Vaginal discharge
Obstetrics & Gynaecology · Topic 22
Source: NMC CBME Curriculum 2024 · Volume III · Obstetrics & Gynaecology · Topic 22 · combined PDF page 436
Practice questions
- A patient reports a modest increase in clear vaginal discharge around mid-cycle but has no itching, odor, pain, or other symptoms. Examination shows no evidence of inflammation. What is the most appropriate interpretation?
- A patient presents with new vaginal discharge. Which approach best reflects the recommended initial evaluation?
- A patient has marked vulvovaginal itching and thick white discharge. The vaginal pH is in the usual acidic range. Which diagnosis best fits this pattern?
- A patient has bothersome symptoms attributed to vulvovaginal candidiasis. Which treatment approach is specifically described in the cited practice guideline?
- A patient describes a thin, homogeneous discharge with a fishy odor. Which diagnosis is most consistent with this presentation?
- A patient has bothersome symptoms and clinical findings consistent with bacterial vaginosis. Which treatment is described in the cited practice guideline?
- Which of the following common causes of vaginal discharge is explicitly classified as a sexually transmitted infection in the cited guideline?
- A wet-mount examination of vaginal discharge shows motile flagellated organisms. Which diagnosis is most likely?
- A patient has vaginal itching and thick white discharge. Which additional bedside finding would make bacterial vaginosis less likely and candidiasis more likely?
- A patient has persistent vaginal discharge after treatment, but the original diagnosis was based only on symptoms. What is the most appropriate next step?
- A patient with vaginal discharge reports a new sexual partner and inconsistent barrier use. According to the cited practice guideline, what is the most appropriate implication for testing?
- A clinician assumes that any patient presenting with vaginal discharge has a sexually transmitted infection. Which statement best corrects this assumption?
- A clinic uses an abnormal-vaginal-discharge flowchart to identify cervical gonorrhoea and chlamydia. What is the principal concern identified by systematic reviews?
- In a setting without etiologic testing, a patient is managed using a vaginal-discharge syndrome algorithm. Which limitation should be considered when counselling the clinic team?
- A patient has an abnormal vaginal discharge, but the cause is uncertain. Which approach best aligns with the shift advocated in a recent review?
- A surveillance report lists candidiasis and bacterial vaginosis in overlapping proportions among women presenting with vaginal discharge. Which interpretation is most appropriate?
- A laboratory is revising its vaginal-discharge examination protocol. Which set of steps most closely matches the scope of the recent standardization guideline?
- Which laboratory practice most directly supports comparability of vaginal-discharge results between examiners?
- A patient reports increased discharge that resembles candidiasis, but initial clinical assessment does not clearly distinguish common infectious causes. Which investigation is most directly useful as part of the evaluation described in the cited guidance?
- A patient has recurrent increased discharge with an acidic vaginal pH. Wet-mount microscopy shows cytolysis and increased lactobacilli. Which diagnosis is most consistent with this combination?
- A patient with discharge has a low white blood cell count on microscopy, an acidic pH, and increased lactobacilli with cytolysis. Which finding is specifically included in the review's description of cytolytic vaginitis?
- A patient with increased discharge is suspected of having lactobacillosis or cytolytic vaginitis. Why is further assessment important?
- A patient is diagnosed with candidiasis but reports no bothersome symptoms. Which management principle is supported by the cited Dutch guideline?
- A patient has bothersome discharge and testing confirms bacterial vaginosis. Which statement best reflects the cited treatment guidance?
- A patient with vaginal discharge has no increased STI risk on history and examination supports a vaginal rather than cervical cause. Which approach is most consistent with the cited Dutch guideline?
- A public-health programme reviews local causes of vaginal discharge to decide whether its syndromic protocol remains suitable. Why is periodic etiologic reassessment useful?
- A symptomatic patient has vaginal discharge, and the clinic is considering a syndromic algorithm for presumed cervical infection. Which performance concern is supported by the meta-analysis of abnormal-discharge flowcharts?
- A clinician is deciding whether to treat a patient with a possible Candida infection or bacterial vaginosis. Which principle is supported by the cited practice guideline?
- A patient reports increased discharge, but examination and microscopy do not support candidiasis, bacterial vaginosis, or trichomoniasis. Which next step is most appropriate?
- A patient with vaginal discharge is tested and found to have trichomoniasis. Which classification has an important implication for clinical assessment?
- A laboratory receives specimens for vaginal-discharge examination from multiple clinics. Which action best supports dependable interpretation of the results?
- A patient describes increased discharge that resembles both lactobacillosis and cytolytic vaginitis. According to the review, which test may help differentiate these conditions?
- A service is reviewing a vaginal-discharge algorithm that treats all patients with discharge for cervical infection. Which concern best supports revising the algorithm where etiologic testing is feasible?