Viral Infections

Question 1

HSV-1 is found where typically?

Answer 1

Face and oral cavity

Question 2

HSV-2 is typically found where?

Answer 2

Genitals, usually sexually transmitted

Question 3

HHV-3 is which herpes virus?

Answer 3

Varicella-zoster virus (VZV) responsible for chicken pox and shingles

Question 4

HHV-4 is which herpes virus?

Answer 4

Epstein-Barr virus (EBV)

Question 5

HHV-5 is which herpes virus?

Answer 5

Cytomegalovirus (CMV)

Question 6

HHV-8 is which herpes virus?

Answer 6

Kaposi’s sarcoma herpesvirus (KSHV) usually sexually transmitted

Question 7

Which DNA virus is spread through saliva or perioral lesions, is best adapted above the waste and resides in the trigeminal ganglion?

Answer 7

HSV-1

Question 8

Gingivostomatitis is found in people ________ and younger while pharyngotonsillitis is usually in people ______and older

Answer 8

18, 18

Question 9

Pain, burning or itching 6-24h before a herpes lesion develops is called what?

Answer 9

Prodrome

Question 10

Recurrent herpes lesions are almost always found where?

Answer 10

On keratinized bound mucosa

*Primary herpes may be both movable or attached mucosa

Question 11

Gingivostomatitis is usually caused by HSV __ whereas pharyngotonsillitis can be HSV ___ or ___

Answer 11

1, 1, 2

Question 12

What are 3 less common presentations of HSV-1?

Answer 12

1-Herpetic whitlow (thumb or fingers)
2-Herpes gladiatorum/scrumpox (wrestlers)
3-Herpes barbae (shaving)

Question 13

Patients with chronic skin conditions may develop diffuse, life-threatening infection called what?

Answer 13

Eczema herpeticum or Kaposi’s varicelliform eruption

Question 14

What three main features are typical of histological HSV?

Answer 14

1-Multinucleation
2-Ballooning degeneration (acantholysis, nuclear clearing, nuclear enlargement)
3-Tzanck cells (free floaters)

Question 15

What are the primary and recurrent infections of VZV called?

Answer 15

Primary- chickenpox

Secondary-Shingles (unilateral)

Question 16

Where does VZV establish latency?

Answer 16

dorsal spinal ganglia

*usually only one recurrence

Question 17

Where do oral VZV lesions present?

Answer 17

• Movable or bound tissue

- usually terminate at the midline

Question 18

Associated with shingles, what are the 5 things that make up Ramsay Hunt Syndrome?

Answer 18

1-Cutaneous lesions of the external auditory canal
2-Involvement of ipsilateral face and auditory nerves
3-Facial paralysis
4-Hearing deficits
5-Vertigo

Question 19

What is the most common disease resulting from EBV exposure?

Answer 19

Infectious mononucleosis

Question 20

What are three other lesions which demonstrate EBV?

Answer 20

1-Oral hairy leukoplakia
2-Lymphomas/lymphoproliferative disorders (Notably African’s Burkitt’s lymphoma)
3-Nasopharyngeal carcinoma

Question 21

How do you diagnose infectious mononucleosis caused by EBV?

Answer 21

Presence of Paul-Bunnell heterophil antibodies

Question 22

Which herpes virus can reside in salivary gland cells, endothelium, macrophages, and lymphocytes and has an owl eye histology?

Answer 22

Cytomegalovirus (HHV-5)

Question 23

What are the 3 main classifications of enteroviruses?

Answer 23

1-Echoviruses
2-Coxsackievirus
3-Poliovirus

Question 24

Caused by cocksackieviruses which 3 conditions are particularly important to oral health?

Answer 24

1-Herpangina
2-Hand-foot-and-mouth disease
3-Acute lymphonodular pharyngitis

Question 25

Which cocksackievirus manifestation presents as a skin rash that begins as red macules with fragile vesicles that rapidly ulcerate?

Answer 25

Herpangina

Question 26

Which cocksackievirus manifestation resembles herpangina but is larger and more numerous with hand and oral lesions as well as on the borders of palms and soles?

Answer 26

Hand-Foot-And-Mouth disease

Question 27

Which cocksackievirus manifestation has 1-5 yellow to dark-pink nodules on the soft palate or tonsillar pillars?

Answer 27

Acute lymphonodular pharyngitis

Question 28

What is caused by a paramyxovirus and has 3 stages?

Answer 28

Rubeola (Measles)

Question 29

What are the 3 C’s of the first stage of rubeola measles?

Answer 29

1-Coryza (runny nose)
2-Cough
3-Conjunctivitis

Question 30

Koplik’s spots, appearing as grains of salt on a red background are typical of what?

Answer 30

Stage 1 of Rubeola (Measles)

Question 31

In the second stage of Rubeola (measles), koplik spots _____ but fever _____

Answer 31

fades, continues

Question 32

What characterized the 3rd stage of measles?

Answer 32

Fever ends, Rash fades and brown pigmentary staining

Question 33

What is caused by a toga virus and has the capacity to induce birth defects?

Answer 33

Rubella (german measles)

*cause congenital rubella syndrome

Question 34

Oral lesions in Rubella (german measles) are called?

Answer 34

Forchheimer’s sign

*small discrete, dark-red papules on the palate

Question 35

What are the 3 things that make up Congenital Rubella syndrome?

Answer 35

1-Deafness (80%)
2-Heart disease
3-Cataracts

Question 36

What disease is a disease of the exocrine glands and of which the salivary glands are the best known site of involvement?

Answer 36

Mumps (Epidemic parotitis)

Question 37

What is the target cell of HIV?

Answer 37

CD4+ helper T lymphocyte

Question 38

What are the 5 oral manifestations of HIV?

Answer 38

1-Candidiasis
2-Oral Hairy leukoplakia (EBV)
3-Kaposi’s sarcoma (HHV-8)
4-Non-Hodgkin’s lymphoma
5-Periodontal diseases

Question 39

How does Oral hairy leukoplakia present?

Answer 39

White mucosal plaque that does not rub off. Usually occur on the lateral border of tongue bilaterally

Question 40

What is a multifocal neoplasm of vascular endothelial cell origin called?

Answer 40

Kaposi’s Sarcoma (HHV-8)

Question 41

What are 3 atypical periodontal disease patterns associated with HIV?

Answer 41

1-Linear gingival erythema
2-Necrotizing ulcerative gingivitis (NUG)
3-Necrotizing ulcerative periodontitis (NUP)