Varicella zoster virus


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Varicella zoster virus


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Varicella zoster virus


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Varicella zoster virus


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USMLE® Step 1 questions

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High Yield Notes

10 pages


Varicella zoster virus

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USMLE® Step 1 style questions USMLE

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A 71-year-old woman presents to her primary care provider for evaluation of painful lesions on the forehead. The lesions appeared approximately one week ago and started off as small fluid filled sacs. Over the past few days, the lesions have become more red and painful. Past medical history is notable for hypertension, hyperlipidemia, and asthma. She does not consume tobacco or alcohol. Vital signs are within normal limits, and physical examination is notable for the following finding:

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If untreated, this patient is at highest risk of developing which of the following complications?

External References

First Aid








Crust (skin) p. 487

varicella zoster virus p. 491

Varicella zoster virus (VZV) p. 161, 487, 491

guanosine analogs p. 198

immunodeficient patients p. 116

meningitis p. 177

rash p. 178

Reye syndrome p. 399

vaccine p. 108


Content Reviewers

Rishi Desai, MD, MPH


Stefan Stoisavljevic, MD

Sam Gillespie, BSc

Varicella zoster virus is one of the herpesviruses and it causes two diseases - varicella or chickenpox, and herpes zoster also known as shingles.

Zoster actually refers to a type of belt used by ancient Greek warriors because of the belt like appearance of shingles.

Now, let’s first talk a bit about the nervous system - it consists of two parts.

The central nervous system which includes the brain and the spinal cord, and the peripheral nervous system includes the nerves that fan out from the central nervous system to reach the skin, muscles, and organs.

Peripheral nerves that originate from the brain are called cranial nerves, and they’re in charge of motor and sensory innervation of the head and neck.

A specific cranial nerve, cranial nerve V, is the trigeminal nerve and it’s responsible for the sensation in the face.

Its sensory neurons create a nerve cell cluster called trigeminal ganglion, located in the bones on the side of the face between the eyes and ears.

The peripheral nerves originating from the spinal cord are called the spinal nerves.

Each nerve is formed by a dorsal and a ventral root.

Ventral roots contains neurons that carry motor innervation from the spinal cord to the muscles.

Sensory information, like touch, temperature, pain, and pressure from the skin and other tissues travel through 1st order sensory neurons, in the dorsal root ganglion near the spinal cord, then through the dorsal root, and into the spinal cord, where it synapses with the 2nd order neurons.


Varicella zoster virus (VZV) is a virus that causes two different diseases, chickenpox (varicella) and shingles (herpes zoster). Chickenpox is a highly contagious disease that primarily affects children, causing an itchy rash, fever, and other symptoms. The virus can be transmitted through direct contact with the rash, as well as through the air. Shingles is a painful condition that occurs when the virus reactivates later in life, usually in older adults or people with weakened immune systems. Shingles typically cause a painful rash, blisters, and other symptoms, and can sometimes lead to long-term nerve pain. The virus is spread through direct contact with the shingles rash. Vaccines are available to help prevent both chickenpox and shingles, and antiviral medications can be used to treat both conditions.


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