A 34-year-old female has a diffuse maculopapular rash and generalized lymphadenopathy. Which test will confirm a suspected diagnosis of secondary syphilis?

The Venereal Disease Research Laboratory (VDRL) test is a non-treponemal test used to screen for syphilis, and it is particularly relevant in cases of secondary syphilis where clinical signs such as a diffuse maculopapular rash and generalized lymphadenopathy are present. In secondary syphilis, the presence of treponemes in the body can lead to the production of antibodies that the VDRL test is designed to detect. A positive VDRL result indicates that the person has been exposed to the syphilis bacteria, thus supporting the diagnosis of secondary syphilis.

Although the VDRL test can yield false positives due to other conditions, it is still the most appropriate initial serologic test to confirm suspected cases of syphilis in conjunction with clinical findings. After a positive screening, it is important to follow up with a more specific treponemal test for confirmation.

The other tests mentioned are not relevant to diagnosing secondary syphilis. Patch testing is utilized for allergic reactions, acetowhitening involves vinegar application to visualize cervical changes during a gynecological exam, and Gram stain and culture are primarily used for identifying bacterial infections, not for diagnosing syphilis. Thus, the