Infections: herpes zoster ophthalmicus: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Infections: herpes zoster ophthalmicus

Sample item

A 70-year-old has painful vesicles on the forehead and a vesicle on the tip of the nose. Which nerve involvement does this predict, and what is its significance?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Nasociliary branch, with a high risk of ocular involvement

Hutchinson sign, a vesicle on the nasal tip or side, shows involvement of the nasociliary branch of the ophthalmic nerve, which also supplies the eye, and predicts ocular complications such as keratitis and uveitis. Ophthalmic review and oral antivirals are needed. The maxillary and mandibular branches do not supply the nasal tip.

Option by option

  • A. Mandibular branch, with a risk of otitis

    The mandibular branch supplies the lower face.

  • B. Facial nerve, with Bell palsy

    Facial nerve involvement is Ramsay Hunt syndrome with ear vesicles.

  • C. Nasociliary branch, with a high risk of ocular involvement (correct)

    Correct. Nasal tip vesicles predict ocular involvement.

  • D. Maxillary branch, with a risk of dental infection

    The maxillary branch supplies the cheek and upper lip.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Nasociliary branch, with a high risk of ocular involvement. Hutchinson sign, a vesicle on the nasal tip or side, shows involvement of the nasociliary branch of the ophthalmic nerve, which also supplies the eye, and predicts ocular complications such as keratitis and uveitis.

Why is "Mandibular branch, with a risk of otitis" not the answer?

The mandibular branch supplies the lower face.

Why is "Facial nerve, with Bell palsy" not the answer?

Facial nerve involvement is Ramsay Hunt syndrome with ear vesicles.

Why is "Maxillary branch, with a risk of dental infection" not the answer?

The maxillary branch supplies the cheek and upper lip.

What concept does this question test?

It tests Infections: herpes zoster ophthalmicus in Dermatology. Ophthalmic review and oral antivirals are needed. The maxillary and mandibular branches do not supply the nasal tip.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infections: herpes zoster ophthalmicus?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.