AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentEasy
A 24-year-old male presents with a 3-day history of low-grade fever, malaise, and a widespread, non-pruritic maculopapular rash involving his palms and soles. He also reports generalized lymphadenopathy. What is the most likely diagnosis?
- AMeasles
- BErythema Multiforme
- CSecondary Syphilis
- DPityriasis Rosea
Show answer & explanationAnswer & explanation
Correct answer: C. Secondary Syphilis
The classic presentation of secondary syphilis includes a widespread maculopapular rash, often involving the palms and soles, accompanied by systemic symptoms like fever and lymphadenopathy. This distinct pattern is highly indicative of the disease.
Why the other options are wrong
- A. Measles presents with a high fever, cough, coryza, conjunctivitis, Koplik spots, and a rash that typically starts on the face and spreads downwards, sparing palms and soles.
- B. Erythema multiforme is an acute, self-limited, and sometimes recurrent skin condition characterized by 'target' lesions, often triggered by infections or drugs, and less commonly presents with widespread lymphadenopathy.
- D. Pityriasis Rosea typically presents with a 'herald patch' followed by smaller oval lesions in a 'Christmas tree' distribution, usually sparing palms and soles.
Secondary Syphilis
A systemic stage of syphilis characterized by mucocutaneous lesions, lymphadenopathy, and constitutional symptoms, occurring weeks to months after the primary infection.
- Widespread maculopapular rash, often involving palms and soles.
- Associated with systemic symptoms like fever, malaise, lymphadenopathy.
- Caused by the spirochete Treponema pallidum.
Memory trick: Syphilis Spreads Systemically: Palms, Soles, and Systemic Signs.