Viral Infections

Question 1

Cause of slapped cheek syndrome

Answer 1

Parvovirus B-19

Question 2

Treatment of ophthalmic zoster

Answer 2

acyclovir - drops or tablets - may prefer tablets as less epithelial toxic

Question 3

Complications of Parvovirus B-19

Answer 3

spontaneous abortion, aplastic crisis, chronic anaemia

Question 4

What predicts the severity of chicken pox

Answer 4

extremes of age and depressed cell mediated immunity

Question 5

Causes of erythema multiform

Answer 5

HSV, drug eruptions, mycoplasma pneumonia bacteria

Question 6

Virus causing chicken pox and shingles

Answer 6

varicella zoster

Question 7

What medications should be avoided in chicken pox?

Answer 7

ibuprofen (necrotising fasciitis/secondary skin infection), aspirin (reye’s syndrome - leads to liver and brain swelling)

Question 8

Presentation of chicken pox

Answer 8

generalised rash and fever, itch

Question 9

What is eczema herpeticum?

Answer 9

the spread of herpes simplex virus to an area of eczema

Question 10

Patients at risk of aplastic crisis

Answer 10

thalassaemia, sickle cell, hereditary spherocytosis

Question 11

Sign of ophthalmic zoster

Answer 11

Hutchison’s sign - acute red eye + spots on the nose

Question 12

Cause of molluscum contagiosum

Answer 12

pox virus

Question 13

Presentation of Parvovirus B-19 in children

Answer 13

slapped cheek rash which may also occur on limbs

Question 14

pain lasting longer than 4 weeks after shingles is called…?

Answer 14

post-herpetic neuralgia

Question 15

How may the chicken pox vaccine help with shingles?

Answer 15

reduces the amount of shingles and associated post-herpetic neuralgia in >70s, routinely given

Question 16

Most common groups to have shingles

Answer 16

elderly and immunocompromised

Question 17

Presentation of erythema multiform

Answer 17

target lesions with erythema

Question 18

complication of shingles…

Answer 18

ophthalmic zonster

Question 19

where does a recurrent herpes simplex virus usually appear?

Answer 19

around the vermillion border of the mouth

Question 20

Presentation of Parvovirus B-19 in adults

Answer 20

Polyarthritis of the small joints - may occur without the rash

Question 21

how does shingles present?

Answer 21

tingling/pain –> erythema –> vesicles in a dermatomal distribution

Question 22

How does acyclovir work to treat varicella zoster and herpes simplex viruses?

Answer 22

it is a guanosine analogue which is incorporated into the DNA and thus inhibits replication. It does not eradicate latent virus

Question 23

Presentation of molluscum contagiousum

Answer 23

small pink papules with a depressed central punctum

Question 24

What does the herpes simplex virus cause?

Answer 24

primary gingivostomatitis - ulceration in and around the mouth

Question 25

Which type of herpes simplex virus does this describe: main cause of oral lesions, 50% of genital warts, encephalitis?

Answer 25

Herpes simplex type 1

Question 26

How is molluscum contagiosum treated?

Answer 26

it is self-limiting but may take months

Question 27

Where does the varicella zoster virus establish latency?

Answer 27

the sensory nerve roots

Question 28

What type of vaccination is the chicken pox vaccine?

Answer 28

Live attenuated - not routinely given in UK

Question 29

complications of chicken pox (4)

Answer 29

secondary bacterial infection, pneumonitis, scarring, encephalitis

Question 30

What sort of pain is produced by shingles?

Answer 30

neuralgia

Question 31

Which type of herpes simplex virus does this describe: rare cause of oral lesions, 50% of genital warts, encephalitis/disseminated infection?

Answer 31

Herpes simplex type 2

Question 32

Presentation of Ramsay Hunt Syndrome - Type 2?

Answer 32

pain in the ear, loss of taste from front of the tongue, facial muscle palsy, dry eyes and mouth, vesicular rash (ear canal, tongue, hard palate), may also affect CN VIII (tinnitus, deafness, vertigo)

Question 33

What is Ramsay Hunt Syndrome - Type 2?

Answer 33

herpes zoster otis - (varicella zoster reactivated in the geniculate ganglion of CN VII)

Question 34

HPV causing genital warts

Answer 34

6 and 11

Question 35

HPV causing cervical cancer

Answer 35

16 and 18

Question 36

Common virus causing warts?

Answer 36

HPV