ch 7 viral infections

Question 1

)What are the members of the Herpetoviridae family

Answer 1

HSV-1 HSV-2
Varicella Zoster (VSZ or HHV-3) Epstein Barr (EBV or HHV-4) Cytomegalovirus (CMV or HHV-5) Kaposi Sarcoma (KS or HHV-8)

Question 2

Which is the oral herpes

Answer 2

HSV-1

Question 3

Which is the genital herpes

Answer 3

HSV-2

Question 4

When is HSV 2 dangerous

Answer 4

delivery of baby

Question 5

Why do women have more risk of getting an STD

Answer 5

anatomy

Question 6

2 ways HSV-1 is spread

Answer 6

infected saliva or active perioral lesions

Question 7

Primary HSV-1 infection (Primary infection) age range

Answer 7

1st exposure, young age (6 mo-5 yrs, peak at 2-3 yrs due to daycare)

Question 8

Primary HSV-1 infection symptoms

Answer 8

fever to flu-like symptoms followed by lesions on lips and gums

Question 9

When is the only time HSV-1 while present on the lips and gums

Answer 9

Primary Infection

Question 10

What is the term for the Primary herpes infection presentation of fever with eventually ulcerations of the lips and gums

Answer 10

Primary/Acute Herpetic Gingivostomatitis

Question 11

What is the only thing that has unequivocally been proven to induce herpetic lesions after infection

Answer 11

UV light

Question 12

6 things that can reactivate HSV-1

Answer 12

UV light Emotional Stress

Trauma Respiratory illness Systemic diseases Malignancy

Question 13

Most common site of recurrence of HSV-1 and what is it called

Answer 13

Vermillion border and adjacent skin o f lips Herpes labialis

Question 14

Lay term for Herpes Labialis (Recurrent HSV-1)

Answer 14

cold sore/fever blister

Question 15

Herpes labialis symptoms

Answer 15

pain, burning, itching, local warmth

Question 16

Herpes Labialis course

Answer 16

prodromal pain 6-24 hours pre-lesion. Vesicle ruptures and crusts +2 days. Healing 7-10 days

Question 17

HSV-1 primary infection b/w ages 6 mos – 5 yrs, peaking at 2-3 yrs, w/ abrupt onset, cervical lymphadenopathy, fever (103-105), nausea, anorexia, irritability, mouth lesions

Answer 17

Acute Herpetic Gingivostomatitis

Question 18

Character of the lesions of Primary Herpetic Gingivostomatitis

Answer 18

distinctive punched out erosions, enlarged gingival, erythema, lesions all over mouth

Question 19

Herpes histology

Answer 19

Ballooning degeneration, multi-nucleated giant cells, Tzanck cells

Question 20

HSV-1 on thumbs or forefingers

Answer 20

Herpetic Whitlow

Question 21

3 topical anti-virals for HSV-1 treatment

Answer 21

Acyclovir Docosonal Penciclovir

Question 22

3 Systemic anti-virals for HSV-1 treatment

Answer 22

Acyclovir 200 mg Famciclovir 125 mg Valacyclovir 500mg

Question 23

What is the holistic approach for HSV-1 treatment

Answer 23

L-lysine 500mg

Question 24

Chicken pox primary infection b/w 5-9 years

Answer 24

Vericella Zoster Virus (HHV-3)

Question 25

Adult reactivation of Varicella-Zoster (HHV-3)

Answer 25

Herpes Zoster (shingles)

Question 26

What is the classic finding of Herpes Zoster (Shingles) and in what age

Answer 26

pt over 60, pain along nerve from back to front, then get lesions that scab in the area that look like shingles

Question 27

Where does Herpes Zoster (Shingles) reside when dormant

Answer 27

Dorsal Spinal ganglion

Question 28

Where does HSV-1 reside when dormant

Answer 28

Trigeminal nerve

Question 29

)Is there a vaccine for Herpes Zoster (Shingles)

Answer 29

Yes. Live attenuated vericella vaccine for adults

Question 30

Histology for HSV-1.Refers to free floating epithelial cell in any intraepithelial vesicle

Answer 30

Tzanck cells

Question 31

With the Herpes Zoster (Shingles) diagnosis, are the pain and lesions unilateral or bilateral

Answer 31

unilateral and painful

Question 32

Syndrome associated with Herpes Zoster (Shingles) that is a combination of cutaneous lesions of the external auditory canal and involvement of the ipsilateral facial and auditory nerves leading to facial paralysis, hearing defects, vertigo

Answer 32

Ramsay Hunt Syndrome

Question 33

symptomatic disease form exposure to Epstein-Barr Virus (HHV-4)

Answer 33

Infectious Mononucleosis

Question 34

When is Epstein Barr Virus (HHV-4) symptomatic: children or young adults

Answer 34

Young adults

Question 35

Infectious Mononucleosis (Epstein Barr Virus/HHV- 4) symptoms

Answer 35

``` Fever Lymphadenopathy Pharyngitis Tonsilitis Hepatosplenomegaly & rash (less frequent) ```

Question 36

What is a differential for lymphadenopathy in young adult

Answer 36

Cat scratch fever | Epstein Barr Virus (HHV-4/ Mononucleosis)

Question 37

2 tests that confirm Epstein Barr Virus

Answer 37

Paul-Bunnell heterophil antibody Indirectimmunofluorescent test for EBV-specific antibodies

Question 38

Treatment for Epstein Barr Virus (HHV-4)

Answer 38

non-aspirin antinpyretics and NSAIDS No contact sports if enlarged spleen

Question 39

This Herpetiform virus can reside latently in salivary gland cells, endothelium, macrophages, and lymphocytes

Answer 39

Cytomegalovirus (CMV, HHV-5)

Question 40

3 Enteroviruses of dental significance

Answer 40

Herpangina Hand-Foot-and-Mouth Disease Acute Lymphonodular pharyngitis

Question 41

Herpangina symptoms

Answer 41

acute onset of significant sore throat Dysphagia | Fever

Question 42

what is the character of the oral lesions associated with Herpangina

Answer 42

start as red maculles that ulcerate into 2-4 mm diameter ulcer, 2-6 total, posterior palate and tonsilar pillars

Question 43

Most well-known enterovirus infection

Answer 43

Hand-Foot-and-Mouth Disease

Question 44

What precedes what in the development of symptoms of Hand –foot-and-Mouth disease

Answer 44

Oral precedes cutaneous

Question 45

what is the difference in the oral lesions of Hand foot and Mouth versus Herpangina

Answer 45

Hand-Foot-and-Mouth has numerous oral lesions (1-30) that can be anywhere in the mouth, where Herpangina is 2-6 posterior mouth only

Question 46

This Enterovirus is characterized by 1-5 yellow to dark pink nodules on the soft palate and tonsillar pillars representing hyperplastic lymphoid tissue

Answer 46

Acute Lymphonodular Pharyngitis

Question 47

Will Acute Lymphonodular pharyngitis ulcerate

Answer 47

No

Question 48

Diagnosis of Enteroviruses

Answer 48

By clinical presentation

Question 49

Treatment of Enteroviruses

Answer 49

Self-limiting, so direct therapy toward symptomatic relief w/ non-aspirin anti-pyretics and topical anesthetics

Question 50

Infection produced by a paramyxovirus that has largely been controlled with vaccines

Answer 50

50.)Rubeola/Measles

Question 51

What is the most distinctive oral manifestion of Rubeola/Measels in its initial stage

Answer 51

Koplik’s spots

Question 52

What are Koplik’s spots

Answer 52

mucosal erythema w/ numerous small blue-white macules within

Question 53

What are the Pathoneumonic histologic cells for Measels

Answer 53

Warthin Finkeldey Giant Cells

Question 54

This sounds like the virus that causes normal measles, but this is a mild viral illness produced by a Togavirus, and has capacity to cause birth defects

Answer 54

Rubella/ German Measles

Question 55

What is the classic triad of congenital rubella syndrome (Siversky said good exam question)

Answer 55

Deafness Heart Disease | Cataracts

Question 56

This is a virus also caused by a Paramyxovirus, but this causes a diffuse disease of exocrine glands, with the Parotic salivary glands being the best known site of involvement

Answer 56

Mumps/ Endemic Parotitis

Question 57

What is a clinical symptom of Mumps/Endemic Parotitis

Answer 57

pain during initial parotid enlargement, then pain w/ chewing and salivation

Question 58

What is the 2nd most common place, beside the Parotid, that can swell due to Mumps/Endemic Parotitis

Answer 58

Testicles (Epididymoorchitis)

Question 59

What are oral infections associated with Human immunodeficiency Virus (HIV)

Answer 59

Candidiasis HIV associated Kaposi’s Sarcoma HIV associated Oral Hairy Leukoplakia

Question 60

What does HIV associated Kaposi’s Sarcoma look like

Answer 60

multiple lesions of skin and oral mucosa. Brown or reddish purple that do no blanch under pressure

Question 61

What are the common oral areas for HIV associated Kaposi’s Sarcoma

Answer 61

Hard Palate Gingiva Tongue