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Genital herpes — DRCOG MCQ

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ModerateContraceptionGenital herpesDRCOG

A 67-year-old woman has painful vulval ulcers, dysuria and tender inguinal lymph nodes. What is the most likely diagnosis?

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Correct answer: BFirst episode genital herpes

First episode genital herpes is the best answer because the vignette is testing Genital herpes and the recommended approach is consistent with BASHH Genital Herpes guideline. The other diagnoses do not explain the combination of timing, examination findings and investigation results as well as the correct diagnosis. Specifically, Endometriosis; Stress urinary incontinence; Vulvovaginal candidiasis; Offer depot medroxyprogesterone acetate would be suboptimal in this scenario. The key discriminator is the pattern across symptoms, examination and timing, not a single isolated symptom.

Reference: BASHH Genital Herpes guideline