]> 2026-07-31T07:27:54+00:00 WBR0004 0 en Repeat VDRL in 1 week. Obtain RPR for confirmation. Obtain DS-DNA serology. Obtain a fluorescent treponemal antibody absorption (FTA-ABS). Proceed with treatment of the suspected disease. This patient's clinical presentation and positive VDRL are consistent with primary syphilis. However, correct diagnosis should be confirmed with treponemal testing (either FTA-ABS or FTA-TP) before treatment since VDRL and RPR may be turned falsely positive by some autoimmune diseases. WJG NOTES: This question strikes me as a bit off. Why wouldn't you just treat the patient with penicillin? It's not as though you are giving a toxic chemotherapy - and there are no other signs of autoimmune disease in this patient such as synovitis or joint problems.<br/> '''Educational Objective:''' <br/> '''References:''' Internal medicine Anonymous (Edited by Will Gibson) A 34-year-old man presents to the health center concerned that he has contracted a venereal disease. He nervously shows you an ulcerated lesion on the shaft of his penis and states that it has been present for over 1 week. On physical exam, the man is afebrile and except for mild lymphadenopathy in the neck, has a nontender ulcer on his penis measuring 1.5 x 1 x 0.5 cm. Laboratory testing demonstrates that he is VDRL positive. What is the next step in diagnosis? D Infectious Disease 2020-10-27T23:02:03Z 2459150.4597569 WBR0004