Conjunctiva: phlyctenular: practice question

A Ophthalmology 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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Ophthalmology · Conjunctiva: phlyctenular

Sample item

A child with a tuberculous contact has a small nodule at the limbus with surrounding hyperaemia. What is the mechanism of phlyctenular conjunctivitis?

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

The answer and the reasoning

D. Delayed hypersensitivity to microbial antigens

Phlyctenules are type IV delayed hypersensitivity reactions to antigens of tubercle bacilli or staphylococci. Treatment is topical steroids and treating the underlying cause.

Option by option

  • A. Viral replication in epithelium

    It is not a viral epithelial infection.

  • B. Direct bacterial invasion

    The organism is not actively invading the tissue.

  • C. Immediate hypersensitivity to pollen

    Immediate hypersensitivity causes vernal and hay fever types.

  • D. Delayed hypersensitivity to microbial antigens (correct)

    Correct. This is a delayed hypersensitivity response.

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 Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, Delayed hypersensitivity to microbial antigens. Phlyctenules are type IV delayed hypersensitivity reactions to antigens of tubercle bacilli or staphylococci.

Why is "Viral replication in epithelium" not the answer?

It is not a viral epithelial infection.

Why is "Direct bacterial invasion" not the answer?

The organism is not actively invading the tissue.

Why is "Immediate hypersensitivity to pollen" not the answer?

Immediate hypersensitivity causes vernal and hay fever types.

What concept does this question test?

It tests Conjunctiva: phlyctenular in Ophthalmology. Treatment is topical steroids and treating the underlying cause.

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 Conjunctiva: phlyctenular?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology 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.