Dr. Trump Virus lecture

Question 1

Herpes simplex virus type 1

Answer 1

spread primarily through saliva or active perioral lesion

Question 2

Herpes simplex virus type 2

Answer 2

spread primarily through sexual contact

Question 3

if you are younger than 18 and you get HSV-1 what is the clincial presentation going to be called?

Answer 3

gingivostomatitis

Question 4

if you are older than 18 and you get HSV-2 what is the clinical presentation going to be called?

Answer 4

pharyngotonsillitis

Question 5

Primary herpes-acute herpetic gingivostomatitis

Answer 5

• most common pattern of primary HSV-1 infection
• most cases are before age 5
• affected mucosa develops pinhead vesicles that rapidly collapse and form small red lesions
• initial lesions enlarge and develop central areas of ulceration covered by yellow fibrin
• adjacent ulcerations coalesce

Question 6

primary herpes-acute herpetic gingivostomatitis presentation in oral cavity

Answer 6

• on both movable and attached oral mucosa
• gingiva looks enlarged, painful, and extremely erythematous
• can spread onto vermillion
• self inoculation of fingers, eyes can occur

Question 7

primary herpes-pharyngotonsillitis symptoms

Answer 7

sore throat
fever
headache

Question 8

primary herpes-pharyngotonsillitis presentation

Answer 8

numerous small vesicles develop on tonsils and posterior pharynx

• rapidly rupture to form shallow ulcerations which coalesce
• diffuse, gray-yellow exudate forms
• can be due to HSV-1 and HSV-2

Question 9

recurrent Herpes simplex aka secondary herpes

Answer 9

can occur anywhere along the surface epithelium supplied by the involved ganglion(trigeminal)

Question 10

most common site of recurrence for HSV-1 is where?

Answer 10

vermilion border and adjacent skin of the lips

• herpes labialis
• cold sore
• fever blister
• usually will have prodrome 24 hr b4 lesion

Question 11

what can cause a recurrence

Answer 11

age
stress
pregnancy
allergies
trauma
illness
UV-only condition to induce lesion experimentally
-immunosuppression

Question 12

recurrent herpes simplex- intra oral lesions

Answer 12

almost ALWAYS on keratinized, bound mucosa

-palate, and attached gingiva

Question 13

are symptoms less or more intense than primary infection?

Answer 13

less

Question 14

presentation of secondary intra oral herpes lesions

Answer 14

begin as 1-3 mm vesicles

• rapidly collapse to form a cluster of erythematous macules that coalesce and slightly enlarge
• damaged epithelium is lost
• central, yellowish area of ulceration
• heals in 7-10 days

Question 15

HSV-1 less common presentation

-herpetic whitlow(herpetica paronychia)

Answer 15

infection of the thumb or fingers

Question 16

HSV-1 less common presentation

-herpes gladiatorum or scrumpox

Answer 16

herpetic infection found in wrestlers or rugby players with contaminated abrasions

Question 17

HSV-1 less common presentation

-herpes barbae

Answer 17

herpes over the bearded region of the face into minor injuries created by daily shaving

Question 18

histopathologic features of HSV

Answer 18

ballooning degeneration
multinucleation
Tzanck cells

Question 19

Varicella-zosters virus

Answer 19

chickenpox is primary infection
herpes zosters (shingles) is recurrence
-spreads through air droplets or direct contact w/acitve lesions
-most cases of primary between ages of 5-10
-90% infected by age 15

Question 20

Shingles

Answer 20

occurs in 20% of those who had chicken pox
prevalence increases with age
-single recurrence

Question 21

shingles oral lesions

Answer 21

occur with trigeminal nerve involvement
present on movable or bound tissue (diff than HSV)
lesions extend to midline and stop

Question 22

important things to look for in shingles

Answer 22

if the tip of the nose is involved, it is a sign ocular infection may occur
*referral to ophthalmologist is mandatory if pt experiences these lesions

Question 23

what is Ramsay Hunt Syndrome

Answer 23

cutaneous lesions of the external auditory canal with shingles

• involvement of ipsilateral face and auditory nerves
  
  • facial paralysis
  • hearing deficits
  • vertigo

Question 24

HHV-8

Answer 24

Kaposi’s sarcoma herpesvirus (causes cancer)
primary infection via sexual contact
-asymptomatic primary infection
-associated with a variety of lymphomas and Castleman’s disease

Question 25

HHV-6

Answer 25

creates specific pattern called roseola

Question 26

HHV-7

Answer 26

similar to HHV6

Question 27

In HHV-6 and HHV-7 where does primary latency reside?

Answer 27

in CD4 lymphocytes

-recurrences can result in widespread multiorgan infection

Question 28

HHV-4

Answer 28

epstein barr

Question 29

HHV-5

Answer 29

cytomegalow virus

Question 30

facts about the herpes virus

Answer 30

• humans are only natural reservoir
• all types cause primary infection and remain latent within specific cell types for life
• virus is shed in saliva or genital secretions