Postherpetic Neuralgia: ABFM practice questions

4 board-style questions on postherpetic neuralgia in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 68-year-old woman presents with a 2-day history of severe, burning, unilateral pain on the right side of her torso followed by a grouped vesicular eruption on an erythematous base in a dermatomal distribution (T6). She has not been vaccinated against herpes zoster. She has no immunosuppression. Symptom onset was approximately 48 hours ago. What is the most appropriate management?

1. Gabapentin for pain and observation since antiviral window has passed
2. Valacyclovir 1000 mg three times daily for 7 days, initiated immediately, plus pain management
3. Topical acyclovir cream applied to the vesicles
4. Administer Shingrix vaccine now to prevent progression

Sample question 2

A 72-year-old woman presents with a 2-day history of a painful, burning sensation along the right side of her trunk followed by the appearance of grouped vesicles on an erythematous base in a band-like distribution that does not cross the midline. She is otherwise healthy and takes only lisinopril for hypertension. She has not received the shingles vaccine. Which of the following is the most appropriate management?

1. Oral valacyclovir initiated as soon as possible, with consideration of gabapentin for pain management
2. Oral acyclovir and reassurance that the pain will resolve when the rash heals
3. Intravenous acyclovir and urgent ophthalmology consultation
4. Topical mupirocin and warm compresses

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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