The Daily PANCE and PANRE Question 37

A female presents complaining of a grayish, watery vaginal discharge. The KOH prep does not reveal any hyphae. Clue cells are identified on the wet mount. A paucity of WBCs is noted. What diagnosis is most likely?

  1. Gonorrhea
  2. Chlamydia
  3. Candidiasis
  4. Bacterial Vaginosis
  5. Trichomoniasis

Answer: D

Bacterial Vaginosis

Clue cells mean BV

Know Your Content Blueprint

Bacterial Vaginosis is covered in the NCCPA™ Content Blueprint Reproductive System (8%)

  • FISHY, grey, scant, THIN, STICKY
  • PH > 4.5 (BACTERIA = BASIC)
  • Wet-prep shows epithelial cells with bacteria coating on surface = “clue cells”
  • KOH testing causes the release of amine odor (+ whiff test)
  • First Line Treatment:
    • Metronidazole: 500 mg PO b.i.d. × 7 days
    • Metronidazole gel 0.75%: 5 g intravaginally daily × 5 days
    • Clindamycin 2% cream: 5 g intravaginally qhs × 7 days

Review Topic: Vaginitis

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