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Bacterial vaginosis — MCCQE Part 1 MCQ

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EasyVaginal DischargeBacterial vaginosisMCCQE Part 1

A 30-year-old woman has thin grey vaginal discharge with fishy odour. Vaginal pH is elevated and clue cells are seen on microscopy; there is no cervical motion tenderness. Which of the following is the most appropriate treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Metronidazole therapy

Clue cells, elevated pH and fishy odour indicate bacterial vaginosis, commonly treated with metronidazole. Fluconazole treats candidiasis, which usually has normal pH and budding yeast. Cervicitis or PID therapy is needed only if features suggest upper genital tract or STI involvement.

Reference: Canadian Guidelines on Sexually Transmitted Infections; SOGC vaginal discharge guidance