OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is syphilis. While this may seem a odd practice, it is useful to see multiple examples of how syphilis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 24 year old woman comes tot he office because of a vulvar lesions that she noticed a couple of days ago. The lesion began as a papule, but then this morning she noticed a very small ulcer in its center. There is no pain or discharge present. She has noticed mild burning when she urinates, but denies a fever, other skin lesions, or any oral ulcers. She is sexually active, and has had 7 male patterns in the past 5 years. She uses oral contraceptives as a means of birth control. She is a smoker, drinks alcohol regularly, and also admits to using illicit drugs. Her vital signs are within normal limits. Vulvar examination shows a 2-cm ulcer that is present with a nonexudative base, and a raised margin that is indurated. There is no tenderness with palpation. The physician notes bilateral inguinal lymphadenopathy. What is the most likely diagnosis in this patient?
Explanation: painless genital lesion = syphilis
Question # 2
A previously health 15 year old girl comes to the clinic because of a painless lesion on her vulva for the past 4 days. She is an immigrant from sub-Saharan Africa. She is sexually active with one male partner and they do no use any contraception during intercourse. A physical exam shows a 1.1 cm non-tender, sharply demarcated, elevated, round lesion on the right labium magus. The base of the lesion is smooth. The lesion is non purulent. What is the likely diagnosis in this patient?
Explanation: painless genital lesion = syphilis
Question # 3
A 25-year-old graduate student comes to the clinic because of a 7-day history of low-grade fever, sore throat, fatigue, and general malaise. 5 weeks ago, she had a painless ulcer on her vulva that resolved on its own. The experienced no other symptoms during that time. She is sexually active and has had five partners since the age of 16 years. She uses an oral contraceptive for birth control. Her temperature is 100.5°F, pulse is 98/min, and blood pressure is 115/60 mm Hg. Her physical exam is remarkable for a rash that covers her palms and the solves of her feet. She also has mild cervical lymphadenopathy. The rest of the physical exam is non-contributory. A pelvic and rectal exam show no abnormalities. What is the likely diagnosis in this patient?
Explanation: past history of painless genital lesion + current rash that covers palms/soles of feet = syphilis (secondary syphilis)
Page Updated: 10.09.2016