viral infections of the skin soft tissue, bone, muscle and joints I

Question 1

papilloma

Answer 1

• benign growth of the skin or mucous membranes

Question 2

macule

Answer 2

• small DISCOLORED patch of skin that forms an area distinct from the normal surrounding surface

Question 3

papule

Answer 3

• CIRCUMSCRIBED RAISED PORTION OF THE SKIN

Question 4

vesicle

Answer 4

-small pouch of CLEAR fluid

Question 5

pustule

Answer 5

full of pus

Question 6

warts

Answer 6

• hyperkearatotic
• cutaneous are often painless if cutaneous
• CAUSED BY HPV
• LOOK CAULIFLOWER LIKE

Question 7

Name for common wart
plantar wart
flat warts

Answer 7

verruca vulgaris
verruca plantaris
verruca plana

Question 8

HPV

Answer 8

• nonenvveloped
  dsDNA
  replication depends on differentiation status of the tissue

Question 9

what layer of the skin would you expect to find a new HPV infection

Answer 9

suprabasal

-infected at basal layer, virion matures as moves up

Question 10

where does the bump come from in warts?

Answer 10

• expanding of all layers due to proliferation
• proliferation initiated so that the virus can use the cell’s machinery to replicate itself
• specifically- HPV-7 and HPV-6 are used to inactivate tumor suppressor cells Rb and P53 respectively causing the cells to go into S phase more and reprematurely

Question 11

what are the main cutaneous HPV viruses divided into common and plantar warts

Answer 11

• common- 2,3,10

- plantar- 1.4

Question 12

transmission of HPV? incubation of HPV? diagnosis?

Answer 12

• HPV- direct contact or with contact with surfaces
• 3-4 months
• diagnosis- appearance-koilodal cells (large nuclei with halo/nonstained around them) and hyperkeratosis

Question 13

Treatment/prevention for HPV

Answer 13

• common and plantar warts usually spontaneous regress after a few months- 2 yrs
• wart removal- cryotherapy, cytotoxic, chemicals, surgical removal
• > NOTE HPV 16, 18, 6, 11: do not protect against cutaneous warts

Question 14

Molluscum Contagiosum

Answer 14

• painless, pearly, umbilicated, nodules
• seen in genitals (sexual-for adults), hands on kids via contact
• has concavity
• in microscope, it has LARGE AMOUNT IN CELL
• large eosiophilic cytoplasmic inclusions (molluscum bodies)
• poxviridae
• large dsDNA genome
• replicates within cytoplasm - UNIQUE

Question 15

incubation and transmission of molluscum contagiosum

Answer 15

• 14-50 days

- transmission via direct contact with lesions or fomaite transmission thru a towel or something

Question 16

treatment of molluscum contagiosum

Answer 16

• often resolution with in 2-12 months without treatment

- removal thru surgery or cryotherapy

Question 17

Herpes labialis

Answer 17

• cold sores
• painful/[painless and found in vermillion boarder of lip
• a reactivation of the herpes simplex virus
• HOWEVER, AT PRIMARY INFECTION YOU CAN GET A WIDE RAGE OF INFECTIONS LIKE WIDESPREAD INFECTION OF THE MOUTH INCLUDING gingicomastitis (in gums)
• herpes simplex virus

Question 18

Herpes Simplex keratitis

Answer 18

• leading cause of infectious blindness in US
• initial infection causes conjunctivitis that takes weeks to heal
• recurrent disease lead to corneal opacity
• caused by leading simplex

Question 19

herpes simplex encephalitis

Answer 19

• rare
• mortality rate over 30% even with antivirals
• commonly leads to neuro probs
• caused by herpes simplex virus

Question 20

herpetic whitlow

Answer 20

• lesions in the digits

- from herpes simplex

Question 21

what is the herpes simplex virus

Answer 21

• dsDNA

- latent and lytic phases of the life cycle exist

Question 22

during a herpes outbreak, what is the productive phase of the life cycle?

Answer 22

-lytic

Question 23

cold sore pathology

Answer 23

• HSV virus comes and infects the epithelium of the mouth, and replication occurs
• some of the virus gets into the sensory neuron and stays latent there
• when cold sore goes away and there is stress via emotional or traumatic, we get the virus coming out of neuron for outbreak

Question 24

what is HSV-1 and HSV2 known to cause?

Answer 24

1 = mouth lesions
2= genital lesions
90% of the population has them just not everyone shows it

Question 25

what is prescribed for herpes? how does it work?

Answer 25

FOSCARNET AND ACYCLOVIR - acyclovir works like this: - > relies on the viruse's thymidine kinase to phosphorylate it converting it to acyclovir monophosphate - > use cellular kinases to make acyclovir triphosphate which is a nucleotide mimic that allows it to inhibit the viral DNA polymerase incorporation into viral DNA to get CHAIN TERMINATION

Question 26

Varicella

Answer 26

- chicken pox - lesions on trunk, scalp and face most - fever and lesions last approx. 5 days

Question 27

what is important to note about the lifecycle of varicella?

Answer 27

- it is an evolutionized process - starts as vesicles -> pustules -> scabs (healing) - GET "CROPS OF LESIONS"- there are multiple evolutionary stages in a single area of the body

Question 28

though varicella is seen all over, where is it NOT?

Answer 28

- soles of feet or palms

Question 29

what are some complications of varicella

Answer 29

- from itching, can inoculate self with bacteria as a secondary infection - pneumonia - can be due to the viral infection of the lungs or a secondary bacterial infection -> viral has worse outcome and is attributed to MOST OF THE DEATHS FROM CHICKEN POX

Question 30

chicken pox and pregnancy first 20 weeks of gestation vs infection late gestation

Answer 30

- infection during the first 20 weeks- low birth weight, skin, scarring, encephalitis, chorioretinitis and microcephaly - infection late in gestation or right after birth- gives lesions on viscera and disseminated infection =worse!!

Question 31

herpes zoster

Answer 31

- causes shingles- reactivation of VSV - epidemiology- elderly and immunosuppressed - get paresthesia (pins and needles) before break out - GET VESICULAR LESIONS ON FACE AND TRUNK UNILATERALLY - FLOWS DERMATOMES - get fever and malaise

Question 32

postherpetic neuralia

Answer 32

- herpes zoster | - Shingles outbreak that causes pain long after lesions have resolved

Question 33

what is varicella-zoster virus?

Answer 33

``` - dsDNA enveloped - herpesviradae fam - LATENT INFECTION- USUALLY IN THE DORSAL ROUTE OR TRIGEMINAL -one serotype ```

Question 34

how is varicella-zoster transmitted? incubation time? diagnosis?

Answer 34

- tx- via lesions or respiratory secretions - incubation time- 2 wks - diagnosed via TZANCK SMEAR, antibodies, clinical analyses

Question 35

varicella vaccine

Answer 35

- PREVENTS PRIMARY INFECTIONS - LIVE ATTENUATED - grown in tissue culture - combined with measles, mumps, rubella - first dose - 12-15 months old - second dose- 4-6 years old

Question 36

zoster vaccine

Answer 36

- to protect against from VZV REACTIVATIONS - SAME LIVE ATTENUATED VACCINE WITH HIGHER TITER -recommended for all adults over 60regardless -

Question 37

when are anti-herpetic drugs used on patients to treat varicella zoster? what drugs are used?

Answer 37

- when patient obtains a primary infection late in the their life - acyclovir - varicella is not as susceptible to acyclovir as HSV