In secondary syphilis, a patient presents with generalised maculopapular rash including palms and soles. The definitive confirmatory test (not screening) for syphilis is:

• A VDRL (Venereal Disease Research Laboratory) test
• B RPR (Rapid Plasma Reagin) test
• C Treponema pallidum haemagglutination (TPHA) test — titre ≥1:80
• D Fluorescent treponemal antibody-absorption (FTA-ABS) test ✓

Explanation

FTA-ABS (fluorescent treponemal antibody-absorption) and TPHA/TPPA are treponemal-specific tests used for confirmation, while VDRL and RPR are non-treponemal (cardiolipin) tests used for screening and monitoring treatment response. Of the confirmatory tests, FTA-ABS is the most sensitive for early primary syphilis and remains positive for life after treatment — making it the gold standard confirmatory test cited in microbiology textbooks. TPHA/TPPA also confirm but have slightly lower sensitivity in very early disease.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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