Vaginal discharge

Question 1

Key history in vaginal discharge

Answer 1

Amount, color, consistency, odor, duration; associated vaginal burning, pain, or pruritus; recent sexual
activity; onset of last menstrual period; use of contraceptives, tampons, and douches; history of similar
symptoms; history of STDs

Question 2

Key physical exam in vaginal discharge

Answer 2

Vital signs; abdominal exam; complete pelvic exam

Question 3

28 yo F with thin, grayish-white, foul-smelling vaginal discharge

Answer 3

Bacterial vaginosis
Vaginitis—candidal
Vaginitis—trichomonal
Cervicitis (chlamydia, gonorrhea)

Pelvic exam
Wet mount
Cervical cultures
KOH prep (“whiff test”)
pH of vaginal fluid

Question 4

30 yo F with thick, white, cottage cheese-like, odorless vaginal discharge and itching

Answer 4

Vaginitis—candidal
Bacterial vaginosis
Vaginitis—trichomonal

Pelvic exam
KOH prep (“whiff test”)
Wet mount
Cervical cultures
pH of vaginal fluid

Question 5

35 yo F with malodorous, profuse, frothy, greenish vaginal discharge and intense itching and discomfort

Answer 5

Vaginitis—trichomonal
Vaginitis—candidal
Bacterial vaginosis
Cervicitis (chlamydia, gonorrhea)

Pelvic exam
Wet mount
Cervical cultures
pH of the vaginal fluid
KOH prep (“whiff test”)