The USMLE microbiology assessment evaluates medical students' knowledge of microorganisms and their role in human health and disease. It includes questions on topics such as bacterial, viral, fungal, and parasitic infections, their diagnosis, treatment, and prevention. The assessment assesses the u...
1. A 22-year-old female presents to the physician with a painful vesicular eruption on her left
labium majus. She describes the pain as burning and stinging. She has a fever of 101F and left-sided
inguinal lymphadenopathy. Which of the following best describes the viral etiology?
A) DNA; enveloped; linear
B) DNA; enveloped; circular
C) DNA; non-enveloped; linear
D) DNA; non-enveloped; circular
E) RNA; enveloped; linear
F) RNA; enveloped; circular
G) RNA; non-enveloped; linear
H) RNA; non-enveloped; circular
, MEHLMANMEDICAL.COM 3
The answer is A.
This patient has an acute genital herpes infection.
This may be due to either HSV1 or HSV2. The literature has in the past supported a propensity for
HSV1 to cause herpes labialis (oral herpes) and HSV2 genital herpes, but the relationship is not
absolute and considerable overlap exists.1, 2, 3
Primary herpes infection
• Primary (first-time) infection often presents more severe than subsequent flareups, and is
frequently accompanied by fever and regional adenopathy.4
• Systemic symptoms, including headache, fever, myalgia, and backache occur in about 70% of
women and 40% of men.4, 5
The herpesviridae are double-stranded linear, enveloped, DNA viruses.6
This is in contrast to hepatitis B, which is a double-stranded circular, enveloped, DNA virus.7
The USMLE really likes this distinguishing structural detail between herpesviridae and
hepatitis B.
Bottom line: On your USMLE: Herpes is “DNA, enveloped, linear.” Hepatitis B is “DNA,
enveloped, circular.”
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