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Dermatology Week 2 2017/18 > 4: Microbiology - viral skin infections > Flashcards

4: Microbiology - viral skin infections Flashcards

1
Q

Which virus causes both chicken pox and shingles?

A

Varicella zoster virus

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2
Q

What is chicken pox also known as?

A

Varicella

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3
Q

What is shingles also known as?

A

Herpes zoster or zoster

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4
Q

What kind of virus is varicella zoster?

A

Part of the herpes family

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5
Q

When do patients typically get chicken pox?

A

Childhood

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6
Q

What is the presentation of chicken pox?

A

Distinctive red macular > papular > vesicular rash which then scabs over without scarring

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7
Q

After the first infection, varicella zoster virus becomes ___ within the body.

A

latent

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8
Q

When do patients typically develop shingles?

Why?

A

Late in life / immunosuppressed

Virus reactivates and immune system cannot deal with it

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9
Q

Where do varicella zoster viruses sit when they are latent?

What happens when they reactivate?

A

Dorsal sensory nerve

Same presentation as chicken pox in ONE DERMATOME only (i.e shingles)

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10
Q

Chicken pox rash is centripetal. What does this mean?

A

Primarily found on the trunk

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11
Q

What are other symptoms of chicken pox, apart from the rash?

A

Pruritus

Pain

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12
Q

What are some complications of chicken pox?

A

Secondary infection e.g pneumonia

Haemorrhage

Scarring

Encephalopathy (spread to the brain)

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13
Q

Why is shingles rash so distinctive?

A

Dermatomal, meaning it’s restricted to one or more dermatomes and is found on one side of the body usually

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14
Q

Who tends to develop shingles?

A

Elderly

Immunocompromised

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15
Q

What occurs in addition to the rash of shingles?

A

Tingly pain

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16
Q

If pain persists four weeks after a shingles infection, what is it called?

A

Post herpetic neuralgia

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17
Q

What are the three divisions of the trigeminal nerve (CN V)?

A

V1 - opthalmic division

V2 - maxillary division

V3 - mandibular division

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18
Q

If a patient has shingles affecting the opthalmic division of their trigeminal nerve, where will the rash be?

A

On the face (unilaterally), affecting the forehead and eye down to the bridge of the nose

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19
Q

Who should a patient with opthalmic zoster be referred to?

A

Opthalmologist

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20
Q

Why could children develop shingles?

A

Mother had chicken pox in utero

Immunocompromised

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21
Q

Adults tend to get herpes zoster in their ___ and ___ nerves.

Children tend to get herpes zoster in their ___ and ___ nerves.

(cervical, thoracic, lumbar, sacral)

A

thoracic , lumbar

cervical , sacral

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22
Q

What is Ramsay-Hunt syndrome?

What are the possible symptoms?

A

VSV in the 7th and 8th cranial nerves

Facial palsy, deafness, tinnitus

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23
Q

Which kind of vaccine is used to prevent chickenpox?

A

Live attenuated

alive, but less virulent

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24
Q

How is shingles vaccinated against?

A

The same live attenuated chicken pox vaccine

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25
Q

Which virus commonly causes infections in young people in the form of primary gingivostomatitis?

What does this infection look like?

A

Herpes simplex

Ulceration in and around mouth

26
Q

How long does primary gingivostomatitis last?

A

1-2 weeks

27
Q

When herpes simplex virus recurs it presents as ___ ___ around the mouth.

A

cold sores

28
Q

Dentists and anaesthetists sometimes develop lesions in their nail folds called herpetic whitlow - why?

A

Their fingers are inoculated with herpes simplex virus by contact with the cold sores around people’s mouths

29
Q

If herpes simplex virus encounters the open skin of a child with eczema, what life threatening infection can occur?

A

Eczema herpeticum

(Dermatitis herpetiformis is associated with CROHN’S DISEASE)

30
Q

Herpes simplex virus can be divided into Type _ and Type _.

A

1 , 2

31
Q

If herpes simplex virus spreads to the brain, what sign will the patient show?

A

Encephalopathy

32
Q

Which herpes virus is the main cause of oral lesions?

A

Herpes simplex type I

33
Q

Which drug can be used to treat VZV and HSV?

A

Aciclovir

34
Q

Does aciclovir treat latent infection?

A

No

35
Q

How can viral infection be confirmed?

A

Take a swab

36
Q

Which skin condition is associated with herpes simplex virus (as well as some drug reactions) and presents as a bullseye rash?

A

Erythema multiforme

37
Q

What is a common infection in children which presents as fleshy, firm, umbilicated nodules?

A

Molluscum contagiosum

38
Q

What type of infection is molluscum contagiosum?

A

Viral infection

39
Q

Which virus causes warts?

A

Human papilloma virus

40
Q

What are warts called if they appear on the feet?

A

Verrucas

because they’re squashed flat

41
Q

What are some other diseases caused by human papilloma virus?

A

Genital warts

Cervical cancer

42
Q

What is herpangina?

A

Blistering rash at the back of the mouth

43
Q

Which family of viruses cause herpangina?

A

Enteroviruses

(coxsackie virus)

44
Q

What member of the enterovirus family causes herpangina and hand, foot and mouth disease?

A

Coxsackie virus

45
Q

Which infection is also known as slapped cheek disease because it presents as a raised red rash on a child’s cheek?

A

Erythema infectiosum

46
Q

Which virus causes erythema infectiosum (slapped cheek disease)?

A

Parvovirus

47
Q

Where children develop erythema infectiosum, what do adults present with when they are infected with parvovirus?

A

Acute arthritis

48
Q

How is suspected parvovirus infection investigated?

A

Blood IgM test (NOT a swab)

49
Q

Which virus causes scabby mouth in sheep and appears as firm, fleshy nodules on the hands of farmers?

A

Orf

50
Q

Which bacteria has a primary infection phase, then disseminates to cause secondary symptoms all over the body?

A

Syphilis

51
Q

What is a chancre?

A

Painless ulcer found at the site of syphilis infection

52
Q

What happens in the secondary phase of syphilis infection?

A

Red rash all over the body

soles of feet, palms, mucous membranes

53
Q

What happens in the tertiary phase of syphilis?

A

Life threatening systemic presentation

  • CNS, cardio etc.
54
Q

Which bacteria causes syphilis?

A

Treponema pallidum

55
Q

How is syphilis diagnosed?

A

Swab at chancre site

OR

Blood test

56
Q

How is syphilis treated?

A

Benzylpenicillin

57
Q

What kind of ulcers, found in the mouth, are consistent with syphilis?

A

Snail track ulcers

58
Q

What is a bacterial infection which is spread by ticks?

A

Lyme disease

59
Q

What is the bacteria responsible for Lyme disease?

A

Borrellia burgdorferi

60
Q

What is the pathognomonic skin sign of Lyme disease?

What does it look like?

A

Erythema migrans

Bullseye rash

61
Q

How is Lyme disease treated?

A

Doxycycline or amoxicillin

62
Q

How can a late diagnosis of Lyme disease be diagnosed?

A

Blood test

Dermatology Week 2 2017/18 (8 decks)

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