Sketchy Micro: HSV 1 and 2

Question 1

What’s the difference between herpes virus and herpes simplex virus?

Answer 1

Herpesvirus includes many different viruses, while HSV is a specific strain within that family.

Question 2

What kind of virus is HSV?

Answer 2

It is a linear dsDNA virus (represented by the blue overtones and the straight, double-yellow road lines).

Question 3

What covering does HSV have?

Answer 3

It is enveloped (like the bag of mail that Hermes is carrying).

Question 4

Histologically, how does HSV present?

Answer 4

With Cowdry bodies –intranuclear eosinophilic inclusions

Think of the COW hide pattern that is on Hermes’ outfit.

Question 5

How can HSV be transmitted?

Answer 5

Sex, saliva, and vertically (the last of which is represented by the torch, because HSV is one of the TORCH species)

Question 6

How does HSV 1 usually present?

Answer 6

With gingivostomatitis and cold sores; it can infect the eyes and lead to keratoconjunctivitis

(Think of Hermes holding up one finger next to his red lips and red eyes.)

Question 7

How can you evaluate someone for the ophthalmologic complication of HSV 1?

Answer 7

Using a fluorescein lamp, you will see serpiginous bodies on the cornea.

(Think of the snakes wrapping around Hermes’ staff.)

Question 8

The most serious complication of HSV 1 is ______________.

Answer 8

temporal lobe encephalitis, which can cause hemorrhage and necrosis in the temporal lobes, fever, confusion, and seizures

(Think of the red wings on the sides of Hermes’ black helmet –the red symbolizes hemorrhage, being on the side of the helmet symbolizes temporal lobes, and the black helmet symbolizes necrosis.)

Question 9

HSV 1 remains dormant in the ______________.

Answer 9

trigeminal ganglion (like the three gems on Hermes’ helmet)

Question 10

How does the HSV rash present?

Answer 10

As small, clear vesicles on erythematous bases (“dew drops on a rose”)

(Think of how Hermes tripped and threw the still-dewy roses into the air.)

Question 11

What is it called when HSV presents on a finger?

Answer 11

Herpetic Whitlow rash

Question 12

What is erythema multiforme?

Answer 12

A rash caused by HSV1 that presents as flat, red spots on the hands and then moves in centrally 1-2 weeks after an infection. It can be caused by other viruses, bacteria, and even drugs.

(Think of the postage stamps moving up Hermes’ arm.)

Question 13

What rash is common in HSV 2?

Answer 13

Painful, vesicular rash with lymphadenopathy

Think of the fluffy border of Hermes’ tunic.

Question 14

Where does HSV 2 reside dormant?

Answer 14

In the sacral ganglia.

Think of the jewels on Hermes’ codpiece that are in the same orientation as the sacrum.

Question 15

What neurologic complication can HSV 2 cause?

Answer 15

Aseptic meningitis (like the white neck brace worn by Hermes)

(Think: HSV 1 causes encephalitis, which is 1 word, while HSV 2 causes aseptic meningitis, which is 2 words.)

Question 16

Although PCR is commonly used to diagnose HSV now, what test was used to diagnose HSV before PCR?

Answer 16

The Tzank test, in which you scrape an ulcer and look for multi-nucleated giant cells

(Think of the tank with the multi-nucleated camouflage.)

Question 17

What can be used to prevent HSV breakouts?

Answer 17

Acyclovir and valacyclovir (like the recycling bin behind Hermes)