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Primary syphilis — DRCOG MCQ

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HardContraceptionPrimary syphilisDRCOG

A 59-year-old has a persistent painless vulval ulcer with induration and no recent sexual exposure. What is the best next step?

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Correct answer: D — Arrange an urgent suspected-cancer referral for vulval assessment

The best answer is “Arrange an urgent suspected-cancer referral for vulval assessment”. An unexplained vulval ulcer or mass in an older woman should prompt urgent suspected-cancer referral. Infection testing can be added when indicated, but it must not delay specialist examination and biopsy of a persistent indurated lesion.

Reference: NICE NG12: Suspected cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/recommendations-organised-by-site-of-cancer