Viral Pathogens of the Skin - HERMEL

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Can you name the Viral Pathogens of the Skin ?

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_______ Vaccine: Live virus vaccine consists of vaccinia, the causative pathogen of cowpox. Vaccine should be given within 4 days of exposure.
Virus is highly transmissible via airbrone droplets.
HSV is ______ and results in cell death, leading to ulceration
_____ infection of HSV: Virus enters cutaneous neurons, and migrates to ganglion where it enters a latent state.
Fever before rash in ________.
Mortality rate for chicken pox is ~3-9/100,000; up to 15% in children with ___ cell defects.
HSV: _____ is the drug of choice. Valacyclovir, famciclovir and penciclovir (topical) are also used.
Effective HAART prevents the development of, and treats _____ in in HIV+ pts; modifying immunosuppressive regimen in transplant pts
_______: Like HSV, especially dangerous to immunocompromised pts, who may develop severe pneumonitis, encephalitis, hepatitis or systemic disease
HPV: Virus persists in the ____ cell layer
_____, attenuated viral vaccine available for chicken pox (Varivax). Recommended for children at 12 and 18 mos.
Smallpox Variola ____: 1% mortality rate. Caused by less virulent strains, or infection in a partially immune host
A second VZV vaccine (Zostavax) was developed to prevent shingles/PHN by boosting a waning cell-mediated immune response to VZV with advancing age greater than _____years old.
Typically have a carpet-like (verrucous) surface.
____ patients: Get disseminated infection of HSV involving respiratory, GI tract, or liver
Causes the development of Kaposi’s sarcoma (KS) in pts with depressed cellular immunity, especially AIDS pts
Varicella zoster: Early ______ therapy is beneficial in reducing acute pain for HZ. Pts will generally also require analgesics. NSAIDS are usually ineffective, and opioids may be r
Pathogen of farm animals; occasionally infects humans (farm workers or veterinarians). Causes solitary cutaneous vesicular mass that later develops a central necrosis, typically on
Varicella zoster: The rash is more pronounced on _____ and trunk
dsDNA enveloped virus: member of Poxvirus family. Only one serotype. Spread by aerosoles.
A reactivation of VZV that affects mainly the flanks and can be excruciating.
HPV: Viral replication causes ____ and prickle cell (stratum spinosum) layers to thicken, with overproduction of keratin (keratosis).
(enlarged keratinocytes with clear haloes and shrunken nuclei) are characteristic of HPV infection.
Diagnosis of HSV.
A _____ (papilloma) is a benign, self-limited proliferation of skin that generally will regress over time.
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Smallpox Variola ______: has characteristic vesicular rash and ~30% mortality rate
Diagnosed histologically from findings of large eosinophilic vacuolated cells. Treatment are ablative techniques (curettage, electrocautery or liquid N2)
______ Differentials: chickenpox, vaccinia (cowpox) and other poxvirus diseases [esp. with travel history and/or animal exposure], herpes simplex, measles, acne, insect bites.
Enveloped, icosahedral ds DNA viruses.
The most common complication of herpes zoster, occurring in 10–18% of patients.
Causes nodular, smooth umbilicated papular eruptions with a dimple or pit in the center, generally on the face, trunk, genitals or extremities.
HSV: Primary (as opposed to reactivation infections) tend to be more severe and have more ______ symptoms (headache, fever, lymphadenopathy, etc).
Fever and rash concurrent in _______.
______ is an AIDS-defining illness and is the most common neoplasm in HIV+ pts
HSV: Virus travels up the ____ to the root ganglion, where it enters a latent (non-lytic) state.
_______ infection: as per HSV. Visceral dissemination is associated with a mortality rate of 5- 15%.
Rash clearly follows a single dermatome
Herpetic _____: Often seen in health care workers; causes painful ulcerations on fingers (can also be caused by HSV-2).
Rare infection of humans. The virus naturally infects nonhuman primates in the tropical rain forests in Africa.
HPV _____ wart: They appear as individualized papules or nodules with a rough surface.
Usually diagnosed from clinical signs (rash, pocks). Electron Microscopy is the gold standard.
HPV _____ warts are slightly raised, of skin color or pigmented with flat, slightly rough surface. The face and back of hands are the most common locations.
A common, benign, self-limiting infection in children; typically in the 2-5 year age group.
HPV does not _______ its genome into host cell DNA, but exists as a separately replicating episome (akin to plasmid replication in bacteria).
Category A bioweapons that may produce cutaneous manifestations include agents causing anthrax, plague, _______, tularemia, and certain viral hemorrhagic fevers.
Nonenveloped dsDNA viruses. Causes persisten infections (even after resolution)
Herpes _____: characterized by herpes lesions clustering most often on the neck, chest, face, stomach, and legs of wrestlers and high school athletes
HPV _____ wart: Found more in adolescents and young adults on the plantar region of the foot. Caused mainly by HPV type 1. They are commonly painful.
Bacterial _______: Caused by Staphylococcal colonization of a lesion, from scratching.

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