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RB Y2 Dermatology > Viral Skin Infections > Flashcards

Viral Skin Infections Flashcards

(86 cards)

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1
Q

what are chicken pox and shingles due to

A

varicella zoster virus

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2
Q

how does shingles occur

A

reactivation of dormant VZV in dorsal root ganglion - is dermatomal

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3
Q

shingles vaccine

  • type
  • schedule
  • side effects
  • contraindications
A
  • live attenuated
  • given SC
  • over 70 - catch up campaign
  • chicken pox is a rare side effect
  • as live contraindicated in IS, pregnancy and active infection
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4
Q

chicken pox symptoms

A
  • fever
  • itchy rash that starts on head/trunk then spreads
  • initally macular then papular and then vesicular
  • mild systemic upset
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5
Q

what are some 2y features of chickenpox

A

bacterial infection - due to scratching

pneumonitis

haemorrhagic

scarring encephalitis

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6
Q

haemorrhagic chickenpox

A
  • Thrombocytopenia and purpura
  • more common in IC etc
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7
Q

pneumonia as a complication of chicken pox

A

Chickenpox can spread to the lungs and cause pneumonia, more common in adults (smokers), pregnant people and those with weakened immune systems.

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8
Q

what is neonatal VSV

A

2y to chickenpox in mother in late pregnancy - may produce latency of VZV in the dorsal root ganglia of the foetus

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9
Q

what is the mortality of neonatal VSV like

A

higher than normal

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10
Q

how can you prevent neonatal VSV

A

varicella zoster immune globulin in susceptible women

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11
Q

who is shingles seen in

A

elderly and IC

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12
Q

shingles CF

A

tingling/pain that is greater with increasing age, followed by dermatomal rash

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13
Q

describe shingles pain

A

neuralgic - sharp and proximal along course of nerve

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14
Q

what is the complication that can occur if shingles lasts >4 weeks

A

post herpetic neuralgia - burning pain that lasts long after rash and blisters have disappeared

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15
Q

where does post herpetic neuralgia commonly affect

A

first branch of trigeminal nerve, but also V2 and V3

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16
Q

is scarring more common in shingles or chickenpox

A

chickenpox

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17
Q

herpes zoster ophthalmicus

A

zoster of CNVI (accounts for 20% of all shingles), affects the globe in 50%

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18
Q

waht is seen on the nose in herpes zoster ophthalmicus

A
  • Hutchison’s sign: the nasociliary branch of CNV1 supplies the tip of the nose, this is a strong risk factor for ocular involvement
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19
Q

what is ramsay hunt syndrome caused by

A

complication of shingles - dormant VZV reactivates in the geniculate ganglion of CNVII

also known as herpes zoster oticus/geniculate

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20
Q

ramsay hunt syndrome CF

A

severe otalgia followed by VII and other cranial nerve palsy

zoster vesicles around ear and deep meatus (ear canal)

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21
Q

what nerve supplies the sensation of taste to the anterior 2/3 of tongue

A

CNVII

this is why taste is lost in ant 2/3 of tongue in Ramsay Hunt Syndrome

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22
Q

what is idiopathic CNVII palsy called

A

bells palsy

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23
Q

what may recurrent herpes infection cause

A

bells palsy - herpes inflames CNVII

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24
Q

in ramsay hunt syndrome what can irritation of CNVIII cause

A

deafness, vertigo and tinnitus

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25
VSV and HSV therapy
acyclovir - antiviral - oral for VZV, this reduces the incidence of post herpetic neuralgia
26
what is acyclovir
analogue of guanosine
27
what is the effect of acyclovir
doesnt eliminate virus - slows the growth and spread
28
presentation of erythema multiforme
multiple target lesions
29
what can erythema mulitforme be triggered by
hypersensitivity reaction triggered by * Herpes simplex virus * *Mycoplasma* *pneumoniae* bacterium * Co-trixomazole treatment
30
erythema multiforme major
more severe form - has mucosal involvement
31
what is the name for pox virus
molluscum contagiosum
32
describe molluscum contagiosum
grouped, pearly white or pink, firm umbilicated papules
33
molluscum contagiosum treatment
liquid nitrogen
34
who is molluscum contagiosum common in
children
35
can molluscum contagiosum be sexually transmitted
yes
36
what causes warts
HPV in keratinocytes
37
who are warts common in
children and IS
38
treamtent for warts
topical salicylic acid
39
what are warts on feet called
verrucas cauliflower appearance
40
what does HPV also cause
head and neck cancer, cervical cancer, genital warts
41
what types of HPV are responsible for what
* Types 1-4 are responsible for warts/verrucas mainly * Types 6 and 11 are responsible for genital warts * Types 16 and 18 are mainly responsible for cervical cancer
42
enteroviruses
* Single stranded RNA viruses * Transmission route through intestine (enteric meaning intestine) * E.g. coxsackie, echovirus, poliovirus etc.
43
what more serious problems can coxsackie virus B cause
myocarditis, pericarditis and meningitis
44
what is herpangina
blistering, painful rash at back of mouth
45
what is herpangina caused by
enterovirus (coxsackie or echovirus)
46
what is hand foot and mouth disease caused by
enterovirus (coxsackie A virus in particular)
47
clinical presentation of hand foot and mouth disease
vesicles in mouth and on hands and soles of feet
48
what is erythema infectiosum also called
slapped cheek disease
49
what causes erythema infectiosum
erythrovirus (formerly parvovirus) B19 - it is the most common manifestation in children
50
what are some complications of erythrovirus B19
spontaenous abortion aplastic crisis chronic anaemia in IS patients
51
what is the most common manifestation of erythema infectiosum in adults
arthritis
52
what is orf
para pox virus acquired from infected lambs
53
what does 1y infection with syphillis cause
chancre - painless ulcer
54
what does 2y infection with syphillis cause
red rash that is prominent on the soles of feet and palms of hands
55
what does 3y infection with syphillis cause
CNS, cardio, gummatous
56
what is a gumma
a non cancerous growth originating from 3y stage syphillis
57
what is the bacteria responsible for syphilis as STI
treponema pallidum
58
what do you treat syphilis with
penicllin
59
lyme disease
* Initial characteristic **erythema chronicum migrans** rash – **bullseye lesion**
60
what is the causative organism and vector for lyme disease
Borrelia burgdorferi vector - ticks
61
what is the therapy for lyme disease
doxycycline or amoxcillin
62
what is Zika spread by
mosquito Aedes aegypti
63
what are 2 complications of zika
guillan barré and microcephaly
64
HSV infection -primary infection
* commonly seen in pre school children * primary infection is often with gingivostomatitis * virus then remains latent but can be reactivated by stress etc as an inactive form remains in the dorsal root ganglia
65
subsequent presentations of HSV
often with cold sores eg herpes labialis
66
what is the worst end of spectrum of disease seen with HSV
* gingivostomatitis - primary infection * get fever and local lymphadenopathy too
67
which type of HSV is commonly acquried in childhood
type 1 * main cause of oral lesions * spread by saliva etc
68
69
herpetic whitlow
* intensely painful red, swollen finger, may have blisters etc * due to HSV
70
who is at particualr risk of herpetic whitlow
* Occupational hazard of dentistry and anesthetics exposed to oral secretions * Also seen in thumb sucking children
71
treatment of herpetic whitlow
* Treatment is allowing virus to run its course, drainage runs the risk of bacterial infection
72
eczema herpeticum
* **Develops when the virus infects large areas of skin, rather than being combined to a small area as in the common cold sore** * disseminated viral infection characterised by fever and clusters of itcy blisters/punched out erosions
73
what is eczema herpeticum often a complication of
atopic dermatitis
74
which type of HSV causes eczema herpeticum
1 or 2
75
who usually gets eczema herpeticum
* More commonly seen in **infants and children** with atopic dermatitis, or when there are other reasons for breakdown of skin barrier e.g. burns, pemphigus vulgaris
76
presentation of eczema herpeticum
* Usually initially presents with a cluster of itchy and painful blisters * Monomorphic (all appear similar to each other) punched out lesions
77
complications of eczema herpeticum
* Can be life threatening * Secondary bacterial infection with Staph or Strep may lead to impetigo and/or cellulitis
78
management of eczema herpeticum
acyclovir - IV if systemically unwell
79
what serious complication can HSV cause in brain
encephalitis - spreads to CN ganglion
80
prophylaxis of HSV
low dose acyclovir daily
81
apthous ulcers
* non viral and self limiting * Recurring painful ulcers of the mouth that are shallow, round or ovoid and have inflammatory halos. Heal without scarring * They are confined to the mouth and seen in the absence of systemic disease * Each ulcer lasts less than 3 weeks
82
**Behçet’s Disease**
* systemic autoimmune inflammatory condition of unknown cause * **Classically, recurrent oral and genital ulceration and anterior uveitis**
83
what gene is behcets assoicated with
HLA B25
84
other features of behcets
* Skin lesions * Thrombophlebitis – inflammatory process that cause a blood clot to form * Arthritis * Can also involve visceral organs
85
where is behctes most common
middle east and asia
86
name some systemic diseases that cause non viral recurrent ulcers
* Gluten-sensitive enteropathy (coeliac) or IBD (diarrhoea and weight loss) * Drug reactions * Reiter’s disease (arthritis) * Skin diseases

RB Y2 Dermatology (22 decks)

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