Quiz: Shingles in brief: Recognition, management, and the role of pharmacists

1. Which of the following is correct regarding herpes zoster in Australia?

1. The incidence of herpes zoster increases with increasing age
2. The lifetime risk of herpes zoster at age 50 is close to 50%
3. Herpes zoster is more common in younger adults who are in close quarters such as university students or the military
4. The incidence of herpes zoster is approximately 1 in 100,000

2. True or false: Primary varicella zoster infection in the past is required for herpes zoster to occur.

1. True
2. False

3. Which of the following features of this presentation would be indicative of shingles? Choose two (TWO):

Michael is a 75-year-old man who has presented to the pharmacy complaining of discomfort along his ribs which worsens with movement. He reports burning pain, and that he thinks he may have been stung by a jellyfish during a recent swim as it is quite red. He also reports itch along the side of his body.

Your examination reveals vesicles with erythema along the front of his chest in a line.

1. The rash stops at the midline of the body
2. The presence of vesicles and discomfort
3. The rash is in a diagonal line in line with the expected location of a nerve
4. The presence of itch

4. Which of the following is INCORRECT regarding initiation of antiviral medications?

Based on examination and patient history, you determine Michael is most likely to be experiencing herpes zoster.

1. They are indicated for immunocompetent patients within 72 hours of rash eruption
2. Valaciclovir and Famciclovir are considered first-line
3. Famciclovir is suggested first line in pregnancy
4. Limited data suggest valaciclovir is safe in pregnancy

5. Which of the following management strategies could you suggest to Michael?

1. Use of simple analgesics to manage pain
2. Cover the blisters to prevent transmission
3. Use of ice may be of use for burning pain
4. All of the above