Deck 59: Herpes Simplex Infections

Question 1

Your patient is a 35-year-old man who has HIV and herpes simplex virus (HSV) infection. He has a new boyfriend and he wants to reduce the risk of transmission of HSV-2 to his partner. You should counsel him to consider:

A) The administration of valacyclovir 250 mg three times a day for 7-10 days during his typical HSV-2 outbreaks
B) The administration of valacyclovir 1 g twice a day for 1 day at the first sign of his prodromal symptoms of HSV-2 or an active lesion
C) The administration of daily valacyclovir to reduce the risk of HSV-2 to his partner
D) Avoiding sex during outbreaks because no medication has been shown to reduce transmission of HSV-2

Answer 1

C

Question 2

Prodromal symptoms of recurrent HSV infection can include all of the following symptoms except:

A) Tender lymph nodes
B) Burning pain
C) Tingling
D) Itching of the involved skin or mucus membranes

Answer 2

A

Question 3

Your patient is a 24-year-old woman who has no prior history of STDs. Her boyfriend, and sexual partner for the last 2 years, has genital HSV but he has not had any symptoms of active infection in 12 months. Would you recommend HSV-2 screening for this patient?

A) Yes. It is recommended that HSV-2 screening be offered to the general population as a part of routine screening.
B) Yes. Asymptomatic people who have a sexual partner with HSV-2 should be offered screening.
C) No. Only HIV-positive people should be offered screening for HSV-2.
D) No. Only people at increased risk for acquisition of HIV should be offered screening for HSV-2.

Answer 3

B

Question 4

When an active lesion suspected to be HSV is present, the recommended diagnostic test to confirm the diagnosis is:

A) HSV viral culture
B) HSV polymerase chain reaction
C) Pap smear
D) Type-specific HSV serologies

Question 5

According to the Centers for Disease Control and Prevention (2015), all of the following counseling topics should be discussed when counseling a person with genital HSV infection except:

A) The importance of abstaining from sexual activity with uninfected partners when lesions or prodromal symptoms are present
B) The effectiveness of suppressive therapy for persons experiencing a first episode of genital herpes in preventing symptomatic recurrent episodes
C) The risk for neonatal HSV infection
D) The effectiveness of male latex condoms, which when used consistently and correctly can eliminate the risk for genital herpes transmission

Question 6

The majority of HSV-2 genital infections are acquired during contact with persons unaware that they have the infection and who are asymptomatic when transmission occurs.

Question 7

The first clinical episode of genital herpes in a patient with antibodies to HSV-1 or HSV-2 is:

A) Primary infection
B) Recurrent infection
C) Nonprimary first-episode infection
D) Primary HIV

Question 8

A recurrent HSV infection can be triggered by:

A) Stress
B) Acute illness
C) Menstrual period
D) All of the above

Question 9

Most pregnant women with a history of recurrent genital herpes can deliver their infants vaginally with a risk of neonatal transmission of less than 1%.

Question 10

Symptomatic treatment for acute HSV outbreaks includes all of the following except:

A) Topical anesthetic or viscous lidocaine
B) Lysine
C) NSAIDs for pain control
D) Antiviral medications such as acyclovir or valacyclovir

Question 11

You should consider daily suppressive antiretroviral therapy when an individual has:

A) Three or more HSV outbreaks per year
B) One HSV outbreak per year but is distraught about having any HSV outbreaks
C) Six or more HSV outbreaks per year
D) One outbreak in her first trimester of pregnancy