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Genital ulcer differential — DFSRH MCQ

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HardSTIsGenital ulcer differentialDFSRH

A 36-year-old woman has painful vulval ulcers after a flu-like illness. She also has a faint palmar rash and a new partner. What is the most appropriate investigation?

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Correct answer: D — HSV swab and syphilis serology

Painful ulcers suggest HSV, but palmar rash and sexual risk raise concern for syphilis; both need assessment. Testing for one pathogen alone may miss co-infection or a mimic. Genital ulcers require a broad STI approach.

Reference: BASHH Guidelines; NICE CKS; UKHSA STI guidance; BNF