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Flashcards in L74 Deck (53)
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31

Who is most likely to get chicken pox complications?

IC pts: newborns, pregnant, transplant, AIDs

32

Complications of chicken pox

CNS
Lungs: pneumonitis
Liver
Reye's syndrome - aka don't give aspirin to kids!!!

33

Hallmarks of Shingles rash

Vesiculopustular
Painful
Stops at midline

34

Shingles complications

Post-herpetic neuralgia
If CN 5 involvement --> encephalitis

35

What is the Shingles complication if there is geniculate ganglion involvement?

Ramsey Hunt Syndrome
- 1 sided facial palsy
- Lesions in ear
- Loss taste ant 2/3 tongue

36

Immune response to VZV

IgM + IgG - limit spread
CD4 - resolve rash

37

You're probably diagnosing CP/Shingles clinically, but if you really wanted to what test would you order?

Pap smear of a lesion
Direct fluorescent Ab
PCR of CSF if neuro involvment

38

What is the chicken pox vaccine?

Live, attenuated
2 shots
Prevents chicken pox in kids & decreases shingles in elderly

39

Which vaccine do you give to IC pts?

VZIG = immunoglobulin
Ex: pregnant women who have been exposed to chicken pox
Babies whose mothers have chicken pox

40

When and how do you treat chicken pox?

24 hrs of 1st lesion: PO acyclovir
Otherwise supportive

41

How do you treat IC pts with chicken pox?

Acyclovir IV

42

When and how do you treat Shingles in normal pts?

72hrs of 1st lesion: 7 day course of PO
- Acyclovir
- Famciclovir
- Valacyclovir

43

Which shingles complication/presentation should you always treat?

Opthalmic zoster

44

How do you treat shingles in IC pts?

IV acyclovir
Goal: decrease severity + speed healing

45

When does HHV 6 infection occur in life in comparison to CMV and EBV?

Earlier in life!

46

Which skin disease is most common in kids due to HHV6?

Roseola = exanthem subitum
1. Fever
Followed by
2. Red, raised rash w/o fever

47

Which conditions would clue you into an HHV 6 infection in kids AND adults?

Mono
Seizures in kids
Delayed bone marrow grafts in bone marrow transplant pts
DRESS syndrome = drug rxn eosinophila w/ systemic symptoms

48

Diagnose HHV6 infection.

Clinical
Serology: IgM & IgG
PCR

49

What 3 characteristics are unique about HHV8?

1. Tumor promoting genes
2. Lympho AND angiotrophic
3. Has proteins homologous to cell proteins

50

Which tissues does HHV8 infect?

Uro & GI epithelium

51

How does HHV8 lie latent?

Episome - contributes to oncogenic reactivation

52

Where in the world are HHV8 infections most prevalent?

Mediterranean + Africa

53

HHV8 transmission

Sex***
Mom-baby
Oral
Blood