AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentEasy
A 24-year-old female presents with a 3-day history of low-grade fever, malaise, and a widespread, non-pruritic maculopapular rash involving her palms and soles. She reports a painless sore in her genital area about 6 weeks ago that resolved spontaneously. Which diagnostic test is most appropriate to confirm the suspected diagnosis?
- AHerpes Simplex Virus (HSV) culture from a rash lesion
- BHuman Immunodeficiency Virus (HIV) antibody test
- CComplete Blood Count (CBC) with differential
- DRapid Plasma Reagin (RPR) with confirmatory Fluorescent Treponemal Antibody Absorption (FTA-ABS) test
Show answer & explanationAnswer & explanation
Correct answer: D. Rapid Plasma Reagin (RPR) with confirmatory Fluorescent Treponemal Antibody Absorption (FTA-ABS) test
The patient's symptoms, including the rash on palms and soles and a history of a painless genital sore, are classic for secondary syphilis. RPR is a non-treponemal test for screening, and FTA-ABS is a treponemal test used for confirmation.
Why the other options are wrong
- A. While a genital sore can be HSV, the widespread rash on palms and soles is not typical for HSV and points away from this diagnosis.
- B. HIV testing is important for patients with STIs, but it is not the primary diagnostic test for the described rash and prior sore.
- C. A CBC might show non-specific findings but is not diagnostic for syphilis.
Secondary Syphilis Diagnosis
Diagnosis of secondary syphilis involves serological testing, typically starting with a non-treponemal test (like RPR or VDRL) followed by a confirmatory treponemal test (like FTA-ABS or TP-PA).
- Often presents with widespread maculopapular rash, including palms and soles.
- History of a painless chancre (primary syphilis) may precede secondary symptoms.
- Serological tests are crucial for diagnosis.
Memory trick: Syphilis Spreads Systemically, Showing Skin Signs.