WBR0004: Difference between revisions
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{{WBRQuestion | {{WBRQuestion | ||
|ExamType=USMLE Step 1 | |||
|MainCategory=Genitourinary | |MainCategory=Genitourinary | ||
|SubCategory=Microbiology | |SubCategory=Microbiology | ||
| Line 7: | Line 8: | ||
|AnswerC=Obtain DS-DNA serology. | |AnswerC=Obtain DS-DNA serology. | ||
|AnswerD=Obtain a fluorescent treponemal antibody absorption (FTA-ABS). | |AnswerD=Obtain a fluorescent treponemal antibody absorption (FTA-ABS). | ||
|AnswerE=Proceed with treatment of the suspected disease. | |AnswerE=Proceed with treatment of the suspected disease. | ||
|RightAnswer=D | |RightAnswer=D | ||
|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. | |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. | ||
|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. | ||
}} | }} | ||
Revision as of 20:44, 13 December 2012
| Author | PageAuthor:: |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Genitourinary |
| Sub Category | SubCategory::Microbiology |
| 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:: |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |