Virology: herpes simplex keratitis: 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 simplex keratitis

Sample item

A 30-year-old man has a painful red eye with photophobia and watering. Fluorescein staining shows a branching linear (dendritic) corneal ulcer. Which treatment should be avoided at this stage?

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

The answer and the reasoning

A. Topical corticosteroid

A dendritic ulcer is the typical lesion of epithelial herpes simplex keratitis, caused by active viral replication in corneal epithelium. Topical corticosteroids suppress local immunity and allow rapid spread, leading to geographic ulcers and perforation, so they are contraindicated in active epithelial disease. Topical or oral antivirals and debridement are used.

Option by option

  • A. Topical corticosteroid (correct)

    Steroids worsen replication in active epithelial disease and are contraindicated.

  • B. Gentle epithelial debridement

    Debridement removes infected epithelium and is an accepted adjunct.

  • C. Topical ganciclovir gel

    Topical ganciclovir is an accepted antiviral treatment.

  • D. Oral aciclovir

    Oral aciclovir is an accepted antiviral treatment.

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 A, Topical corticosteroid. A dendritic ulcer is the typical lesion of epithelial herpes simplex keratitis, caused by active viral replication in corneal epithelium.

Why is "Gentle epithelial debridement" not the answer?

Debridement removes infected epithelium and is an accepted adjunct.

Why is "Topical ganciclovir gel" not the answer?

Topical ganciclovir is an accepted antiviral treatment.

Why is "Oral aciclovir" not the answer?

Oral aciclovir is an accepted antiviral treatment.

What concept does this question test?

It tests Virology: herpes simplex keratitis in Microbiology. Topical corticosteroids suppress local immunity and allow rapid spread, leading to geographic ulcers and perforation, so they are contraindicated in active epithelial disease. Topical or oral antivirals and debridement are used.

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 simplex keratitis?

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.