Viral infections: herpes zoster: 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 · Viral infections: herpes zoster

Sample item

A 68-year-old man has severe burning pain followed by grouped vesicles on an erythematous base confined to the right T5 dermatome, appearing 36 hours ago. What is the best treatment?

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

The answer and the reasoning

C. Oral valaciclovir or acyclovir started within 72 hours, with analgesia

Herpes zoster results from reactivation of varicella-zoster virus in a dorsal root ganglion. Oral antivirals (valaciclovir, famciclovir or acyclovir) started within 72 hours of the rash reduce the duration and severity and may lower the risk of postherpetic neuralgia. Older patients benefit especially. The recombinant zoster vaccine prevents disease.

Option by option

  • A. Topical acyclovir only

    Topical antivirals are ineffective for zoster.

  • B. No treatment because it is self-limiting in all patients

    Treatment is recommended in older adults, because of the risk of postherpetic neuralgia.

  • C. Oral valaciclovir or acyclovir started within 72 hours, with analgesia (correct)

    Correct. Early oral antiviral therapy shortens the illness and reduces complications.

  • D. Oral prednisolone alone

    Steroids alone do not treat the virus and may only be added to an antiviral in selected cases.

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, Oral valaciclovir or acyclovir started within 72 hours, with analgesia. Herpes zoster results from reactivation of varicella-zoster virus in a dorsal root ganglion.

Why is "Topical acyclovir only" not the answer?

Topical antivirals are ineffective for zoster.

Why is "No treatment because it is self-limiting in all patients" not the answer?

Treatment is recommended in older adults, because of the risk of postherpetic neuralgia.

Why is "Oral prednisolone alone" not the answer?

Steroids alone do not treat the virus and may only be added to an antiviral in selected cases.

What concept does this question test?

It tests Viral infections: herpes zoster in Dermatology. Oral antivirals (valaciclovir, famciclovir or acyclovir) started within 72 hours of the rash reduce the duration and severity and may lower the risk of postherpetic neuralgia. Older patients benefit especially. The recombinant zoster vaccine prevents disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Viral infections: herpes zoster?

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.