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Aspirin primary prevention with bleeding risk — USMLE Step 3 MCQ

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HardPreventive Medicine, Epidemiology, BiostatisticsAspirin primary prevention with bleeding riskUSMLE Step 3

A sexually active 28-year-old has a painless genital ulcer and diffuse nonpruritic rash involving the palms and soles. HIV testing is negative and there is no neurologic symptom. Which treatment is most appropriate?

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Correct answer: D — Give intramuscular benzathine penicillin G for early syphilis

The best answer is “Give intramuscular benzathine penicillin G for early syphilis”. A painless genital ulcer with diffuse rash involving palms and soles is syphilis, so treat promptly while obtaining required serology and partner management. Imiquimod, acyclovir, and pelvic-inflammatory-disease regimens treat different conditions. Deferring treatment solely for confirmatory results risks ongoing transmission.

Reference: CDC, Sexually Transmitted Infections Treatment Guidelines: https://www.cdc.gov/std/treatment-guidelines/default.htm