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History of gonococcal urethritis
0%
0/7
History of HIV
29%
2/7
History of abnormal Pap smear
History of autoimmune disease
All pregnant women should be screened for syphilis
71%
5/7
Select Answer to see Preferred Response
All pregnant women should be screened for syphilis, regardless of risk factors. Congenital syphilis is one of the "ToRCHeS" infections (Toxoplasmosis, Rubella, CMV, HIV, HSV, Syphilis). In neonates, it presents with classic signs such as CN VIII deafness, saddle nose deformity, saber shins, Hutchinson's teeth, and "mulberry" molars. Treatment with penicillin prevents maternal transmission to the fetus and treats fetal infection. Mattei et al. note that rates of primary and secondary syphilis have increased over the past 10 years, including in women, underscoring the importance of screening in pregnant women. Wolff et al. reaffirmed the USPSTF recommendations in the Annals of Internal Medicine in 2009, noting that a recent study evaluated the effect before and after the implementation of a universal syphilis screening program for pregnant women and found reductions in rates of congenital syphilis. Furthermore, two additional studies on screening accuracy for syphilis reported false-positive rates of less than 1%. Illustration A depicts the widely-spaced, notched "Hutchinson's teeth" characteristic of congenital syphilis. Incorrect Answers: Answers 1-3: Regardless of risk factors, all pregnant women should be screened for syphilis. Answer 4: The presence of autoimmune disease may cause a false-positive result on nontreponemal antibody tests such as rapid plasma reagin (RPR).
5.0
(2)
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