Herpes Labialis (Cold Sores)

No disease-specific severity scores/tools or resources. If you think this is incorrect, let us know!

1. A patient presents to the pharmacy with tingling, itching and irritation on their upper lip. They have never had any symptoms like this before. This presentation is most consistent with

a) Primary herpes labialis infection

b) Secondary herpes labialis infection 

c) Minor aphthous ulcer

d) None of the above 

2. For which patient would a referral be most appropriate? 

a) A 21 year old female presenting with her 2nd cold sore in two years

b) A 41 year old male presenting with tingling and itching for 7 hours who normally gets cold sores in twice a year

c) A 34 year old male presenting with unresolved lesion that has lasted 14 days 

3. Which of the following may be risk factors for herpes labialis? 

a) Sexually active teens

b) Neonates

c) Stress

d) All of the above

4. Which of the following regarding treatment of herpes labialis is true? 

a) Oral HSV is not self-limiting

b) Analgesics promote healing of sores

c) Antivirals must be initiated within 72 hours of symptom onset

d) None of the above

5. A patient presents with their 2nd cold sore this year. They began to feeling tingling and burning on their lip 4 hours ago and came to the pharmacy right away. Which of the following would be MOST appropriate to treat this patient? 

a) Keep the lesion clean with mild soapy water, do not touch and wash hands frequently 

b) Avoid skin-skin contact with others until the blister dries and crusts over

c) Acetaminophen 325-650 mg po q4-6h PRN (max 4g/day) for pain 

d) Valacyclovir 2g po BID x 1 day

e) All of the above