North American Registry of Midwives (NARM) Practice Exam

What test is considered diagnostic for syphilis?

1. DNA test

2. Positive darkfield microscopic examination

3. ELISA test

4. Western blot test

The correct answer is: Positive darkfield microscopic examination

The diagnostic test considered the gold standard for identifying syphilis is the darkfield microscopic examination. This method allows for the direct visualization of Treponema pallidum, the bacterium that causes syphilis, from fluid samples taken from a syphilitic sore. The darkfield microscopy can reveal the motility and morphology of the spirochetes, confirming their presence in active lesions. While other tests, such as ELISA and Western blot, can detect antibodies to the bacterium and provide useful information regarding exposure and possible infection, they are not considered definitive diagnostic tests. Instead, they are often used as screening tools. The DNA test could theoretically show the presence of the bacterium's genetic material but is not typically used in clinical practice as the primary diagnostic method for syphilis. In summary, the positive darkfield microscopic examination stands out as a direct method to diagnose syphilis, allowing for confirmation of the infection through ocular observation of the pathogen.