Topic 19 — Sexually Transmitted Infections and Vaginal Discharge

A 25-year-old woman presents with mild dysuria and intermenstrual spotting. Speculum examination shows mucopurulent cervical secretion with little vaginal inflammation. Testing for gonorrhea is negative. Which diagnosis should now be considered most strongly?

A woman with gonococcal cervicitis has thick mucopurulent secretion from the cervical os. Which inflammatory response most directly accounts for the purulent appearance?

A patient has completed treatment for syphilis. The clinician wants to assess change in disease activity during follow-up. Which investigation is most useful for this purpose?

A woman presents soon after developing a suspicious early syphilitic genital lesion. Direct demonstration of the causative organism is planned where appropriate facilities are available. Which specimen is most relevant?

A woman with positive syphilis serology develops neurological symptoms but has no current genital ulcer or skin rash. Which interpretation is most appropriate?

During an integrated STI teaching session, students classify infections according to the type of causative organism. Which pairing is correct?

A 30-year-old woman develops marked vulval itching and soreness shortly after completing a prolonged course of antibiotics. She reports no new sexual exposure. Which factor most likely predisposed to her current problem?

A primary-care doctor is differentiating common causes of vaginal discharge. In addition to examination and microscopy, which simple vaginal parameter may contribute to distinguishing the causes?

A woman has recurrent inflammatory vaginal discharge, but the clinical findings are insufficient to confidently identify the cause. Trichomoniasis remains suspected. Which approach best improves etiological confirmation where available?

A 27-year-old woman presents with abnormal genital discharge. The clinician needs to determine whether the secretion originates mainly from the vagina or cervix and also wishes to inspect for cervical friability. Which examination is most useful?

A woman with genital discharge also reports lower abdominal pain. The clinician is concerned that infection may have spread beyond the cervix. Which examination component most directly assesses for upper genital tract involvement?

Two women have HPV infection. One develops external genital warts, while the other develops cervical epithelial dysplasia. Which concept best explains this difference?

A woman presents early in an episode of painful genital vesicles and ulcers. The clinician wishes to confirm herpes simplex infection directly. Which specimen is most appropriate?

A community health team wants to improve STI prevention without creating a separate specialist service. Which approach best reflects integration into reproductive-health care?

A 24-year-old woman attending a reproductive-health clinic has no genital symptoms. She reports a previous STI and a recent new sexual partner. Which interpretation is most appropriate?

A woman and her partner have both received appropriate treatment for a confirmed sexually transmitted infection. Which counseling point most directly reduces immediate onward transmission?

A primary-care facility has reliable microbiological testing available for women with vaginal discharge. Compared with treatment based only on a clinical syndrome, what is the main advantage of identifying the specific cause?

A woman with abnormal vaginal discharge has completed appropriate initial management but continues to have symptoms. No definite cause has been established. Which primary-care principle is most appropriate?

During counseling, a student states that every common cause of abnormal vaginal discharge should be regarded as a sexually transmitted infection. Which pair best demonstrates why this statement is incorrect?

A medical student is counseling a patient about transmission of infections that are commonly sexually transmitted. Which statement best reflects the broader transmission pattern described for this group?