USMLE Forum Archives - USMLE Step 1 - Pathology 42
Pathology 42
TheOne - 12-03-06 16:08
A 65-year-old man develops a vesicular rash localized to a narrow circumferential band on one side of his chest. The rash is very painful, and the vesicles are confluent with some ulceration. No other significant findings are demonstrated on physical examination. Which of the following diagnoses is most likely to be correct?
A. Chicken pox
B. Herpes simplex I infection
C. Herpes simplex II infection
D. Measles
E. Shingles
TheOne - 12-03-06 16:08
A 65-year-old man develops a vesicular rash localized to a narrow circumferential band on one side of his chest. The rash is very painful, and the vesicles are confluent with some ulceration. No other significant findings are demonstrated on physical examination. Which of the following diagnoses is most likely to be correct?
A. Chicken pox
B. Herpes simplex I infection
C. Herpes simplex II infection
D. Measles
E. Shingles
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#2
Re: Pathology 42
TheOne - 12-06-06 10:46 Explanation: The correct answer is E. This is shingles, the recurrent form of herpes zoster infection, which is usually (except in the case of immunosuppressed patients) confined to a single dermatome. Isolated vesicles may be seen outside the dermatome. The primary herpes zoster infection precedes the development of shingles by years or decades; the prevalence of shingles rises steadily with age, to the point that 1% of people older than 80 years have the condition. Shingles lesions are infections and should be considered an infectious hazard in the hospital setting. Acyclovir can ameliorate the condition. Varicella, or chicken pox (choice A), is the primary form of herpes zoster infection and affects face and trunk diffusely. Herpes simplex I (choice B) affects oral and perioral sites. Herpes simplex II (choice C) primarily affects genital sites. Measles (choice D) causes a blotchy rash, rather than a dermatomal one.
#3
Re: Pathology 42
galaxy - 05-28-10 02:33 A 65-year-old man develops a vesicular rash localized to a narrow circumferential band on one side of his chest. The rash is very painful, and the vesicles are confluent with some ulceration. No other significant findings are demonstrated on physical examination. Which of the following diagnoses is most likely to be correct?
E. Shingles or herpes zoster
#4
Re: Pathology 42
babbu5508 - 06-21-10 15:42 E. Shingles due to reactivation of the herpes virus present in latent state in one of the spinal nerve nuclei...called herpes zoster
#5
Re: Pathology 42
bingousmle - 06-30-10 21:47 The primary herpes zoster infection precedes the development of shingles by years or decades which is the recurrent form of herpes zoster infection
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