neuroblastoma
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A 43-year-old male presents to a physician with an ulcer on the shaft of his penis. The ulcer is non-tender, with a raised border, and a smooth base. There is bilateral inguinal adenopathy. The rest of the examination is unremarkable. Dark field microscopy of the ulcer reveals spirochetes. Which of the following screening studies should be performed on this patient?
A. VDRL
B. FTA-ABS
C. HIV antibodies by ELISA
D. Proctosigmiodoscopy
E. Serum prostate specific antigen
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| drdg
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C. HIV antibodies by ELISA
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| titly
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VDRL or FTA-ABS. tell me which one.one of thm is specific for primary syphillis and the other one is specific for secondary syphillis.
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| Ivonne
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I thought we already confirmed the diagnosis of primary syphilis by observing the spirochetes by dark-field microscopy, i think our next duty is rule out HIV. so will go with C.
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| mjl1717
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Simply--- you found ONE STD......Look for another, be a detective! -There is high risk behavior..
[I mean how many spirochetes do you know of?- As I remember Borrelia, anymore common ones??]
If you instead found fastidious gram negative diplococus you'd still do the Elisa answer -C
My sililoquoy: PSA is nonspecifically used for prostate CA/ a free flowing psa is better..
Proctosigmoidoscopy is a "shortcut route" used at times after colonoscopy has been done to r/o rectosigmoid CA..
Some other great doc take the other 2 answers although Im not scard to take or communicate about them..
Edited by mjl1717 on 10/28/07 - 01:08 PM
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| sprint123
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 ..In the initial stages of syphilis dark field microscopy id the investigation of choice and it has revealed spirochetes....Hence, the next screening test would be HIV antibody by ELISA.
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| neuroblastoma
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correct C. HIV antibodies by ELISA
Dark field microscopy (pri syphilis)of the ulcer reveals spirochetes. already diagnosed.
no need of screening 
vdrl fr screening
ftabs fr confirmation
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