervical smear helps to diagnose HPV?

Answer 24

Papanicolaou stained cervical smears.

Question 25

What prevention is there for HPV?

Answer 25

Guardisil and Ceravix.

Question 26

What sort of vaccine is guardasil?

Answer 26

Guardasil is a quadrivalent test that protects against HPV 6,11,16, and 18.
Prepared from viral capsid proteins (L1)

Question 27

What sort of vaccine is Ceravix?

Answer 27

A bivalent HPV vaccine protecting against HPV 16 and 18.

Question 28

Which HPV vaccines are recommended to women and at what age?

Answer 28

Either the bivalent (ceravix) or quadrivalent (guardasil) is recommended for women at ages 11-12.

Question 29

Which HPV vaccines are recommended to men and at what age?

Answer 29

Only the quadrivalent vaccine (guardasil) is recommended for boys at ages 11-12.