[11] Genital Herpes Flashcards Preview

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Flashcards in [11] Genital Herpes Deck (44)
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1
Q

What is genital herpes?

A

A sexually transmitted infection caused by the herpes simplex virus

2
Q

How is genital herpes transmitted?

A

By skin-to-skin contact through vagina, anal or oral sex

3
Q

How long can genital herpes infection take to show?

A

Once infected people may be asymptomatic for a long period before the first flare up

4
Q

What happens to the virus after resolution of primary genital herpes infection?

A

Can lie dormant until it returns in later life causing recurrent outbreaks

5
Q

How many cases of genital herpes are there each year in England?

A

31,000

6
Q

What % of newly diagnosed STI’s are genital herpes?

A

7%

7
Q

What is happening to the rate of genital herpes infections?

A

Rising

8
Q

What % of genital herpes occurs in people aged 15-24?

A

42%

9
Q

Why are diagnostic rates and prevalence of genital herpes thought to be underestimated?

A

Many people don’t know they are infected

10
Q

What are the 2 main types of herpes simplex virus?

A

HSV-1 and HSV-2

11
Q

What can be caused by HSV-1?

A
  • Cold sores

- Genital sores

12
Q

What can be caused by HSV-2?

A

Genital herpes

13
Q

What is the consequence of HSV-1 and 2 causing oral and genital herpes?

A

It can be spread via oral sex with a cold sore sufferer

14
Q

How does HSV enter the body?

A

Via small cracks in the skin or through mucous membranes of the mouth, vagina, rectum, urethra or under the foreskin

15
Q

Where does HSV travel after infecting the surface?

A

The nearest nerve ganglion and remains there

16
Q

What does travelling to the nerve ganglion allow HSV to do?

A

Remain dormant for a long time

17
Q

Why does remaining in the nerve ganglion allow the HSV to remain dormant?

A

It cannot be reached by the immune system

18
Q

How does the HSV become reactivated?

A

It travels back down the nerve onto the surface of the genitals to cause a symptomatic outbreak

19
Q

Can HSV be spread when asymptomatic?

A

Yes

20
Q

How can HSV be spread when asymptomatic?

A

Through asymptomatic shedding

21
Q

What are the risk factors for genital herpes?

A
  • Multiple sexual partners
  • Previous history of STIs
  • Early age of first sexual intercourse
  • Unprotected sexual encounters
  • MSM (and female partners of MSM)
  • Female gender
  • HIV infection
22
Q

What are the symptoms of primary genital herpes infection?

A
  • Small, red, painful blisters around genitals
  • Vaginal or penile discharge
  • Flu-like symptoms, fever and myalgia
  • Itchy genitals
23
Q

What can happen to primary genital herpes blisters?

A

Can form open sores

24
Q

Where do genital herpes sores present in men?

A
  • Penis
  • Anus
  • Buttocks
  • Thighs
25
Q

Where do genital herpes sores present in women?

A
  • Vulva
  • Clitoris
  • Buttocks
  • Anus
26
Q

How long does it take for primary genital herpes lesions to crust and heal?

A

20 days

27
Q

How do secondary genital herpes infections differ from primary infection?

A

Often shorter and less severe and increasingly so with each infection

28
Q

Why are secondary genital herpes outbreaks shorter and less severe?

A

Production of antibodies allows for a more effective response

29
Q

What are the symptoms of recurrent outbreaks of genital herpes?

A
  • Burning and itching

- Painful red blisters

30
Q

What are cold sores?

A

Painful red blisters around the mouth and nose that last 7-10 days

31
Q

What causes cold sores?

A

Mainly HSV-1 but also HSV-2

32
Q

How can cold sores spread to cause genital herpes?

A

If oral sex received from someone with a cold sore

33
Q

What are the differentials for genital herpes?

A
  • Vulvovaginal candidiasis
  • Other STI’s
  • Scabies
  • Psoriasis
  • Dermatitis
  • Reiter’s syndrome
  • Genital malignancy
  • Herpes zoster
34
Q

Where is genital herpes best diagnosed?

A

During primary infection at a GUM clinic or GP surgery

35
Q

What history should be taken to help diagnose genital herpes?

A
  • Sexual partners
  • History of cold sores or similar symptoms
  • Any other STI’s
36
Q

What investigation should be taken if patient presents with open genital herpes sores?

A

Swabs for testing presence of HSV and PCR to differentiate types 1 and 2

37
Q

Is a negative swab a definite exclusion of genital herpes?

A

No

38
Q

How can symptom duration of primary infection and recurrence of genital herpes be treated?

A

Over the counter medications

39
Q

What mediation is effective at reducing the number and size of primary genital herpes lesions?

A

Aciclovir

40
Q

What should a patient be offered after clearance of primary genital herpes infection?

A

Full sexual health screen and advice about preventing transmission

41
Q

What advice should be given to patients with genital herpes?

A

Avoid all sexual contact during outbreak and disclose infection to all recent and current sexual partners

42
Q

What can be used to reduce the discomfort of a genital herpes infection?

A
  • OTC painkillers
  • Petroleum jelly
  • Ice pack
43
Q

What is recommended if episodes of genital herpes are regular?

A

Take aciclovir as soon as symptoms start

44
Q

What is recommended if episodes of genital herpes are very frequent?

A

Daily dose of aciclovir to suppress outbreaks