WBR0707

Author	[[PageAuthor::Mohamed Moubarak, M.D. [1]]]
Exam Type	USMLE Step 3
Main Category	Primary Care Office
Sub Category	Infectious Disease
Prompt	30 years old white male come to clinic for new hire routine check-up. He has no significant complain. He admits having multiple sexual partners, not using condoms frequently. He didn’t have HIV test before. His past medical history is insignificant. He doesn’t smoke but drink alcohol regularly. His physical examination is insignificant. You ordered HIV and RPR test which turned to be positive. His CD4 is 300 mm3 and RPR titer 1:70. What is the best treatment option for this patient?
Answer A	Benzathin penicillin G IM weekly for three weeks
Answer A Explanation	Correct HIV infected patient with latent syphilis of unknown duration, or late syphilis should be treated with benzathin penicillin G IM weekly for three weeks
Answer B	Benzathin penicillin G IM single dose
Answer B Explanation	Incorrect HIV infected patient with early syphilis or early latent syphilis should receive benzathin penicillin G IM in a single dose
Answer C	Follow up this patient with antiretroviral therapy
Answer C Explanation	Incorrect The patient diagnosed with syphilis of unknown duration and must be treated
Answer D	Ceftriaxone IV for 1 week
Answer D Explanation	Incorrect Ceftriaxone IV or IM is a good alternative to penicillin in allergic patients, the dose should be weekly for 3 weeks, and cross reactive hypersensitivity with penicillin should be considered
Answer E	Ceftriaxone IV for 3 week
Answer E Explanation	Incorrect Ceftriaxone IV or IM is a good alternative to penicillin in allergic patients, the dose should be weekly for 3 weeks, and cross reactive hypersensitivity with penicillin should be considered
Right Answer	A
Explanation	HIV infected patient with latent syphilis of unknown duration, or late syphilis should be treated with benzathin penicillin G IM weekly for three weeks Educational Objective: References:
Approved	No
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