Practice Questions) 2026/2027
Exam All Answers and
Illustrations Given
VAGINITIS DIAGNOSIS AND TREATMENT
Organism Discharge Odor Microscopy pH Treatment
Bacterial vaginosis Thin, gray, homogeneous Fishy with positive "whif
test" Clue cells >4.5 Metronidazole 500 mg BID × 7 days or clindamycin
300 mg BID × 7 days or topical metronidazole 1 applicatorful
intravaginally daily × 5 days (lower success rate)
,Candida Adherent, white, "cottage cheese" like Neutral Pseudohyphae
but only 65-85% sensitive <4.5 Fluconazole oral, topical clotrimazole,
miconazole, etc.
Trichomonas Copious yellow, gray, green, foamy. Friable "strawberry"
cervix Malodorous Trichomonads >4.5
Metronidazole 2 g PO once (recommended), or 500 mg
BID × 7 days (alternative) - ANSWER ✔✔
HELPFUL TIP:
The most recent evidence points to insulin resistance as the underlying
cause of PCOS, and these patients may have acanthosis nigricans.
Insulin resistance can be quantified by calculating the ratio of fasting
glucose to insulin. A ratio of less than 4.5 indicates insulin resistance.
Insulin resistance stimulates ovarian androgen production, which leads
to anovulation.
HELPFUL TIP:
,As with other STIs, a patient with Trichomonas should have her partner
tested and treated (or just treated depending whether or not this is
allowable under your state law).
HELPFUL TIP:
While it makes sense that single-dose azithromycin would work better in
treating Chlamydial cervicitis because of compliance issues, the cure
rate is the same whether azithromycin or the doxycycline is used. There
is about a 3% failure rate with azithromycin which isn't seen with
doxycycline.
HELPFUL TIP:
For hirsutism associated with PCOS, - ANSWER ✔✔
Question 1:
A 16-year-old female presents with her mother. They don't look happy.
Her mother says, "She needs a Pap smear because she's been having
sex with a couple of boys—in my house, I will have you know—for a
year!" The patient rolls her eyes.
3
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, Consistent with published guidelines, you recommend:
A
Pap smear
B
Gonorrhea and chlamydia testing
C
Pap smear and gonorrhea and chlamydia testing
D
Return for a Pap after sexually active for 3 years (age 18 for this patient)
E
A chastity belt