herpes

Question 1

HSV1, hsv2 and vzv target cell

Answer 1

mucoepithelial

Question 2

ebv target cell

Answer 2

epithelial cell and b lymphocytes

Question 3

cmv target cell

Answer 3

epithelial cells, monocytes, lymphocyte

Question 4

hsv1, hsv2, hsv3 latency

Answer 4

sensory nerve ganglia

Question 5

ebv latency

Answer 5

b lymphocyte

Question 6

cmv latency

Answer 6

monocyte, lymphocyte

Question 7

how long is a herpes infection? and why?

Answer 7

life long because the primary infection is followed by latent infection and recurrences

Question 8

t or f the herp can be shed assymptomatically

Answer 8

true

Question 9

t or f reccurent cases are a source of contagion

Answer 9

true

Question 10

t or f you hay have the herp but never develop signs or symptoms

Answer 10

true

Question 11

what is the current most common cause of genital herp

Answer 11

hsv 1

Question 12

herp incubation period

Answer 12

1 to 26 days
-average 6-8

Question 13

how does herp manifest the majority of the time

Answer 13

it doesn’t, the herp is silent

Question 14

S+S of the herp when it happens are dependent on what?

Answer 14

the anatomical site, the age and immune status

Question 15

the first episode is typically worse and involves the following symptoms:

Answer 15

-systemic signs and symptoms
-mucosal and extramucosal sites
-longer duration of symptoms
-longer duration of virus isolation from lessions
-higher rate of complications

Question 16

what will be the site of the outbreak

Answer 16

the site of contact

Question 17

gingiovostomatitis and pharyngitis are the most common herp in

Answer 17

kids and young adults

Question 18

where are the painful vesicles/ small blisters in gingivostomatitis and pharyngitis

Answer 18

-hard and soft palate, gingiva, tongue, lip and facial areas

Question 19

other signs and symp of gingiovostomatitis and pharyngitis

Answer 19

fever, malaise, myalgias, not eating, irritable, cervical adenopathy

Question 20

how to swab the lesion?

Answer 20

lift it and swab the base of the lesion to send for testing

Question 21

when is a reactivation more likley?

Answer 21

when immunocomp or stressed

Question 22

drugs that treat the herp

Answer 22

acyclovir and valocyclovir

Question 23

asymptomatic virus excretion in saliva, development of intraoral mucosal ulcerations, herpetic ulcerations on the vermilion border of the lip or facial skin (cold sore) are??

Answer 23

S+S of reactivation
*typically not a systemic thing

Question 24

when is recurrence more common

Answer 24

within the first year

Question 25

what do some people take in the first year

Answer 25

acyclovir as prophylaxis to suppress the virus more

Question 26

what will preceed the blisters

Answer 26

symptoms

Question 27

S+S of genital herp

Answer 27

-fever, headache, malaise, myalgias, pain, itch, discharge, tender lymphadenopathy, lesions (vesicles, pustules or ulcers) and proctitis

Question 28

what is proctitis

Answer 28

anorectal pain, discharge and tenesmus

Question 29

t or f reccurence is more localized

Answer 29

true

Question 30

what is a comon prodrome of genital herp

Answer 30

burning or tingling

Question 31

t or f affected ppl with the genital herp can shed the virus asymptomatically?

Answer 31

true

Question 32

what is herpes whitlow

Answer 32

herp on fingers *common in dentists

Question 33

how can we diagnose hs1 and 2

Answer 33

pcr/naat if we swab a lesion (3-4 times more sensitive than a culture)

Question 34

t or f hsv1 and 2 are included in a standard std pannel

Answer 34

false it is not included, pt may never get S+S and if the infection is latent we may never know where it is

Question 35

what happens if a pt is on suppressors and gets an ulcer

Answer 35

it is likely something else

Question 36

how long is the chickenpox incubation period and can we spread it

Answer 36

14 to 15 days, yes can spread in this time

Question 37

how do the chicken pox skin lesions progress

Answer 37

macule -> papule -> vesicle -> pustule -> scab

Question 38

when is chickenpox no longer infectious

Answer 38

when it is a scab

Question 39

what are complications of varicella

Answer 39

-bacterial infection of a skin lesion, cerebral ataxia, encephalites, meningitis, transverse myelitis, reye syndrome (that can have neurological symptoms), pneumonia

Question 40

who is at risk for the herp complications

Answer 40

adults, immunocomp, prego, newborn

Question 41

how can we diagnose varicella

Answer 41

-hx or physocal exam -pcr -culture (less sensitive test) -serology (more for immunity)

Question 42

t or f a chicken pox spot can also become an abscess or cellulitis

Answer 42

true

Question 43

how are we treating chickenpox

Answer 43

systomatically with antipyretics, soaks, antipruritics

Question 44

what can we do for adults esp immunocomp w chicken pox

Answer 44

AVC, famiciclovir and valacyclovir

Question 45

can immunocomp get the shingles vax

Answer 45

yes they can it is no longer a live vax and there is no risk of developing the pox

Question 46

what preceedes the shingles skin lesion by 2-3 days

Answer 46

pain

Question 47

if you are over 50 what do u have the risk of in shingles

Answer 47

-postherpetic neuralgia which can can happen 25-50% of the time -life long nerve pain

Question 48

what does the shingles follow

Answer 48

the nerve/ dermatone

Question 49

what is diseminated neuralgia

Answer 49

shingles on the whole body -very serious

Question 50

what are the risk factors for postherpetic neuralgia

Answer 50

over 50, severe pain before or after onset of rash, extensive rash, tigenimal or othalmic distribution of the rash

Question 51

can shingles affect the vision

Answer 51

yes it may never recover

Question 52

neurological complications of shingles

Answer 52

-myelitis, encephalitis, ventriculitis, meningoencephalitis, cranial nerve palsies, ischemic stroke syndrome

Question 53

cutaneous dissemination, pneumonia, hepatitis, disseminated intravascular coagulation is?

Answer 53

vzv viremia/ disceminated zoster

Question 54

can someone who never got the pox get the shingles

Answer 54

yes if they get it from a person with zoster -lower risk tho -direct contact with the lesion, MAYBE airbone

Question 55

when is local zoster contageous

Answer 55

-when the rash erupts to when the lesion gets crusty

Question 56

how to diagnose zoster

Answer 56

-pcr, dfa, culture (not as sensitive), serology (for immunity)

Question 57

how to treat zoster

Answer 57

acyclovir and valacyclovir -IV acyclovir if it is more severe

Question 58

what is the shingles vax

Answer 58

shingrix -recombinant zoster

Question 59

what is the older vax

Answer 59

zostavax

Question 60

how is ebv transmitted

Answer 60

saliva -causes mono -can feel like a cold

Question 61

who is at risk for lymphoroliferative disorder from ebv

Answer 61

-immuncomp, aids, transplant

Question 62

why does mono cause hepatosplenomegaly

Answer 62

it goes to b cells. lymphocytes

Question 63

clinical manifestation mono

Answer 63

fever, malaise, pharyngitis, cervical lymphadenopathy, hepatosplenomegaly, nausea, fever

Question 64

complications of mono

Answer 64

laryngeal obstruction, splenic rupture, autoimmune hemolytic anemia, meningocephalitis, guillain barre

Question 65

what is monospot and what is it detecting

Answer 65

rapid test for mono that detects antibodies -but can be caused by other things not ebv