Oral Viral Infections + Paeds Oral Med

Question 1

Types of Herpes Simplex Virus (3)

Answer 1

HSV1+2
- Primary herpetic gingivostomatitis
- Herpes labials

EBV
- Hairy leukoplakia

Varicella Zoster
- Shingles

Question 2

How does the Herpes Simplex virus work? (4)

Answer 2

Acute infection
- Initial

Latency
- Lies dormant in peripheral neurons (trig nerve ganglion)

Reactivation
- Triggered by stimuli (stress/immunocompromised/infection) to reactivate and produce infectious viruses

Physical presentation
- Herpes labialis (cold sores)
- Ulceration

Question 3

Med for herpes simplex

Answer 3

Acyclovir 200mg 5x day for 5 days

Question 4

HSV viral replication stages

Answer 4

1. Binding
2. Entry
3. Release
4. Nuclear entry
5. Gene expression
6. Dna replication
7. Packaging
8. Egress

Question 5

Clinical features of varicella zoster

Answer 5

Vesicles in dermatome
Painful + paraesthesia

Question 6

Complications of varicella zoster

Answer 6

Post hepatic neuralgia
Secondary bacterial infections

Question 7

Med given to prevent post hepatic neuralgia

Answer 7

800mg Aciclovir

Question 8

What 2 infections can coxsackie virus cause?

Answer 8

Hand food and mouth
Herpangina

Question 9

Signs + symptoms of Primary Herpetic Gingivostomatitis

Answer 9

Fluid filled vesicles that rupture to ulcers

Severe gingivitis

Fever

Headache

Malaise

Cervical lymphadenopathy

Question 10

Treatment for Primary Herpetic Gingivostomatitis

Answer 10

Bed rest
Soft diet
Paracetamol
Acyclovir if compromised

Question 11

Most common complication from PHG

Answer 11

Dehydration

Question 12

Triggers for PHG (2)

Answer 12

Sunlight
Stress

Question 13

Clinical presentation of Herpangina

Answer 13

Vesicles in tonsillar/pharyngeal area

Lasts 7-10 days

Question 14

Clinical presentation of Hand food + mouth disease

Answer 14

Ulceration on gingival, tongue, cheeks and palate

Maculopapular rash on hands and feet

Lasts 7-10 days

Question 15

List some causes of oral ulceration (6)

Answer 15

1. Infection
   - Coxsackie
   - HSV
   - Herpes zoster
   -EBV
2. Immune mediated
   - Crohns
   - Behcets
   - Coeliac
3. VBD
   - Pemphigoid
   - Pemphigus
   - Erythema multiforme
4. Trauma
5. Vit deficiencies
   - Iron
   - Vit B12
   - Folate
6. RAS

Question 16

Aetiology of RAS

Answer 16

GI
Trauma
Stress
Hormones

Question 17

Investigations of RAS

Answer 17

Diet diary
FBC
Haematinics (VitB12, Folate, Ferritin)

Question 18

Management of RAS

Answer 18

Symptomatic - difflam
Dietary exclusion
Corsodyl 0.2%
Avoid sharp spicy foods
SLS free paste

Question 19

Clinical presentation of geographic tongue

Answer 19

Red shiny areas
Loss of filiform papillae

Question 20

What type of HPV causes verruca vulgarism

Answer 20

2 + 4

Question 21

What type of HPV causes SS papilloma

Answer 21

HPV 6+11

Question 22

What are the 2 types of mucocele

Answer 22

Mucous extravasation cyst

Mucous retention cyst

Question 23

What is a ranula?

Answer 23

FOM mucocele
Minor salivary glands/sublingual ducts/submandibular