Term
| Currently, how many different herpes viruses are prevalent in clinical medicine? |
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Definition
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Term
| How do viruses exist in the body? |
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Definition
| Each virus persists in a latent stage w/in the host until it becomes reactivated |
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Term
| HSV-2 is primarily where in the body? |
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Definition
| genital but occurs in the mouth as well |
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Term
| HSV-1 is primarily where in the body? |
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Definition
| primarily oral but occurs genitally as well |
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Term
| What factors might cause reactivation of hsv lesions? |
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Definition
| stress, fever, trauma, sun exposure |
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Term
| HSV-1 is ID'd in pts with what pathology? |
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Definition
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Term
| What is the most common cause of genital ulcers? |
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Definition
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Term
| Describe the lesions in HSV-2? |
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Definition
| multiple, painful, grouped lesions |
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Term
| Can you do an HSV swab with a cotton swab? |
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Definition
| no. you use a dacron swab, put it in the correct culture medium and send it immediately to the lab. |
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Term
| Increased risk of HSV-2 is associated with what? |
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Definition
| STD's and increased no's of sexual partners |
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Term
| How is HSV viewed in the lab? |
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Definition
| Tzanck preparation: intranuclear inclusion bodies and multinucleated giant cells |
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Term
| How does HSV present in ocular disease? |
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Definition
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Term
| How is HSV most commonly transmitted in neonatal and congenital infections? |
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Definition
| transmission during delivery is most common |
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Term
| How is herpes encephalitis dx? |
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Definition
| dx by evaluation of spinal fluid |
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Term
| In what pt population does HSV present with disseminated infection? |
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Definition
| most common in immunocompromised pts |
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Term
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Definition
| several antiviral (acyclic) meds available po, topical, and iv preparation: acyclovir, penciclovir, amantadine |
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Term
| How might HSV be prevented? |
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Definition
| barrier precautions and protection |
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Term
| What age group commonly presents w/zoster? |
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Definition
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Term
| In pts w/shingles, does pain begin before or after lesions present? |
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Definition
| pain commonly begins before the appearance of the lesions |
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Term
| Describe the lesions in shingles. |
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Definition
| maculopapular rash developing into vesicles and pustules |
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Term
| How do lesions distribute in zoster? |
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Definition
| lesions follow distribution of nn roots in a unilateral dermatome |
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Term
| How can zoster be prevented? |
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Definition
| contact and respiratory isolation (gowns, gloves, masks). zoster vaccine (VZV) not yet proven |
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Term
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Definition
| keep pt isolated. keep skin clean. antiviral therapy (acyclovir). pain management (narcotic analgesia- vicodin, percocet) |
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Term
| What are the primary symptoms of chickenpox? |
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Definition
| fever and malaise are the primary sympoms |
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Term
| How do lesions progress in distribution in chickenpox? |
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Definition
| pruritic rash begins on face, scalp and trunk and later moves to extremities |
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Term
| How do chickenpox lesions progress in type? |
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Definition
| papules change to vesicular lesions, rupture, form small ulcers (crusts). new lesions may form in several hours and last from 1-5 days. multiple lesions of different stages |
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Term
| How can chickenpox be prevented? |
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Definition
| live attenuated vaccine available and 85% effective |
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Term
| How can chickenpox be tx? |
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Definition
| isolation until crusts resolve. antihistamines and topical agents. antiviral therapy rarely indicated (acyclovir reduces severity and duration in severe disease (immunocompromised, pregnancy, encephalitis)) |
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Term
| What are complications of chickenpox? |
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Definition
| postherpetic neuralgia, secondary bacterial infections |
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Term
| In what age group is mono most common? |
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Definition
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Term
| Of what do pts w/mono frequently complain? |
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Definition
| fever, sore throat, malaise, and myalgias |
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Term
| What are the clinical findings of mono? |
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Definition
| post cervical chain lymphadenopathy. splenomegaly. occasional maculopapular rash. exudative pharyngitis and/or tonsillitis. soft palate petechia. |
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Term
| What are laboratory finding of ebv? What does it detect? When is it usually positive? |
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Definition
| monospot test: detects heterophile Abs, usually positive w/in 4 weeks from onset of symptoms |
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Term
| What are complications of EBV? |
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Definition
| bacterial (strep) pharyngitis (monospot and throat culture occasionally performed during initial visit), splenic rupure (usually secondary to trauma) |
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Term
| What percentage of pts spontaneously recover from ebv? |
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Definition
| greater than 95% of pts spontaneously recover. |
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Term
| A pt presents w/fever, sore throat and malaise. You rx ampicillin and they develop a maculopapular rash. What is the dx? |
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Definition
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Term
| What provides mono pts symptomatic relief? |
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Definition
| avoid contact sports or rough playing. acetaminophen. ibuprofen. Abx for developing bacterial pharyngitis (avoid ampicillin/amoxicillin) |
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Term
| Within how long does a fever resolve in mono? |
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Definition
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Term
| Within how long do lymphadenopathy and splenomegaly resolve in mono pts? |
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Definition
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Term
| Your pt who was undergoing tx for mono comes in to your office after 4 weeks c/o increased sore throat and headache. What might have occured? |
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Definition
| complication of ebv: bacterial (strep) pharyngitis |
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Term
| For how long might a generalized felling of fatigue last in mono pts? |
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Definition
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Term
| What are the common symptoms of CMV? |
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Definition
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Term
| What increases risk of CMV transmission? |
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Definition
| age and no of sexual partners |
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Term
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Definition
| sexual. congenital*. blood products and transplants. person-to-person |
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Term
| What is the primary way CMV is transmitted? |
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Definition
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Term
| CMV perinatal disease is present in what percentage of newborns? |
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Definition
10%- acquired in utero from mothers w/primary CMV infection
(Book states: "Congential CMV is the most common congenital infection in developed countries (1% of all neonates) . . . 10% of infected newborns will be symptomatic w/cmv disease) |
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Term
| What are the 3 primary* presentations of CMV? How else might CMV present? |
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Definition
| hearing loss. vision problems. seizures. (also jaundice, hepatosplenomegaly, thrombocytopenia. later in life may develop neurological deficits) |
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Term
| What immunocompromised host diseases are most common in AIDs pts w/CMV? |
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Definition
| CMV retinitis. GI CMV. Pulmonary CMV. Neurologic CMV. |
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Term
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Definition
| no current vaccine. antivirals recommended for transplant pts. No prenatal screening program or reduction in breast feeding suggesting |
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Term
| What are 4 antiviral agents recognized from CMV infections? |
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Definition
| Ganciclovir. Valganciclovir. Foscarnet. Cidofovir. (if it ends in -vir, it will probably work. the more expensive it is, the better it works) |
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Term
| How prevalent is rabies in US? |
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Definition
| rare. (used to be extremely rare, but a bit more prevalent now) |
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Term
| Worldwide, how many deaths from rabies annually? |
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Definition
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Term
| What animals commonly infect humans w/rabies? |
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Definition
| raccoons. skunks. bats. foxes. dogs. cats. (NOT squirrels, rabbits) |
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Term
| How is rabies contracted? |
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Definition
| viral encephalitis transmitted through infected saliva during an animal bite or through an already open wound |
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Term
| What are the early s/s of rabies? |
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Definition
| h/x of an animal bite. pain at site of bite. early signs: fever, malaise, n/v |
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Term
| What are the late s/s of rabies? |
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Definition
| alternating periods of delerium/calmness. painful swallowing (hydrophobia). seizures. thick tenacious saliva. coma. death. |
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Term
| What is the rabies protocol? |
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Definition
| well animals: observe for 7-10 days. sick/dead animals: conduct rabies examination. wild animals: capture and conduct examination. *if unable to capture and infection is likely presume the animal is infected. |
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Term
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Definition
| high degree of mortality in non-immunized pts that are actually infected. prevention targeted at immunization of household animals. home safety. |
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Term
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Definition
| remove pt from danger. thorough flushing and cleaning of wound. appropriate wound care. post-exposure immunization (situation and extent of wound. spp of animal and potential for rabies) |
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Term
| What is pre-exposure rabies prophylaxis? |
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Definition
| 3 IM injections over 21 day period |
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Term
| What is rabies post-exposure therapy? |
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Definition
| rabies immune globulin injected into and around wound site. human diploid cell rabies vaccine injection (days 0,3,7,14,28) |
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Term
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Definition
| one of the most common causes of std's |
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Term
| How many HPV strains exist and how many are sexually transmitted? |
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Definition
| 100 dif strains w/~30 sexually transmitted |
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Term
| What are the frequent symptoms of hpv? |
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Definition
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Term
| How easily is hpv transmitted? |
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Definition
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Term
| What is the primary cause of genital warts? |
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Definition
|
|
Term
| what causes condylomata acuminata? |
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Definition
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Term
| What is the most common and easily recognized sign of hpv? |
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Definition
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Term
| Describe the lesions of HPV? |
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Definition
| soft, moist, flesh colored warts that appear in the genital area are (penis, vulva, anus, vagina, cervix, and rectum) w/in several weeks or mos after transmission of infection |
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Term
| Within what timeframe do genital warts appear? |
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Definition
| within several weeks or mos after transmission |
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Term
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Definition
| no known tx available for HPV infection. genital warts: topical medication, cryosurgery, electrocautery |
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Term
| What are complications of hpv? |
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Definition
| common cause of an abnormal pap and associated cervical cancer. genital warts may be transmitted to infants during delivery |
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Term
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Definition
| abstinence, sex w/one uninfected partner, latex condoms |
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Term
| What involves multiple species with grouped vesicular pt presentations and is capable of producing life-long infections? |
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Definition
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Term
| What may present similarly to mono? |
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Definition
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Term
| In what illness do s/s typically present 10 days after inoculation and has high mortality? |
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Definition
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Term
| Book ?: What is the most common cause of mono-like syndrome w/negative hetrophil Abs? |
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Definition
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Term
| Book ?: What virus presents with the histopathologic findings of intranuclear "owls eye" and intracytoplasmic inclusions? |
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Definition
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Term
| Book ?: Over 90% of pts w/Burkitt lymphoma have what virus? |
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Definition
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Term
| Book ?: What are the 2 most common causes of acute retinal necrosis? |
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Definition
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Term
| Bell's palsy is associated w/what virus? |
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Definition
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