The second cloze deletion in this card wants us to answer "secondary" syphilis to the question of which disease do the VDRL and RPR tests screen for. Unless I'm missing something, I don't see a need to specify "secondary" as the VDRL and RPR tests are valid screens for primary, secondary, and tertiary syphilis. I read the UpToDate article on "Syphilis: Screening and diagnostic testing" and found the following excerpts relevant: "Serologic testing to diagnose syphilis should include the use of both nontreponemal and treponemal tests" (meaning RPR, VDRL, FTA-ABS, etc.) [no qualification is given for which stage of syphilis], "Examination of cerebrospinal fluid is the only way to definitively diagnose neurosyphilis. A positive cerebrospinal fluid Venereal Disease Research Laboratory (CSF-VDRL) is considered highly specific for neurosyphilis." It is true that the VDRL and RPR test may come back as a false negative in early primary syphilis, but you would still order these tests if a primary syphilis is suspected.
- Positive result confirmed with a treponemal test (e.g., FTA-ABS or TP-EIA)
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