WBR0004
| Author | PageAuthor:: |
|---|---|
| Exam Type | ExamType::USMLE Step 2 CK |
| Main Category | MainCategory::Internal medicine |
| Sub Category | SubCategory::Infectious Disease |
| Prompt | [[Prompt::A 34-year-old man comes to the health center with fears 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 shows him to be 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 likely has syphilis by clinical presentation and positive VDRL testing; however, correct diagnosis should be made with confirmation with treponemal testing (either FTA-ABS or FTA-TP) before treatment since VDRL and RPR may be turned falsely positive by some autoimmune diseases. Educational Objective: |
| Approved | Approved::No |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |