STDs Flashcards
Clinical Vignette: A 28-year-old man presents with a genital lesion that is painless and indurated with a clean base. He denies any systemic symptoms.
Question: What type of lymphadenopathy would you expect in this patient?
A. Tender, regional, painful, suppurative nodes
B. Nontender, rubbery, nonsuppurative bilateral lymphadenopathy
C. Painful, matted, large nodes with fistulous tracts
D. Tender, bilateral inguinal adenopathy
Correct Answer: B
Explanation:
A: Seen in Chancroid. Incorrect.
B: Seen in Primary Syphilis. Correct.
C: Seen in Lymphogranuloma. Incorrect.
D: Seen in Genital Herpes. Incorrect.
Memory Tool: Think “SNN” for Syphilis: Singular, Nontender, None (systemic symptoms).
Reference Citation: Based on material from TABLE 58.2.
Rationale for Question: Understanding the presentation of primary syphilis, including its characteristic lymphadenopathy, is crucial for diagnosis and treatment.
Clinical Vignette: A 35-year-old woman reports painful genital vesicles. She also complains of flu-like symptoms.
Question: What is the nature of the lymphadenopathy in this patient?
A. Nontender, rubbery, nonsuppurative bilateral lymphadenopathy
B. Painful, matted, large nodes with fistulous tracts
C. Tender, regional, painful, suppurative nodes
D. Tender, bilateral inguinal adenopathy
Correct Answer: D
Explanation:
A: Seen in Primary Syphilis. Incorrect.
B: Seen in Lymphogranuloma. Incorrect.
C: Seen in Chancroid. Incorrect.
D: Seen in Genital Herpes. Correct.
Memory Tool: Think “Herpes Hurts” for painful vesicles and tender nodes.
Reference Citation: Based on material from TABLE 58.2.
Rationale for Question: Recognizing the features of genital herpes is essential as it presents differently than other genital ulcer diseases.
Clinical Vignette: A 40-year-old man has a painful genital ulcer with undermined, purulent edges. He has no systemic symptoms.
Question: What type of lymphadenopathy would you expect?
A. Nontender, rubbery, nonsuppurative bilateral lymphadenopathy
B. Painful, matted, large nodes with fistulous tracts
C. Tender, regional, painful, suppurative nodes
D. Tender, bilateral inguinal adenopathy
Correct Answer: C
Explanation:
A: Seen in Primary Syphilis. Incorrect.
B: Seen in Lymphogranuloma. Incorrect.
C: Seen in Chancroid. Correct.
D: Seen in Genital Herpes. Incorrect.
Memory Tool: Think “Chancroid Causes Chunky nodes” for suppurative lymphadenopathy.
Reference Citation: Based on material from TABLE 58.2.
Rationale for Question: Chancroid presents with its own specific set of symptoms, and identifying them can be key for treatment.
A 30-year-old woman presents with vulvar pruritus and external dysuria. She reports that the discharge is white and thick. Which of the following is the most likely diagnosis based on these symptoms?
A. Normal Vaginal Discharge
B. Candidiasis
C. Trichomoniasis
D. Bacterial Vaginosis
Correct Answer: B. Candidiasis
In-depth Explanation:
A. Normal Vaginal Discharge: Although normal vaginal discharge is white and thick, it is not associated with symptoms such as vulvar pruritus or dysuria. (Paragraph 1, Table 58.8)
B. Candidiasis: The symptoms and the nature of the vaginal discharge are characteristic of candidiasis. White, thick, curd-like discharge along with vulvar pruritus and external or superficial dysuria are classic signs. (Paragraph 1, Table 58.8)
C. Trichomoniasis: Typically presents with frothy or purulent discharge and is associated with vulvar erythema and edema, not described in the vignette. (Paragraph 1, Table 58.8)
D. Bacterial Vaginosis: The discharge in bacterial vaginosis is thin and white but lacks the symptoms described in the vignette. (Paragraph 1, Table 58.8)
Memory Tool:
Remember “Candid Candice” has “Curdy Discharge and is Itchy” to remember symptoms of Candidiasis.
Rationale:
Differentiating between various causes of vaginitis is a frequent issue in urology and gynecology. Knowing the specific clinical and microscopic features of each can lead to accurate and prompt treatment.
Question 2:
Which of the following diagnoses would most likely have a pH of greater than or equal to 4.5 and present with white blood cells?
A. Normal Vaginal Discharge
B. Candidiasis
C. Trichomoniasis
D. Bacterial Vaginosis
Correct Answer: C. Trichomoniasis
In-depth Explanation:
A. Normal Vaginal Discharge: Has a pH of less than or equal to 4.5 and white blood cells are absent. (Paragraph 1, Table 58.8)
B. Candidiasis: Also has a pH of less than or equal to 4.5 and white blood cells are absent. (Paragraph 1, Table 58.8)
C. Trichomoniasis: Is the only condition among the choices that has a pH of greater than or equal to 4.5 and has white blood cells present. (Paragraph 1, Table 58.8)
D. Bacterial Vaginosis: Although it has a pH of greater than or equal to 4.5, white blood cells are absent. (Paragraph 1, Table 58.8)
Memory Tool:
Remember “Tri-4.5-White” for Trichomoniasis: pH greater than 4.5 and White Blood Cells.
Rationale:
Understanding the pH and white blood cell count can be valuable diagnostic clues for urologists and gynecologists.
Question 3:
A 28-year-old female presents with frothy vaginal discharge. Upon microscopic examination, you observe mobile organisms. What is the most likely diagnosis?
A. Normal Vaginal Discharge
B. Candidiasis
C. Trichomoniasis
D. Bacterial Vaginosis
Correct Answer: C. Trichomoniasis
In-depth Explanation:
A. Normal Vaginal Discharge: Microscopy usually reveals lactobacilli and no mobile organisms are seen. (Paragraph 1, Table 58.8)
B. Candidiasis: Microscopy shows mycelia, not mobile organisms. (Paragraph 1, Table 58.8)
C. Trichomoniasis: This is the only condition where microscopy reveals mobile trichomonads, aligning with the frothy nature of the discharge. (Paragraph 1, Table 58.8)
D. Bacterial Vaginosis: Microscopy typically reveals clue cells, not mobile organisms. (Paragraph 1, Table 58.8)
Memory Tool:
Think “Mobile Monads” to remember that Trichomoniasis features mobile trichomonads under microscopy.
Rationale:
Microscopic findings are often confirmatory in diagnosing vaginal conditions. Being familiar with the typical findings can streamline diagnosis and treatment.
Question 4:
A 35-year-old woman presents with an increased vaginal discharge that has a fishy odor. Which of the following conditions is she most likely suffering from?
A. Normal Vaginal Discharge
B. Candidiasis
C. Trichomoniasis
D. Bacterial Vaginosis
Correct Answer: D. Bacterial Vaginosis
Correct Answer: D. Bacterial Vaginosis
In-depth Explanation:
A. Normal Vaginal Discharge: Typically has no odor and is not described as increased in volume. (Paragraph 1, Table 58.8)
B. Candidiasis: Does not typically have a fishy odor. (Paragraph 1, Table 58.8)
C. Trichomoniasis: While it may have an amine odor, it is not specifically described as having a fishy odor. (Paragraph 1, Table 58.8)
D. Bacterial Vaginosis: This condition is specifically described as having a fishy odor along with increased discharge. (Paragraph 1, Table 58.8)
Memory Tool:
Recall “Fishy BV” to remember that Bacterial Vaginosis typically has a fishy odor.
Rationale:
Odor characteristics can provide a straightforward diagnostic clue, making it easier for clinicians to reach a diagnosis without invasive tests.
