Your 33-year-old female patient reports the development of a "cold sore" on her lower lip. She asks if this is the kind of sore that is transmitted during sex. The clinician should explain that:
A. The sore can be either herpes type 1 or herpes type 2, and both can be transmitted during sex
B. A cold sore in the oral region is caused by herpes type I, and this is not contagious
C. Herpetic lesions on the lips and in the mouth are herpes type II and caused by oral sex
D. A blood test is done to determine the specific type of virus because treatments for I and II differ
ANS: A
The majority of genital herpes infections are due to HSV2, and approximately 10% are due to the HSV1 virus that has been transferred to the genital area either by sexual or oral contact. Although blood tests can be done to determine the presence or absence of antibodies to HSV1 and HSV2, it is mostly academic because the symptoms, transmission, and treatment are the same regardless of type.
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