viral infections

Question 1

what virus causes chicken pox

Answer 1

varcilla zoster (type of herpes)

Question 2

what is shingles

Answer 2

reactivated dormant virus in dorsal root ganglion

Question 3

how is chickenpox spread + incubation

Answer 3

resp route // chicken pox or singles // infective 4 days before rash and until 5 days after // 10-21 day incubation

Question 4

symptoms chicken pox

Answer 4

dever // itchy rash on head or trunk –> spread // macular –> vesicular

Question 5

supportive mx and isolation advice chicken pox

Answer 5

trim nales // calamine lotion // infectious until all rashes crusted (5days)

Question 6

what analgesia can increase risk of secondary bacterial infection shingles

Answer 6

NSAIDs

Question 7

what organism can cause nec fasc in chicken pox

Answer 7

GAS

Question 8

rare complications chicken pox

Answer 8

pneumonia, encephalitis, DIC // arhtitis, nephrititis, pancreatitis

Question 9

post exposure mx chicken pox pregnancy

Answer 9

check varicella antibodies // if <20 weeks VZIG up to 10 days post exposure // if >20 weeks then VZIG or oral antivirals 7-14 days after

Question 10

mx chicken pox in pregnancy

Answer 10

oral aciclovir if >20 weeks and within 24 hours of rash

Question 11

symptoms shingles

Answer 11

prodromal burn over dermatome + headache, fever, tired // red rash on dermatome, does not cross midline // vesicular

Question 12

RF shingles

Answer 12

age // HIV // immunosuppredsed

Question 13

isolation mx shingles

Answer 13

avoid pregnant women // infectious until vesicle crusted (5-7 days)

Question 14

analgesia mx shingles

Answer 14

1 = paracetamol + NSAID // 2 = TCA // 3 = steroid if not responding

Question 15

antiviral mx shingles

Answer 15

antiviral within 72 hours (unless <50 with mild trunk rash)

Question 16

benifit antivirals in shingles

Answer 16

reduced post-herpetic neurlgia in older people

Question 17

most common shingles complication

Answer 17

post-herpetic neuralgia

Question 18

worrying nerves affected in shingles

Answer 18

occular trigeminal // ramsay hunt (CNVII)

Question 19

who should be offered PEP in chicken pox

Answer 19

significant exposure // increased risk eg immunocompromised (Steroids) pregnant // no antibodies

Question 20

what are the 2 VZV vaccinations

Answer 20

1 for chicken pox, one for shingles

Question 21

what type of vaccine is VZV

Answer 21

live attenuated

Question 22

who gets VZV chicken pox vaccine

Answer 22

health care workers who are not immune // contacts of immunosuppresed patients

Question 23

who gets shingles VZV vaccine

Answer 23

elderly

Question 24

what virus causes molluscum contagiosum

Answer 24

pox

Question 25

spread of molluscum contagiosum

Answer 25

close contacts eg sharing towels, or surfaces // rarely sexual spread

Question 26

who gets molluscum contagiosum

Answer 26

kids 1-4 (with eczema)

Question 27

symptoms molluscum contagiosum

Answer 27

pink or pearly papule // clusters on trunk or flexures // if genital then sexual spread

Question 28

how long for molluscum contagiosum to resolve

Answer 28

18 months

Question 29

mx molluscum contagiosum

Answer 29

not usually needed // maybe cryothrapy // if eczema topical steroids // if infected abx eg fusidic acid

Question 30

when to refer molluscum contagiosum

Answer 30

HIV, eyelid or occular, anogenital

Question 31

what virus causes slapped check syndrome

Answer 31

parvovirus B19

Question 32

symptoms slapped check syndrome

Answer 32

fever, red rash on cheek

Question 33

what tests for exposure to parvovirus in pregnancy

Answer 33

<20 weeks --> IgM and IgG

Question 34

serious presentation parvovirus

Answer 34

panyctopenia // aplastic crisis in sickle cell // hyrops fetalis --> miscarriage

Question 35

mx hydrops fetalis

Answer 35

intrauterine blood transfusion

Question 36

what causes warts

Answer 36

HPV

Question 37

mx warts

Answer 37

topical salyic acid or imiquoid

Question 38

what diseases can enterviruses cause

Answer 38

eg coksaxki --> herpangina (mouth blisters) // hand foot and mouth // pericarditis

Question 39

what causes hand, foot, and mouth

Answer 39

coxsackie A and enterovirus

Question 40

symptoms hand, foot, mouth

Answer 40

mild sore throat and fever // oral ulcer // vesicles on hands and feet // family outbreak

Question 41

mx and isolation hand, foot mouth

Answer 41

no isolation, symptomatic treatment

Question 42

invx enterovirus

Answer 42

PCR

Question 43

what causes orf + symptoms

Answer 43

sheep parapoxvirus virus // single nodule usually on farmer hand

Question 44

how is zika spread

Answer 44

mosquito

Question 45

symptoms zika

Answer 45

fever, rash, headache, joint pain // microcephaly in neonates

Question 46

cause of pityriasis rosea

Answer 46

herpes virus 7 - HHV 7

Question 47

symptoms pityriasis rosea

Answer 47

recent viral illness // herald patch on trunk --> red, oval, scaly patch 'fir tree'