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Bacterial vaginosis — USMLE Step 2 CK MCQ

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EasyObstetrics & GynecologyBacterial vaginosisUSMLE Step 2 CK

A 31-year-old Asian American woman comes to the hospital because of pelvic symptoms or pregnancy-related concerns. History and focused examination are notable for thin gray discharge, fishy odor, clue cells, and vaginal pH above 4.5. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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Correct answer: A — Bacterial vaginosis

The vignette describes Bacterial vaginosis, supported by thin gray discharge, fishy odor, clue cells, and vaginal pH above 4.5. Bacterial vaginosis is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: CDC STI Treatment Guidelines 2021