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33 Cards in this Set

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What are the two distinct clinical syndromes caused by VZV?
Varicella (Chickenpox)

Zoster (Shingles)
VZV:

- natural host
- prevalence
- transmission
Humans

Worldwide

Airborne
What type of disease is varicella in terms of population group, severity, and immunity?
Normal childhood disease that is benign and confers lifelong protective immunity.
T/F - The uniformity of the pox marks on a patient will reveal the stage of the disease.
False:

Different stages/sizes
What are the two types of complications possibly seen in Varicella?
Bacterial SUPERinfection of skin lesions

CNS involvement (rare)
Though rare, what type of CNS involvement can occur with Varicella? x3
Reye's syndrome
Peripheral neuritis
Meningoencephalitis
Can you give ASA to Varicella patients?

Why or why not?

What else can you give?
No. Contraindicated

As an antipyretic has been associated with the development of Reye's syndrome.

Use acetominophen
What age group is most susceptible to varicella complications?
Adults (20 yrs and older)
What complication might be seen with neonates?
Neonatal varicella

Disseminated due to lack of neonatal immune response
What type of complication can be seen in immunosuppressed?
Persistent viremia

involving liver, lung, and CNS
What lab test is needed for varicella diagnosis and why?
None needed b/c clinical symptoms so distinctive.
For primary varicella in immunocompetent children, what is the treatment?
No specific treatment.

Lotion for itching.
What is the treatment approved by the FDA for varicella?

Alternative?
Acyclovir

Immune globulin
(VZIG - Varicella-Zoster immune globulin)
Vaccine name and dosage for varicella.
Varivax

2nd dose is WARRANTED b/c protection wanes to 84% in 2-8 years.
What three problems exist with the Varivax vaccine?
1. NOT absolute protection

2. NOT protect against zoster

3. MAY ACTIVATE Zoster
Zoster is also known as what?
Shingles
Zoster is predominantly seen in what age group?
+60 yrs old
How does Zoster transmit?
Reactivation of latent VZV
Zoster symptoms.
UNILATERAL painful vesicular eruptions

localized to head, upper trunk, or buttocks.
Severe systemic infections of Zoster are seen in whom?
Immunocompromised
What are the complications of Zoster?
Postherpetic neuralgia
(debilitating pain)

Repeated attacks
(motor paralysis)
Laboratory tests needed for Zoster diagnosis.
None needed

b/c distinct clinical symptoms.
Zoster treatment plan
In general there is NO NEED FOR ANTIVIRALS!!!

Acyclovir, valciclovir, and famciclovir is approved by FDA.

Analgesics for pain.

Corticosteroids (controversial)
Zoster Vaccine
Zostavax
HHV-6 has how many variants and name them.
Two variants exist

HHV-6A
HHV-6B
HHV6:

- natural host
- prevalence
- transmission
humans

common, approaching 100% seroprevalence

person to person
(exposure to secretions)
What is Roseola?

Caused by what virus
Common, mild febrile disease of infants.

Caused by HHV6
What is the symptoms of Roseola?
Fever (few days)

Followed by rash (that resolves spontaneously)
What are the complications of Roseola? x5
High Fever
Invasion of CNS
Vomiting
Diarrhea
Hepatosplenomegaly
The most serious disease manifestations of HHV6 are seen in what population group?
Recipients of bone marrow or solid organ transplant
What is the diagnostic lab used for HHV-6?
Detect viral antigen using:

Direct Immunofluorescence
ELISA Techniques
What are the treatments for HHV-6? x2

What is it commonly resistant to?
Ganciclovir
Foscarnet

Resistant to Acyclovir
What is the vaccine used for HHV-6?
NONE