Viruses - Trum 2017

Question 1

What are the 8 herpes viruses and what number are they and what are their common names?

Answer 1

1-Herpes Simplex virus-1 (oral herpes)
2-Herpes Simplex virus-2 (genital herpes)
3-HHV-3 (Varicella-zoster virus/VZV)
4-HHV-4 (Epstein barr/EBV)
5-HHV-5 (Cytomegalovirus CMV)
6-HHV-6
7-HHV-7
8-HHV-8 (Kaposi's sarcoma herpesvirus/KSHV)

Question 2

Primary herpes infections may present orally as what in younger patients vs. 18+?

Answer 2

Young: Gingivostomatitis (usually before age 5)

18+: Pharyngotonsillitis (sore throat, fever, headache)

Question 3

Where does a latent HSV-1 usually reside? How it usually spread? What percentage of people in the US have HSV1?

Answer 3

Trigeminal ganglion

spreads through saliva or active perioral lesions

40%

Question 4

Where are recurrent intraoral herpes simplex lesions almost always found? How quickly does it heal?

Answer 4

Keratinized, bound mucosa like the palate and attached gingiva

heals in 7-10 days

Question 5

What are three histopathologic features of HSV?

Answer 5

1-Multinucleation
2-Ballooning degeneration
3-Tzanck cells (free floating)

Question 6

Primary Varicella-zoster infection is called________ whereas a recurrence is called_______

how is VZV spread?

Answer 6

Chickenpox
Shingles
spread through air droplets or direct contact with active lesions
*remains latent in dorsal root ganglia

Question 7

What VZV condition is characterized by cutaneous lesions on the external auditory canal, ipsilateral face, facial paralysis, hearing deficits and vertigo?

Answer 7

Ramsay Hunt Syndrome

Question 8

What is the main disease caused by EBV?

Answer 8

Infectious mononucleosis

*Diagnosed using Paul-Bunneli heterophil antibodies

Question 9

CMV is common in what patient population?

Answer 9

AIDS patients

Question 10

What are 3 oral health diseases caused by the enterovirus, coxsackievirus?

Answer 10

1-Herpangina
2-Hand-foot-and-mouth disease
3-Acute lymphonodular pharyngitis

Question 11

What are 5 diseases commonly associated with HIV?

Answer 11

1-Candidiasis
2-Oral hairy leukoplakia
3-Kaposi's sarcoma
4-Non-hodgkins lymphoma
5-Periodontal disease

Question 12

Herpes comes from the ancient greek word meaning what?

Answer 12

to creep or crawl

Question 13

What organism are the only natural reservoir for Herpes?

Answer 13

Humans

Question 14

What percent of people with a latent VZV get shingles?

Answer 14

20%

Question 15

Can shingles occur around the mouth? What oral tissues do they appear on?

Answer 15

yes.

they appear on movable or bound tissue which is different from HSV

Question 16

Ocular involvement of VZV can cause what? What sign should you look for to suspect ocular infection?

Answer 16

permanent blindness

look for shingles on the tip of the nose.

Question 17

How is HSV2 usually spread?

Answer 17

sexual contact

Question 18

How do you tell the difference clinically between HSV1 and 2?

Answer 18

you can’t they are identical clinically

Question 19

T/F primary infections of HSV 1 or 2 is asymptomatic

Answer 19

true

Question 20

What is a prodrome?

Answer 20

the pain burning itching or tingling 6-24 hours before an HSV lesion developes.

Question 21

Active viral replication of HSV 1 and 2 infections is complete when?

Answer 21

within 2 days

Question 22

What are some less common HSV1 presentations?

Answer 22

herpetic whitlow (on the fingers or thum)
herpes gladiatorum or scrumpox (on head)
herpes barbae (over bearded region of the face)
occular involvement
diffuse skin spread (life threatening)

Question 23

What do we use to diagnose HSV infections? 4 things

Answer 23

clinical presentation -strong presumptive diagnosis
cytologic smear
tissue biospy
serologic testing after 4-8 days after initial exposure

Question 24

What do we treat HSV with?

Answer 24

acyclovir