WBR0004: Difference between revisions
Jump to navigation
Jump to search
Gerald Chi (talk | contribs) m (Gerald Chi moved page TestQues12 to WBR0004 without leaving a redirect) |
m (refreshing WBR questions) |
||
| (4 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
{{WBRQuestion | {{WBRQuestion | ||
|QuestionAuthor=Anonymous (Edited by Will Gibson) | |||
|ExamType=USMLE Step 2 CK | |ExamType=USMLE Step 2 CK | ||
|MainCategory=Internal medicine | |MainCategory=Internal medicine | ||
|SubCategory=Infectious Disease, Infectious Disease | |SubCategory=Infectious Disease, Infectious Disease | ||
|Prompt=A 34-year-old man presents to the health center concerned that he has contracted a venereal disease. He nervously shows you an ulcerated lesion on the shaft of his penis and states that it has been present for over 1 week. On physical exam, the man is afebrile and except for mild lymphadenopathy in the neck, has a nontender ulcer on his penis measuring 1.5 x 1 x 0.5 cm. Laboratory testing demonstrates that he is VDRL positive. What is the next step in diagnosis? | |||
|Explanation=This patient's clinical presentation and positive VDRL are consistent with primary syphilis. However, correct diagnosis should be confirmed with treponemal testing (either FTA-ABS or FTA-TP) before treatment since VDRL and RPR may be turned falsely positive by some autoimmune diseases. | |||
WJG NOTES: This question strikes me as a bit off. Why wouldn't you just treat the patient with penicillin? It's not as though you are giving a toxic chemotherapy - and there are no other signs of autoimmune disease in this patient such as synovitis or joint problems. | |||
|Prompt=A 34-year-old man | |||
|Explanation=This patient | |||
|AnswerA=Repeat VDRL in 1 week. | |AnswerA=Repeat VDRL in 1 week. | ||
|AnswerB=Obtain RPR for confirmation. | |AnswerB=Obtain RPR for confirmation. | ||
| Line 27: | Line 14: | ||
|AnswerE=Proceed with treatment of the suspected disease. | |AnswerE=Proceed with treatment of the suspected disease. | ||
|RightAnswer=D | |RightAnswer=D | ||
|WBRKeyword=Syphilis, Venereal, Sexual, Sexually transmitted infections, STI, STD | |||
|Approved=No | |Approved=No | ||
|Answer=Repeat VDRL in 1 week.,Obtain RPR for confirmation.,Obtain DS-DNA serology.,Proceed with treatment of the suspected disease. | |Answer=Repeat VDRL in 1 week.,Obtain RPR for confirmation.,Obtain DS-DNA serology.,Proceed with treatment of the suspected disease. | ||
}} | }} | ||
Latest revision as of 23:02, 27 October 2020
| Author | PageAuthor::Anonymous (Edited by Will Gibson) |
|---|---|
| Exam Type | ExamType::USMLE Step 2 CK |
| Main Category | MainCategory::Internal medicine |
| Sub Category | SubCategory::Infectious Disease, SubCategory::Infectious Disease |
| Prompt | [[Prompt::A 34-year-old man presents to the health center concerned that he has contracted a venereal disease. He nervously shows you an ulcerated lesion on the shaft of his penis and states that it has been present for over 1 week. On physical exam, the man is afebrile and except for mild lymphadenopathy in the neck, has a nontender ulcer on his penis measuring 1.5 x 1 x 0.5 cm. Laboratory testing demonstrates that he is VDRL positive. What is the next step in diagnosis?]] |
| Answer A | AnswerA::Repeat VDRL in 1 week. |
| Answer A Explanation | AnswerAExp:: |
| Answer B | AnswerB::Obtain RPR for confirmation. |
| Answer B Explanation | AnswerBExp:: |
| Answer C | AnswerC::Obtain DS-DNA serology. |
| Answer C Explanation | AnswerCExp:: |
| Answer D | AnswerD::Obtain a fluorescent treponemal antibody absorption (FTA-ABS). |
| Answer D Explanation | AnswerDExp:: |
| Answer E | AnswerE::Proceed with treatment of the suspected disease. |
| Answer E Explanation | AnswerEExp:: |
| Right Answer | RightAnswer::D |
| Explanation | [[Explanation::This patient's clinical presentation and positive VDRL are consistent with primary syphilis. However, correct diagnosis should be confirmed with treponemal testing (either FTA-ABS or FTA-TP) before treatment since VDRL and RPR may be turned falsely positive by some autoimmune diseases.
WJG NOTES: This question strikes me as a bit off. Why wouldn't you just treat the patient with penicillin? It's not as though you are giving a toxic chemotherapy - and there are no other signs of autoimmune disease in this patient such as synovitis or joint problems. |
| Approved | Approved::No |
| Keyword | WBRKeyword::Syphilis, WBRKeyword::Venereal, WBRKeyword::Sexual, WBRKeyword::Sexually transmitted infections, WBRKeyword::STI, WBRKeyword::STD |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |