WBR0085

Author	Aditya Govindavarjhulla
Exam Type	USMLE Step 2 CK
Main Category	Pediatrics
Sub Category	Pediatrics, Infectious Disease
Prompt	A 26 year old mother was seen by an Infectious disease consult team on the 2 second day after delivery. She has positive test results for VDRL and FTA-ABS. Which test should be ordered by the team before starting treatment in the infant?
Answer A	Maternal serum – VDRL
Answer A Explanation	Quantitative tests must be performed on infants born to reactive mothers, rather than testing the mother.
Answer B	Infant serum – VDRL
Answer B Explanation	Infant serum-VDRL is a quantitative non-treponemal serologic test. Infant serum VDRl or RPR should be performed on infants born to reactive mothers.
Answer C	Umbilical cord – VDRL
Answer C Explanation	Umbilical cord blood cannot be tested due to maternal and fetal blood mixing, which may give false positive results.
Answer D	Infant serum – FTA-ABS
Answer D Explanation	Infant serum FTA-ABS is a treponemal test and non-treponemal test (RPR and VDRL) should be performed on a infant of reactive mother.
Answer E
Answer E Explanation
Right Answer	D
Explanation	Explanation: All infants born to mothers who have reactive non-treponemal and treponemal test results should be evaluated with a quantitative non-treponemal serologic test (RPR or VDRL) performed on infant serum, because umbilical cord blood can become contaminated with maternal blood and yield a false-positive result. Conducting a treponemal test (i.e., TP-PA, FTA-ABS, EIA, or chemiluminescence assay) on a newborn’s serum is not necessary. Educational Objective: References:
Approved	Yes
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