Virology: oral hairy leukoplakia: 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: oral hairy leukoplakia

Sample item

A man with HIV infection (CD4 count 180 cells per cubic mm) has white corrugated plaques on the lateral borders of the tongue that cannot be scraped off. Biopsy shows epithelial hyperplasia, and in-situ hybridisation shows viral DNA in the upper epithelial layers. Which virus is responsible?

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

The answer and the reasoning

C. Epstein-Barr virus

Oral hairy leukoplakia is a non-malignant lesion caused by productive Epstein-Barr virus replication in tongue epithelium in immunocompromised patients, particularly with HIV. It signals immune decline and usually regresses with antiretroviral therapy.

Option by option

  • A. Cytomegalovirus

    Cytomegalovirus causes mucosal ulceration and does not produce these plaques.

  • B. Human papillomavirus

    HPV causes warty papillomas and not a corrugated, non-scrapable lateral tongue plaque.

  • C. Epstein-Barr virus (correct)

    Correct. Productive EBV replication in the epithelium causes the non-scrapable lateral tongue plaques.

  • D. Human herpesvirus 8

    Human herpesvirus 8 causes Kaposi sarcoma, which appears as violaceous macules or nodules.

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.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Epstein-Barr virus. Oral hairy leukoplakia is a non-malignant lesion caused by productive Epstein-Barr virus replication in tongue epithelium in immunocompromised patients, particularly with HIV.

Why is "Cytomegalovirus" not the answer?

Cytomegalovirus causes mucosal ulceration and does not produce these plaques.

Why is "Human papillomavirus" not the answer?

HPV causes warty papillomas and not a corrugated, non-scrapable lateral tongue plaque.

Why is "Human herpesvirus 8" not the answer?

Human herpesvirus 8 causes Kaposi sarcoma, which appears as violaceous macules or nodules.

What concept does this question test?

It tests Virology: oral hairy leukoplakia in Microbiology. It signals immune decline and usually regresses with antiretroviral therapy.

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: oral hairy leukoplakia?

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.