Buxton - Repro - 11/19 - Causes Of Ulcers/growths

Front 1

Most common HSV cause of oral lesions

Back 1

HSV-1

Front 2

Most common time to contract HSV-1

Back 2

Toddler

Front 3

Most common HSV cause of genital lesions

Back 3

HSV-2

Front 4

Can HSV-1 cause genital lesions? How?

Back 4

Yes, via oral sex

Front 5

Inactive HSV does what?

Back 5

Remains latent in ganglia

Front 6

Pathogenesis of HSV

Back 6

Colonizes and replicates in epithelial cells

ASCENDS to ganglia, where it remains latent

Descends to skin/mucous membrane for infection

Front 7

From the epithelial cells, HSV moves through which ganglia to remain latent?

Back 7

ASCENDING

Front 8

Infection site is always ______ the infected ganglia

Back 8

below

Front 9

Primary HSV infection can be either ______ or _____

Back 9

Asymptomatic

Symptomatic

Front 10

Constitutional signs of symptomatic HSV infection include

Back 10

Pain
Urethral/vaginal discharge
Fever
Meningitis

Front 11

New HSV lesions are characterized by

Back 11

vesciular (raised) serous lesions (clear fluid)

Front 12

Old/healing HSV lesions are characterized by

Back 12

Ulcer-like lesions

Front 13

Scenario of HSV infection with the first sign of lesions after asymptomatic shedding post-infection

Back 13

non-primary first episode

Front 14

What reduces the recurrence of latent HSV?

Back 14

STrong cellular immune response (CD4, CD8) NOT high antibody titer!

Front 15

Asymptomatic with only 1-2 lesions for 7 days, with 5 days of shedding

Back 15

Recurrent HSV infection

Front 16

HSV infection type with multiple lesions with constitutional symptoms for 21 days with 15-20 days of shedding

Back 16

Primary infection

Front 17

Several lesions with absent or mild symptoms for approx 14 days, with 10 days of shedding

Back 17

Non-primary first infection

Front 18

Type of HSV least likely to recur?

Back 18

HSV-I

Front 19

Small serous vesciular lesions may indicate

Back 19

HSV infection

Front 20

Diagnosis of genital HSV is mainly done by

Back 20

clinical appearance

Front 21

Factors other than clinical appearance to dx HSV

Back 21

Isolation with typing
Antigen detection
Serology with typing

Front 22

Use of antiviral drugs in tx of HSV will not do what?

(test question?)

Back 22

Prevent latency, recurrence, or transmission

Front 23

Which antiviral drugs are used to "treat" HSV infections?

Back 23

Acyclovir, Valacyclovir, Famciclovir

Front 24

Goal of antiviral tx for HSV infection?

Back 24

Decrease recurrences, shorten lesion duration, reduce risk of transmission

Front 25

When can antivirals for HSV infections be given?

Back 25

For first episode or in recurrences

Front 26

Antiviral tx for first episode of HSV generally is what duration? What duration for suppressive regimens?

Back 26

7-10 days for primary tx

6 mos or more for suppressive tx

Front 27

Indication for suppressive tx of HSV?

Back 27

>= 6 recurrences per year

Front 28

Treatment regimens for HSV are

Back 28

Primary Episode
Suppressive
Episodic

Front 29

Chancroid is

Back 29

ulcerative STD due to H. ducreyi

Front 30

Difference between Chancroid and Syphilis lesion

Back 30

Chancroid lesions are PAINFUL

Front 31

Diagnosis of Chancroid is made by

Back 31

Ruling out syphilis and genital herpes

Front 32

Papovaviruses are unique in that

Back 32

They promote cell growth, not destrution (unlike most viruses)

Front 33

Method of transmission for papillomaviruses

Back 33

Direct contact

Front 34

HPV types that are typically benign lesions

Back 34

HPV-6
HPV-11

Front 35

HPV types associated with malignancies

Back 35

HPV-16
HPV-18

Front 36

Clinical manifestation of benign HPV

Back 36

Condyloma accuminanta

Front 37

Pre-malignant lesions of HPV

Back 37

Flat condyloma
CIN

Front 38

Malignant lesions of HPV

Back 38

Cervical carcinoma

Front 39

Diagnosis of genital warts d/t HPV

Back 39

clinical presentation

Front 40

Diagnosis of pre-malignant lesions of HPV

Back 40

initially by abnormal PAP smear

Front 41

F/U to abnormal PAP smear

Back 41

HPV DNA test to determine presence of high-risk HPV type (16, 18, 31, 33, etc)

Front 42

Topical treatment of HPV infection

Back 42

Podophyllin
Salcylic Acid
Trichloroacetic Acid

Front 43

Surgical tx of HPV

Back 43

Laser
Cryosurgery
Cauterization
Traditional (?)

Front 44

Immunomodulation tx of HPV

Back 44

Imiquimod

Front 45

MOA of imiquimod

Back 45

Stimulates IFN secretion and promotes Th1 cell inflammatory response

Front 46

Vaccine for HPV

Back 46

quadrivalent vaccine Gardasil

Front 47

What does Gardasil protect against?

Back 47

HPV types 6, 11, 16, and 18

Front 48

When is Gardasil recommended?

Back 48

11-12 year old girls (can be given as young as 9) or females 13-26 who have not yet received it

Front 49

Treponema pallidum causes

Back 49

syphilis

Front 50

H. ducrei causes

Back 50

Chancroid

Front 51

HPV causes

Back 51

genital warts, cervical ca

Front 52

Test used to type high-risk HPV after abnormal PAP

Back 52

nucleic acid hybridization on cervical cells

Front 53

PAP smear histology finding of HPV infection

Back 53

Koilocytes