Virology: herpes zoster ophthalmicus: practice question

A Microbiology 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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Microbiology · Virology: herpes zoster ophthalmicus

Sample item

A 70-year-old man has a painful vesicular rash on the left forehead. Several vesicles are also present on the tip of the nose. Why is this finding important?

AIt indicates geniculate ganglion involvement and Ramsay Hunt syndromeBIt indicates meningitis from haematogenous spreadCIt indicates involvement of the maxillary division and risk to the facial nerveDIt indicates nasociliary nerve involvement, which predicts ocular complications

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

The answer and the reasoning

D. It indicates nasociliary nerve involvement, which predicts ocular complications

The nasociliary branch of the ophthalmic division supplies both the tip of the nose and the cornea. Vesicles at the nasal tip (Hutchinson sign) therefore signal a markedly higher risk of keratitis, uveitis and other eye involvement. Patients need prompt systemic antiviral therapy and ophthalmological review.

Option by option

A. It indicates geniculate ganglion involvement and Ramsay Hunt syndrome
Ramsay Hunt syndrome involves the geniculate ganglion with ear vesicles and facial palsy.
B. It indicates meningitis from haematogenous spread
Zoster of a single dermatome does not imply meningitis.
C. It indicates involvement of the maxillary division and risk to the facial nerve
The lesion lies in the ophthalmic division and does not involve the maxillary division or facial nerve.
D. It indicates nasociliary nerve involvement, which predicts ocular complications (correct)
Hutchinson sign shows nasociliary involvement and predicts eye disease.

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.

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is D, It indicates nasociliary nerve involvement, which predicts ocular complications. The nasociliary branch of the ophthalmic division supplies both the tip of the nose and the cornea.

Why is "It indicates geniculate ganglion involvement and Ramsay Hunt syndrome" not the answer?

Ramsay Hunt syndrome involves the geniculate ganglion with ear vesicles and facial palsy.

Why is "It indicates meningitis from haematogenous spread" not the answer?

Zoster of a single dermatome does not imply meningitis.

Why is "It indicates involvement of the maxillary division and risk to the fa…" not the answer?

The lesion lies in the ophthalmic division and does not involve the maxillary division or facial nerve.

What concept does this question test?

It tests Virology: herpes zoster ophthalmicus in Microbiology. Vesicles at the nasal tip (Hutchinson sign) therefore signal a markedly higher risk of keratitis, uveitis and other eye involvement. Patients need prompt systemic antiviral therapy and ophthalmological review.

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 Virology: herpes zoster ophthalmicus?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.