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Bacterial vaginosis — USMLE Step 3 MCQ

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EasyOB/GYN (prenatal care, contraception, screening)Bacterial vaginosisUSMLE Step 3

A 24-year-old woman has thin gray vaginal discharge and fishy odor. Pelvic examination shows no cervical motion tenderness. Vaginal pH is 5.5, whiff test is positive, and microscopy shows clue cells. She is not pregnant. Which of the following is the most appropriate next step in management?

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Correct answer: B — Treat with metronidazole

Bacterial vaginosis is diagnosed by discharge, elevated pH, positive whiff test, and clue cells; metronidazole is first-line treatment.

Reference: CDC Sexually Transmitted Infections Treatment Guidelines: https://www.cdc.gov/std/treatment-guidelines/