Test 29  (Herpetic eye disease)
1. The following are true about herpes simplex:
a. herpes keratitis in infants is caused mainly by type II 
    herpes simplex

b. ocular disease is the most common manifestation of 
    primary type I herpes simplex

c. herpes simplex can be contracted from pests

d. ocular recurrence is usually caused by virus 
    reactivation within the trigeminal ganglia

e. ocular recurrence is more common than either genital 
    or oral recurrence

2. With regard to herpes epithelial ulcer:

a. the sensation is reduced

b. the disease usually presents initially as punctate keratitis

c. geographical ulcer occurs as a result of inappropriate 
    use of topical steroid

d. the ulcer has typical tapering endings

e. Rose Bengal stains infected epithelial cells

3. The following are true about acyclovir

a. topical acyclovir is more effective than oral acyclovir in 
    the treatment of herpes simplex epithelial keratitis

b. valacyclovir is the prodrug of acyclovir

c. the dosing frequency is less with valacyclovir than 

d. oral acyclovir reduces the incidence and severity of 
    postherpetic neuralgia

e. oral acyclovir given daily can reduce the recurrent of 
    herpes simplex epithelial keratitis

4. In the treatment of herpes simplex ocular disease :

a. oral acyclovir has no effect on the development of 
    stromal keratitis in the subsequent year when given 
    during active herpes simplex keratitis

b. oral acyclovir reduces the development of iritis in the 
    subsequent year when given during active herpes 
    simplex keratitis

c. in patients with previous herpes simplex stromal 
    keratitis, oral acyclovir reduces the likelihood of 
    recurrent stromal disease

d. stopping oral acyclovir in a patient with previous 
    herpes simplex stromal keratitis causes rebound of 
    herpes simplex disease

e. oral acyclovir has no effect on herpes simplex iritis


5. In the treatment of herpes simplex stromal disease, HEDS (Herpetic
    Eye Disease Studies) show that:

          a. topical steroid reduces the duration of the disease

b. patients on topical steroid has better visual outcome at 
    six months review than the non-steroid treated group

c. topical steroid increases the likelihood of epithelial 

d. systemic steroid is useful in the management of 
    necrotizing stromal keratitis

e. oral acyclovir has added benefit in patients treated with 
    topical steroid and trifluridine

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