Question

A 35-year-old man presents with a single painless, firm ulcer on the penile shaft and non-tender lymphadenopathy. What is the most appropriate initial investigation?

Accepted Answer

Dark-field microscopy or PCR for Treponema pallidum and serology for syphilis

Answer

HSV PCR only

Answer

HIV serology only

Answer

Biopsy of the lesion for malignancy

Answer

No tests; treat empirically with topical antivirals

Practice question

A 35-year-old man presents with a single painless, firm ulcer on the penile shaft and non-tender lymphadenopathy. What is the most appropriate initial investigation?