L8: viral infections extras (types of HPV and also, rubella)

Question 1

verruca vulgaris is hpv what?

Answer 1

hpv 2 and 4

Question 2

verruca vulgaris often affects what type of ppl

Answer 2

children

Question 3

clinical presentation of verruca vulgaris

• white _____/ nodule (5mm)
• _____ projections or rough ______ surface
• painless, _________/sessile
• _____/ keratin horn

Answer 3

• white papule/ nodule (5mm)
• papillary projections or rough pebbly surface
• painless, pedunculated/sessile
• cutaneous/ keratin horn

Question 4

what is the name of a common wart

Answer 4

verruca vulgaris

Question 5

location of verruca vulgaris

Answer 5

• vermillion border, labial mucosa
• anterior tongue
• skin of hands

Question 6

clincial presentation of verruca vulgaris

• white papule/ _____ (how many mm?)
• _______ or rough pebbly surface
• painful or not?
• pedunculated/_____
• cutaneous/ _____

Answer 6

• white papule/ nodule (5mm)
• papillary projections or rough pebbly surface
• painless
• pedunculated/sessile
• cutaneous/ keratin horn

Question 7

squamous papilloma is associated with what strains of hpv

Answer 7

6 and 11

Question 8

squamous papilloma clinical presentation

• mainly in what type of ppl?
• solitary or multiple?
• _____ nodule (0.5-3mm)
• _____ like surface projections, blunted/pointed
• ______ or wart like appearance
• painless or painful?
• pedunculated, soft
• what colour?

Answer 8

• mainly in adults (30-50 yo)
• solitary
• exophytic nodule (0.5-3mm)
• finger like surface projections, blunted/pointed
• cauliflower or wart like appearance
• painless, pedunculated, soft
• white/ red/ normal in colour (depend on amunt of surface keratinisation)

Question 9

where are lesions of squamous papilloma found?

Answer 9

anywhere in mouth
is the most common soft tissue mass on soft palate

Question 10

clinical presentation of condyloma acuminatum

• affects what type of ppl? what type of transmission?
• _________ , ____mass (1cm)
• short, ______ surface projections
• painless or painful?
• mobile or sessile (immobile)?
• what colour?
• may cluster together

Answer 10

• teenagers and young adults (sexually transmitted)
• well demarcated, exophytic mass (1cm)
• short, blunted surface projections
• painless
• sessile
• pink
• may cluster together

Question 11

which hpv strain is associated with condyloma acuminatum?

Answer 11

hpv 6 and 11

Question 12

where is condyloma acuminatum found in the oral cavity?

Answer 12

• labial mucosa
• soft palate
• lingual frenum

Question 13

rubeola aka measles is under what virus family?

Answer 13

paramyxovirus

Question 14

incubation time of rubeola

Answer 14

10-12 days

Question 15

when is rubeola infective?

Answer 15

2 days before symptoms to 4 days after appearance of rash

Question 16

how does rubeola spread?

Answer 16

airborne

Question 17

clinical features of rubeola:

• __________ – peyer’s patches, tonsils, adenoids, lymph nodes
• _____ due to giant cell infiltration

Answer 17

• lymphoid hyperplasia – peyer’s patches, tonsils, adenoids, lymph nodes
• vasculitis due to giant cell infiltration

Question 18

clinical features of rubeola
- lymphoid hyperplasia - ________ patches, tonsils, adenoids, lymph nodes
- vasculitis due to ________

Answer 18

• lymphoid hyperplasia – peyer’s patches, tonsils, adenoids, lymph nodes
• vasculitis due to giant cell infiltration

Question 19

How many stages in measles?

Answer 19

3 stages lasting 3 days each

Question 20

1st stage of measles have what characteristics? (3 Cs)

Answer 20

• coryza (inflammation of mucous membrane in nose_
• cough
  -conjunctivitis
• also got Koplik’s spots

Question 21

what are Kopliks spots

• ____ white macules within _____ mucosa
• foci of _________
• ____ on red bg appearance
• can involve oral, conjunctiva, and/or vaginal mucosa

Answer 21

• bluish white macules within erythematous mucosa
• foci of epithelial necrosis
• grains of salt on red bg appearance
• can involve oral, conjunctiva, and/or vaginal mucosa

Question 22

what happens in 2nd stage of measles?

-______ fade away
- ______, morbilliform ____ develops
- _____ is the first to be involved
- gradual downward spread to trunk and extremities
- ______ on pressure
- abdominal pain from ______ is possible

Answer 22

• Kopliks spots fade away
• maculopapular, morbilliform rash develops
• face is the first to be involved
• gradual downward spread to trunk and extremities
• blanch on pressure
• abdominal pain from lymphadenopathy is possible

Question 23

what happens in 3rd stage of measles?

• ____ ends
• ____ starts to fade in downward progression
• replaced by brown _______ with ______ of skin

Answer 23

• fever ends
• rash starts to fade in downward progression
• replaced by brown hyperpigmentation with desquamation of skin

Question 24

in young children, measles can affect what process?

Answer 24

odontogenesis

Question 25

in immunocompromised px, if they get measles they can have what complications?

Answer 25

-candidiasis - NUG or stomatitis

Question 26

common complications of measles?

Answer 26

- otitis media (ear inflammation) - pneumonia - persistent bronchitis - diarrhea

Question 27

rare delayed complication of measles?

Answer 27

subacute sclerosing panencephalitis - up to as late as 11 years - will see cns changes like personality change, seizure, coma and death

Question 28

at what age is measles vaccination given?

Answer 28

two doses: first one at 12-15 months booster at 4-6 yo

Question 29

what kind of supportive care should be given to px with measles?

Answer 29

- antipyretics but avoid aspirin for risk of reyes syndrome - antirivrals in immunocompromised px like Ribavarin, interferon and immunoglobulin

Question 30

rubella not the same as rubeola rubella caused by what kind of virus?

Answer 30

togavirus

Question 31

rubella spread by what

Answer 31

airborne

Question 32

incubation time for rubella

Answer 32

14-21 days

Question 33

infective period for rubella

Answer 33

7 days before rash to 5 days after devleopment of rash

Question 34

classic triad of congenital rubella syndrome

Answer 34

- deafness - heart disease - cataract

Question 35

for rubella, rash resolves by when

Answer 35

by day 3

Question 36

clinical features of rubella _____ sign: - small, discrete ______ papules on the soft +/- hard palate - occurs _____ with the ___ but last no longer than ______ hours palatal _______ maybe present

Answer 36

forcheimer's sign: - small, discrete dark red papules on the soft +/- hard palate - occurs simultaneously with the rash but last no longer than 12 -14 hours palatal petechiae maybe present

Question 37

for rubella, passive immunity can be rendered by administering _____ - given when? - given to whom>

Answer 37

adminstering human rubella immunoglobulin - given in the first few days to decrease severity - only given to pregnant women who decline abortion

Question 38

epidemic parotitis is known as what and is caused by what virus

Answer 38

mumps, paramyxovirus family