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viral infections Flashcards

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1
Q

Viruses have 2 cycles, name them.

A

Lytic cycle and lysogenic cycle

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2
Q

T/F: HHV is double stranded DNA viruses.

A

TRUE

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3
Q

HHV 3 is also known as?

A

varicella zoster

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4
Q

HIV is DNA or RNA?

A

RNA

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5
Q

HHV has 2 patterns name them

A 
Primary infection (goes latent)
Secondary infection
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6
Q

HSV 1 moves to which nerve ganglion via sensory nerves??

A

Trigeminal nerve ganglion

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7
Q

How does HSV 1 travel between the nerves and skin?

A

via axons in the nerves

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8
Q

HSV 1 common primary infection in child is called?

A

Acute herpetic gingivostomatitis

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9
Q

HSV 1 presents as what in adults?

A

pharyngotonsilitis in adults (if never exposed to HSV 1 as a child)

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10
Q

Young child comes in, cannot eat and mouth is very painful. What is your first thought of virus?

A

HSV 1

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11
Q

What % of cases are symptomatic in HSV 1?

A

15%! was asked as mcq in previous path exam.

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12
Q

Give the common clinical symptoms that patients represent with in HSV 1.

A

lymphadenopathy, fever, malaise, painful mouth, small vesicle that then ulcerates and coalesces, very very painful and heals without scars. All mucosa is affected - keratinised and non-keratinised. HSV1 is more common to appear in immunocompromised patients.

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13
Q

T/F apthous stomatisis is never preceded by vesicles

A

TRUE, you see it ulcerate from the start

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14
Q

Which cells does HSV 1 affect?

A

epithelial

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15
Q

do you need to biopsy HSV1?

A

No, clinicaly diagnosis

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16
Q

T/F spread to an uninfeted host can occur from symptomatic, active lesions or asymptomatic viral sheeding in saliva

A

TRUE, was asked in previous exam

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17
Q

Explain what secondary HSV 1 is.

A

reactivation of the virus from the trigeminal nerve

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18
Q

is herpes virus always in the saliva?

A

YES, 2/3patients always have hsv 1 in their saliva, therefore can infect someone without having active lesions.

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19
Q

what is the most common type of secondary infection in HSv 1?

A

herpes labialis- fever blisters

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20
Q

What is herpes labialis known as?

A

A cold sore

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21
Q

What triggers herpes labialis to occur?

A

UV, trauma, stress, immune deficiency

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22
Q

prodromal signs of herpes labialis?

A

itching, tingling, erthema, can see on hard palate too- 6-24 hrs before lesion develops

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23
Q

what is herpetic whitlow?

A

infection of fingers

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24
Q

How would you manage a patient with primary herpatic gingivostomatitis (HSV 1)?

A
  • try prevent auto inoculation
  • bed rest, soft fluids
  • acyclovir suspension= during the early phase for severe cases (at prodromal phase)
  • NSAID for fever and pain (dont give asprin to children! and dont give asprin to pts with viral infection. Dont want to get Reyes syndrome!) Give child paracetemol.
  • Give cholrhexidine rinse to prevent 2ndary infection(with chlorhexidine need to tell patient dont eat or drink anything 30min after rinse, dont rinse mouth or brush teeth after use.
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25
Management of herpes labialis (2ndary herpes)
- pencyclovir cream during prodromal stage (dont put on if vesile already formed cus it wont help but only cause resistance). - Systemic medication needed for immunosupressed patients - patients wash hands to prevent autoinocculation!
26
T/F most cases of primary VZV infection are symptomatic
TRUE! unlike HSV 1, VZV infections are in most cases symptomatic, HSV usually subclinical so dont see symptoms because it goes latent, but if immunocompromised, HSV 1 will show symptoms on contraction.
27
Does ZVZ heal with/without scarring?
😞 ZVZ heals with scarring. where HSV heals without scarring.
28
Varicella zoster virus is also known as what in the primary infection?
Chicken pox/varicella/HHV 3.
29
What are the symptoms that are seen with VZV?
- Malaise and pharyngitis in beginning. - Pruritic rash then develops: has stages or erythema, vesicle, pustle, crust formation. - Oral lesions may precede the skin lesion. - Complications in adults! - It then goes latent in dorsal root ganglia and trigeminal ganglia (this is why you get the oral lesions). - NB VZV gingival lesions look similar to those of primary HSV infection BUT difference is VZV lesions tend to be painless in the mouth compared to painful lesions of HSV.
30
How do the lesions of primary VZV appear in the mouth compared to that of HSV primary infection?
primary HSV infection gingival lesions are similar to that of primary VZV infection. The only main difference is that the VZV lesions are not painful and the HSV primary lesions are painful. -answer: HSV is painful and VZV is not painful in the oral cavity (this is the primary infections)
31
VZV secondary infection is also known as?
shingles
32
If you see herpes zoster (shingles) in a young pt what should you investigate?
Immunodeficiency! usually only see in old patients! therefore do HIV test if young pt with shingles comes in!
33
Where does shingles proliferate?
In the dorsal root ganglia, then moves along sensory nerve to skin.
34
clinical features of shingles (herpes zoster) depend on?
Which nerve is affected.
35
A big clinical feature of shingles is?
Unilateral vesicles! (does not cross the midline), they ulcerate!
36
If shingles occurs in the ear then what other complications can arrise?
We call it ramsay-hunt syndrome (facial paralysis, hearing deficits, vertigo)
37
Name the common complications that can occur in shingles.
``` postherpatic neuralgia (if pain is longer than 3 months after vesicles have dissapeared) Also ulcers heal with scars ```
38
Treatment of VZV and shingles?
- Analgesics for pain - Antivirals (acyclovir) most effective in first 72hrs - Pts with AIDS you will see unilateral involvement of necrotic alveolar bone- bone rots on one side of the jaw.
39
Where are common places for herpangina lesions to form?
Soft palate and tonsillar pillars
40
How to herpangina lesions begin as?
Start as red macules and form ulcers.
41
Herpangina is caused by which virus?
Coxsackie A virus
42
T/F most cases of herpangina are subclinical (no symptoms)
TRUE
43
Name some clinical symptoms that herpangina can represent with.
- Severe painful throat with ulcerating vesicles - preceded by vesicles - White ulcer with red around it
44
How do you manage herpangina?
- do not give anti-biotics or anti-fungals. - Use NSAIDS for pain. - andolex C - Soft diet
45
What other disease is associated with herpangina?
hand foot mouth disease
46
T/F HPV is a DNA virus
TRUE
47
nr 1 cancer in black female women in SA is due to?
HPV
48
HPV has 2 kinds of lesions
benign and cancerous (malignant?)
49
Most common soft tissue mass arising from soft palate is?
squamous cell papilloma
50
HPV types associated with squamous cell papilloma?
Type 6 and 11
51
Describe squamous cell papilloma
soft, pedunclated (small stork on it and can lift it and see attach to underlying mucosa), is painless and cauliflower like
52
Is a squamous cell papilloma easy to excise?
YES
53
If you see many squamous cell papilloma what can you suspect in the patient?
They have HIV infection and are on ARVs
54
Provide treatment of squamous cell papilloma
Conservative surgical excision, including the base of the lesion, reoccurance is unlikely. Submit for biopsy analysis. Dont confuse with SCC (has higher mitotic figures)
55
What happens when a pt has HPV 6 or 11 and goes on ARVs?
Increase in HPV lesions of squamous cell papilloma
56
is verucca vulgaris easily spread?
YES, can spread by touching
57
verucca vulgaris is known as?
Common wart
58
HPV types involved in verucca vulgaris?
HPV 2,4,6,40
59
treatment of verucca vulgaris is?
Excision, lazer, cryotherapy or electrosurgery. Resolve in 2-3 years.
60
Can verucca vulgaris malignant?
No, 2/3 will disapear spontaneously within 2 years otherwise get cut out
61
why is verucca vulgaris white?
Hyperkeratosis occurs
62
condyloma acuminatum is venereal meaning?
relating to sexual intercorse therefore its important if found in children
63
Condyloma acuminatum is due to which HPV types?
2,6,11,53,54
64
Should conyloma acuminatum be removed?
Yes, its a conyloma and its contagious, can spread via autoinoculation and to other people. Get it also by oral sex
65
Diagnostic criteria of condyloma acuminatum?
Blunt process, larger than squamous cell papilloma (>1cm), broad based and sessile (doesnt hae a stalk like squamous cell papilloma), whole lesion attached to the mucosa. Multiple and not solitary.
66
How do you manage condyloma accuminatum?
Excision and couselling!
67
Multifocal epithlial hyperplasia is also known as?
Hecks disease
68
Hecks disease is due to which types of hpv?
13 and 32
69
hecks disease is common in?
children and crowded places
70
Give the clinical discription of hecks disease
flat mucosa colour nodular lesion onthe oral mucosa. Multifocal (on many sites) regresses after a few years. Cobblestone appearance and is very smooth!
71
Give the management of hecks disease
Reassure patient they didn't do anything wrong, no serious complication, it will regress, can excise for cosmetic reasons. No maliganancy chance.

MFP 470 (9 decks)

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