drswapna
Forum Senior
Topics: 52
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A 24-year-old man presents with fever, rash, a mild headache, and
a sore throat. He denies HIV risk factors, although he is sexually active.
On examination, his temperature is 100.8°F and his pulse is 90/min. There
is a diffuse, erythematous, maculopapular rash over most of his body.
Generalized adenopathy is appreciated, and photophobia is noted when
funduscopic examination is attempted. If this man is not treated, which
of the following changes in his serologic status will most likely occur?
A. The FTA-ABS titer would fall
B. The FTA-ABS titer would rise
C. The VDRL titer would fall
D. The VDRL titer would rise
E. Both FTA-ABS and VDRL would fall
F. Both FTA-ABS and VDRL would rise
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| reet
Forum Fanatic
Topics: 152
Posts: 1,411
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C??
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| skyhigh
Forum Guru
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d?
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| ed222
Forum Senior
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this is sle with a vdrl rise
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| Geroo
Forum Guru
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C
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| drk1980
Forum Guru
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i thot this ws syphilis secondary 
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| Natasa
Forum Elite
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Yes it is and in secondaru syphilis VDRL(non-treponemal anti cardiolipin antibodies) go down and FTA-ABS specific go up.
In primary-its the other way around.That's why they do anti cardiolipin first.
At least,that is what I know.
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| drswapna
Forum Senior
Topics: 52
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then B & C are right?
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| robin082006
Forum Hero
Topics: 471
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C for sure
this is syphilis
FTA-ABS rises all the time if the condition is not treated well or regressed
VDRL is positive after FTA-ABS positive but will fall in late period with either treatment or not
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| sturge_weber
Forum Guru
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yep its c,
well the vdrl, rpr, all these titres will fall with time, but the fta abs will remain pretty constant or rise..
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| coolmavs
Forum Elite
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Guys are you sure that the VDRLtest will be negative, cause I thought that it will turn negative with treatment?
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| krsna
Forum Senior
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ya vdrl will be negative with time n progression of disease
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| coolmavs
Forum Elite
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The basis of VDRL is that there is Reagin antibodies that are present due to damage by Trponema pallidum and in secondary syphilis also there is damage that takes place. So why should the VDRL titer decrease? Anyone can help me with this query?
This is what the eMedicine article on syphils has to say
"Serologic reaginic tests
Screening tests include the rapid plasma reagin (RPR) test and the VDRL test.
Sensitivities are 70-80% for patients with primary syphilis and approach 99-100% for patients with secondary syphilis. These tests have high false-positive rates. Other factors (eg, lupus, concomitant viral or bacterial infection, recent immunization, pregnancy) may give false-positive readings.
Serological tests cannot differentiate the different species of the treponeme family (eg, yaws).
Use VDRL titers to follow efficacy of treatment.
The VDRL test turns positive 1-2 weeks after chancre formation. After a positive VDRL test finding, follow up with a more specific test.
A small percentage of adequately treated individuals have persistently positive VDRL test findings. See Further Outpatient Care for more information.
The fluorescent treponemal antibody absorption (FTA-ABS) test is reactive in 85% of primary cases, in 99-100% of secondary cases, and in 95% of latent or late cases. It should be used as a confirmatory test for positive VDRL or RPR test findings. "
Guys am I missing out on something?
Edited by coolmavs on 01/29/06 - 08:41 AM
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