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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor=Aditya Govindavarjhulla  
|QuestionAuthor=Aditya Govindavarjhulla
|ExamType=USMLE Step 1
|ExamType=USMLE Step 2 CK
|MainCategory=General Principles
|MainCategory=Pediatrics
|SubCategory=Microbiology
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=General Principles
|MainCategory=Pediatrics
|SubCategory=Microbiology
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=General Principles
|MainCategory=Pediatrics
|SubCategory=Microbiology
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=General Principles
|MainCategory=Pediatrics
|MainCategory=Pediatrics
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=Pediatrics
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=Pediatrics
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=Pediatrics
|SubCategory=Infectious Disease, Pediatrics
|MainCategory=Pediatrics
|MainCategory=Pediatrics
|SubCategory=Infectious Disease, Pediatrics
|Prompt=A 26 year old mother was seen by an Infectious disease consult team on the 2 second day after delivery.  She has positive test results for VDRL and FTA-ABS.  Which test should be ordered by the team before starting treatment in the infant?
|Prompt=A 26 year old mother was seen by an Infectious disease consult team on the 2 second day after delivery.  She has positive test results for VDRL and FTA-ABS.  Which test should be ordered by the team before starting treatment in the infant?
|Explanation=Explanation: All infants born to mothers who have reactive non-treponemal and treponemal test results should be evaluated with a quantitative non-treponemal serologic test (RPR or VDRL) performed on infant serum, because umbilical cord blood can become contaminated with maternal blood and yield a false-positive result. Conducting a treponemal test (i.e., TP-PA, FTA-ABS, EIA, or chemiluminescence assay) on a newborn’s serum is not necessary.
|Explanation=Explanation: All infants born to mothers who have reactive non-treponemal and treponemal test results should be evaluated with a quantitative non-treponemal serologic test (RPR or VDRL) performed on infant serum, because umbilical cord blood can become contaminated with maternal blood and yield a false-positive result. Conducting a treponemal test (i.e., TP-PA, FTA-ABS, EIA, or chemiluminescence assay) on a newborn’s serum is not necessary.
|AnswerA=Maternal serum – VDRL
|AnswerA=Maternal serum – VDRL
|AnswerAExp=Quantitative tests must be performed on infants born to reactive mothers, rather than testing the mother.
|AnswerAExp=Quantitative tests must be performed on infants born to reactive mothers, rather than testing the mother.
|AnswerB= Infant serum – VDRL
|AnswerB=Infant serum – VDRL
|AnswerBExp=Infant serum-VDRL is a quantitative non-treponemal serologic test. Infant serum VDRl or RPR should be performed on infants born to reactive mothers.
|AnswerBExp=Infant serum-VDRL is a quantitative non-treponemal serologic test. Infant serum VDRl or RPR should be performed on infants born to reactive mothers.
|AnswerC= Umbilical cord – VDRL
|AnswerC=Umbilical cord – VDRL
|AnswerCExp=Umbilical cord blood cannot be tested due to maternal and fetal blood mixing, which may give false positive results.
|AnswerCExp=Umbilical cord blood cannot be tested due to maternal and fetal blood mixing, which may give false positive results.
|AnswerD=Infant serum – FTA-ABS
|AnswerD=Infant serum – FTA-ABS
|AnswerDExp=Infant serum FTA-ABS is a treponemal test and non-treponemal test (RPR and VDRL) should be performed on a infant of reactive mother.  
|AnswerDExp=Infant serum FTA-ABS is a treponemal test and non-treponemal test (RPR and VDRL) should be performed on a infant of reactive mother.
|RightAnswer=D
|RightAnswer=D
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 17:07, 7 February 2013

 
Author PageAuthor::Aditya Govindavarjhulla
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::Pediatrics
Sub Category SubCategory::Infectious Disease, SubCategory::Pediatrics
Prompt Prompt::A 26 year old mother was seen by an Infectious disease consult team on the 2 second day after delivery. She has positive test results for VDRL and FTA-ABS. Which test should be ordered by the team before starting treatment in the infant?
Answer A AnswerA::Maternal serum – VDRL
Answer A Explanation AnswerAExp::Quantitative tests must be performed on infants born to reactive mothers, rather than testing the mother.
Answer B AnswerB::Infant serum – VDRL
Answer B Explanation AnswerBExp::Infant serum-VDRL is a quantitative non-treponemal serologic test. Infant serum VDRl or RPR should be performed on infants born to reactive mothers.
Answer C AnswerC::Umbilical cord – VDRL
Answer C Explanation AnswerCExp::Umbilical cord blood cannot be tested due to maternal and fetal blood mixing, which may give false positive results.
Answer D AnswerD::Infant serum – FTA-ABS
Answer D Explanation AnswerDExp::Infant serum FTA-ABS is a treponemal test and non-treponemal test (RPR and VDRL) should be performed on a infant of reactive mother.
Answer E AnswerE::
Answer E Explanation AnswerEExp::
Right Answer RightAnswer::D
Explanation [[Explanation::Explanation: All infants born to mothers who have reactive non-treponemal and treponemal test results should be evaluated with a quantitative non-treponemal serologic test (RPR or VDRL) performed on infant serum, because umbilical cord blood can become contaminated with maternal blood and yield a false-positive result. Conducting a treponemal test (i.e., TP-PA, FTA-ABS, EIA, or chemiluminescence assay) on a newborn’s serum is not necessary.

Educational Objective:
References: ]]

Approved Approved::Yes
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