Nu 672 FiNal Exam Study GuidE Exam NEwESt 2025/2026 with
ComplEtE QuEStioNS aNd CorrECt aNSwErS |alrEady GradEd
a+||BraNd NEw VErSioN!|
Bacterial Vaginosis (BV)
-Loss of normal flora, decreased lactobacilli, overgrowth of anaerobic organisms
-Not sexually transmitted but sexually associated (common in sexually active en)
EXAM FINDINGS
-Fishy vaginal odor
-Profuse, watery, homogenous, discharge
-Pruritus
-Dyspareunia
-No redness or edema
-Basic pH (>4.5 - DETAILED ANSWER-DIAGNOSIS
At least three of the following characteristics are present: Homogeneous discharge;
Production of a fishy, amine odor when a 10% potassium hydroxide solution is dropped
onto the secretions (positive amine/whiff); Vaginal pH > 4.5 (usually 5.0 to 6.0); The
,-
appearance of characteristic "clue cells" on wet-mount microscopic studies-more than
20%
-Commercial tests: BD Affirm VP III; OSOM BVBlue
MANAGEMENT
-Nonpharmacological: Good hygiene; STI screening; Complete meds before resuming
sex; Avoid douching, sanitary pads, panty liners, nylon underwear -Pharmacological:
Metronidazole (Flagyl)-oral or gel: 500 mg PO BID x 7 days OR 0.75% gel- 1 full applicator
daily x 5 d OR
Clindamycin vaginal cream
§2%- 1 full applicator intravaginally hs x 7 days; Tinidazole as an alternate
Pregnancy: Metronidazole 500 mg PO BID x 7d
Chlamydia
-Chlamydia trachomatis-"Silent STD"-usually asymptomatic presentation
-May cause nongonococcal urethritis
-Most prevalent STD in the US
-Highest among adolescents/young adults
-Incidence declines with age, especially after 21 years
EXAM FINDINGS
Women: Asymptomatic; Mucopurulent cervicitis, cervical motion tenderness;
Edematous, friable cervix, dysuria, pyuria, dyspareunia, higher premature rupture of
membranes during pregnancy
-Men: Dysuria; Proctitis; Epididymitis; Prostatitis; Penile discharge
-Infants: Afebrile; Pneumonia; Conjunctivitis - DETAILED ANSWER-DIAGNOSTICS
, -
-Nucleic acid amplification test (NAAT)-Gold standard
-Gen-Probe-chlamydia, gonorrhea
-Wet prep
-In absence of the ability to test, treat based on clinical suspicion when signs/symptoms
present, and the patient is sexually active
MANAGEMENT
-Nonpharmacological: Abstinence; Evaluate/treat sexual partners; May use expedited
partner treatment; Report to the health department
-Pharmacological:
-Azithromycin 1 g PO single dose OR
-Doxycycline 100 mg PO BID x 7d OR
-If epididymis or PID then 10-14 d
-2nd line
-Levofloxacin 500 mg PO QD x 7d OR
-Erythromycin 500 mg PO QID x 7 d
Gonorrhea
-Neisseria gonorrhoeae-Bacterial sexually transmitted disease
-May thrive in the oropharynx and rectum
-May be asymptomatic early
Untreated may lead to disseminated gonococcal infection-joint pain, skin lesions
-Resistance to antibiotics increasing worldwide
-Perinatally transmitted from infected mother to newborn
ComplEtE QuEStioNS aNd CorrECt aNSwErS |alrEady GradEd
a+||BraNd NEw VErSioN!|
Bacterial Vaginosis (BV)
-Loss of normal flora, decreased lactobacilli, overgrowth of anaerobic organisms
-Not sexually transmitted but sexually associated (common in sexually active en)
EXAM FINDINGS
-Fishy vaginal odor
-Profuse, watery, homogenous, discharge
-Pruritus
-Dyspareunia
-No redness or edema
-Basic pH (>4.5 - DETAILED ANSWER-DIAGNOSIS
At least three of the following characteristics are present: Homogeneous discharge;
Production of a fishy, amine odor when a 10% potassium hydroxide solution is dropped
onto the secretions (positive amine/whiff); Vaginal pH > 4.5 (usually 5.0 to 6.0); The
,-
appearance of characteristic "clue cells" on wet-mount microscopic studies-more than
20%
-Commercial tests: BD Affirm VP III; OSOM BVBlue
MANAGEMENT
-Nonpharmacological: Good hygiene; STI screening; Complete meds before resuming
sex; Avoid douching, sanitary pads, panty liners, nylon underwear -Pharmacological:
Metronidazole (Flagyl)-oral or gel: 500 mg PO BID x 7 days OR 0.75% gel- 1 full applicator
daily x 5 d OR
Clindamycin vaginal cream
§2%- 1 full applicator intravaginally hs x 7 days; Tinidazole as an alternate
Pregnancy: Metronidazole 500 mg PO BID x 7d
Chlamydia
-Chlamydia trachomatis-"Silent STD"-usually asymptomatic presentation
-May cause nongonococcal urethritis
-Most prevalent STD in the US
-Highest among adolescents/young adults
-Incidence declines with age, especially after 21 years
EXAM FINDINGS
Women: Asymptomatic; Mucopurulent cervicitis, cervical motion tenderness;
Edematous, friable cervix, dysuria, pyuria, dyspareunia, higher premature rupture of
membranes during pregnancy
-Men: Dysuria; Proctitis; Epididymitis; Prostatitis; Penile discharge
-Infants: Afebrile; Pneumonia; Conjunctivitis - DETAILED ANSWER-DIAGNOSTICS
, -
-Nucleic acid amplification test (NAAT)-Gold standard
-Gen-Probe-chlamydia, gonorrhea
-Wet prep
-In absence of the ability to test, treat based on clinical suspicion when signs/symptoms
present, and the patient is sexually active
MANAGEMENT
-Nonpharmacological: Abstinence; Evaluate/treat sexual partners; May use expedited
partner treatment; Report to the health department
-Pharmacological:
-Azithromycin 1 g PO single dose OR
-Doxycycline 100 mg PO BID x 7d OR
-If epididymis or PID then 10-14 d
-2nd line
-Levofloxacin 500 mg PO QD x 7d OR
-Erythromycin 500 mg PO QID x 7 d
Gonorrhea
-Neisseria gonorrhoeae-Bacterial sexually transmitted disease
-May thrive in the oropharynx and rectum
-May be asymptomatic early
Untreated may lead to disseminated gonococcal infection-joint pain, skin lesions
-Resistance to antibiotics increasing worldwide
-Perinatally transmitted from infected mother to newborn
