RUHS, Jaipur, PB B.Sc Nursing Entrance-2022
Medical & Surgical Nursing
Easy
The definitive diagnostic test for herpes zoster is ?
Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2022
Explanation
- The correct option is 'Culture of the lesion' because it is a definitive method for diagnosing herpes zoster among the choices provided.
- A viral culture involves taking a sample from a skin vesicle and allowing the virus to grow in a laboratory setting.
- This process allows for the specific isolation and identification of the varicella-zoster virus (VZV), which is the causative agent of herpes zoster.
- While Polymerase Chain Reaction (PCR) is now considered the most sensitive and preferred test, it is not an option here. Culture provides an unequivocal confirmation by isolating the live virus.
Why Other Options Were Wrong
- Option A: A skin biopsy is an invasive procedure where a tissue sample is removed for microscopic examination. It is not the primary or standard test for a typical herpes zoster infection.
- Option B: A Wood's light examination uses long-wave ultraviolet light to detect fluorescence in the skin. It has no role in diagnosing viral infections like herpes zoster.
- Option D: A patch test is a method used to determine if a specific substance is causing an allergic inflammatory reaction on the skin (allergic contact dermatitis).
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definitive diagnostic methods for Herpes Zoster (Shingles) as background academic context rather than a clinical decision trigger.
- Accurate and timely diagnosis of herpes zoster is crucial for initiating antiviral therapy within 72 hours of rash onset. This significantly reduces the severity and duration of the acute illness and lowers the risk of developing postherpetic neuralgia (PHN), a chronic and often debilitating pain condition.
- Nurses play a key role in recognizing the characteristic dermatomal rash, assessing the patient's pain, and educating them about the importance of adhering to antiviral treatment and keeping the lesions clean to prevent secondary bacterial infections.
- What if? If a patient presents with crusted-over lesions instead of fresh vesicles, a viral culture would have very low sensitivity. In this case, PCR would be the test of choice as it can detect viral DNA even from scabs, making it more reliable for late-stage diagnosis.
How to Approach the Question
- First, identify the core of the question, which asks for the 'definitive' diagnostic test for 'herpes zoster'.
- Recall that herpes zoster is caused by the varicella-zoster virus (VZV). A 'definitive' test must be able to specifically identify this virus.
- Evaluate each option based on this requirement.
- Eliminate 'Wood's light examination' and 'Patch test' as they are used for fungal/pigmentary disorders and allergies, respectively, not viral infections.
- Consider 'Skin biopsy'. While it can be used in dermatology, it's invasive and not the standard first-line definitive test for a classic zoster rash.
- Analyze 'Culture of the lesion'. This method aims to grow and isolate the specific virus from a lesion, which directly confirms the presence of VZV. This fits the definition of a definitive test.
Concept Tested & Keywords
- Concept Tested: Definitive diagnostic methods for Herpes Zoster (Shingles).
- Stem keywords: definitive diagnostic test, herpes zoster
- Lead-in keywords: is
Question ID
QfHhkgJJDyMd09qKUlFxZk
Reference Book
E6 Medicine Harrison 22e Part 1 p. 1547-1549
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 61-63
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 2009-2011
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