Vaginal Infections to TSS

Here is your 40-item HIGH-YIELD MCQ quiz on Vaginitis → Cervicitis → PID → Toxic Shock Syndrome, formatted exactly like your requested exam style. VAGINAL INFECTIONS TO TOXIC SHOCK SYNDROME – 40-ITEM MCQ QUIZ 1. A 24-year-old woman presents with thin, gray-white discharge with fishy odor and no vulvar erythema. Vaginal pH is 5.2. Most likely diagnosis?​ A. Candidiasis​ B. Trichomoniasis​ C. Bacterial vaginosis​ D. Physiologic discharge Answer: C​ Rationale: BV presents with thin gray discharge, fishy odor, and pH >4.5. 2. Which organism is most responsible for maintaining normal vaginal pH?​ A. Gardnerella vaginalis​ B. Escherichia coli​ C. Lactobacilli​ D. Staphylococcus epidermidis Answer: C​ Rationale: Lactobacilli produce lactic acid to maintain acidic pH. 3. A 29-year-old with severe vulvar itching and thick white discharge has pH 4.0. Most likely cause?​ A. BV​ B. Trichomonas​ C. Candida​ D. Gonorrhea Answer: C​ Rationale: Candida causes acidic pH and curd-like discharge. 4. Amsel’s criteria for BV requires how many positive findings?​ A. 1 of 4​ B. 2 of 4​ C. 3 of 4​ D. 4 of 4 Answer: C​ Rationale: Three out of four criteria are needed. 5. Which is NOT part of Amsel’s criteria?​ A. Clue cells​ B. pH >4.5​ C. Positive whiff test​ D. Strawberry cervix Answer: D​ Rationale: Strawberry cervix is seen in trichomoniasis. 6. Frothy yellow-green discharge and strawberry cervix suggest:​ A. BV​ B. Candida​ C. Trichomoniasis​ D. PID Answer: C​ Rationale: Classic for Trichomonas infection. 7. Best diagnostic test for trichomoniasis?​ A. Gram stain​ B. Wet mount only​ C. NAAT​ D. Culture only Answer: C​ Rationale: NAAT is most sensitive. 8. Treatment of trichomoniasis in non-pregnant women:​ A. Metronidazole 2 g once​ B. Metronidazole 500 mg BID x7 days​ C. Fluconazole​ D. Clindamycin Answer: B​ Rationale: Multidose regimen is preferred in women. 9. Partner treatment is mandatory in:​ A. BV​ B. Candida​ C. Trichomoniasis​ D. Physiologic discharge Answer: C​ Rationale: Trichomoniasis is an STI. 10. Which condition is “sexually associated” but not an STI?​ A. Trichomoniasis​ B. BV​ C. Gonorrhea​ D. Chlamydia Answer: B​ Rationale: BV is associated with sex but not classified as STI. 11. A patient on antibiotics develops pruritus and curdy discharge. Diagnosis?​ A. BV​ B. Candida​ C. Trichomonas​ D. PID Answer: B​ Rationale: Antibiotics predispose to candidiasis. 12. First-line oral treatment for uncomplicated candidiasis:​ A. Metronidazole​ B. Fluconazole 150 mg once​ C. Doxycycline​ D. Ceftriaxone Answer: B​ Rationale: Single-dose fluconazole is standard. 13. Which vaginitis typically has NO inflammation?​ A. BV​ B. Trichomoniasis​ C. Candida​ D. Gonorrhea Answer: A​ Rationale: BV lacks significant inflammatory response. 14. A friable cervix with mucopurulent discharge suggests:​ A. BV​ B. Cervicitis​ C. Candidiasis​ D. PID Answer: B​ Rationale: Mucopurulent cervicitis causes friability. 15. Most common pathogens in endocervicitis:​ A. HSV and Candida​ B. Trichomonas and BV​ C. Chlamydia and Gonorrhea​ D. E. coli and Staph Answer: C​ Rationale: C. trachomatis and N. gonorrhoeae are primary causes. 16. Best test for cervicitis pathogens:​ A. Culture​ B. ELISA​ C. NAAT​ D. Wet mount Answer: C​ Rationale: NAAT is most sensitive. 17. First-line treatment for chlamydial cervicitis:​ A. Azithromycin IM​ B. Doxycycline 100 mg BID x7 days​ C. Metronidazole​ D. Penicillin Answer: B​ Rationale: Doxycycline is first-line. 18. Treatment for uncomplicated gonococcal cervicitis (<150 kg):​ A. Ceftriaxone 250 mg​ B. Ceftriaxone 500 mg IM once​ C. Cefixime 400 mg​ D. Penicillin Answer: B​ Rationale: Recommended dose is 500 mg IM. 19. A woman with pelvic pain, fever, and cervical motion tenderness most likely has:​ A. BV​ B. Cervicitis​ C. PID​ D. TSS Answer: C​ Rationale: CMT + pain suggests PID. 20. Minimum criteria for presumptive PID includes:​ A. Fever alone​ B. Discharge only​ C. Cervical motion tenderness​ D. Elevated CRP only Answer: C​ Rationale: CMT is part of minimum criteria. 21. Which organism is commonly associated with chronic PID in IUD users?​ A. Gonorrhea​ B. Chlamydia​ C. Actinomyces​ D. Candida Answer: C​ Rationale: Actinomyces is linked to long-term IUD use. 22. Most common cause of chronic PID worldwide:​ A. Gonorrhea​ B. Chlamydia​ C. Tuberculosis​ D. E. coli Answer: C​ Rationale: Genital TB is major cause globally. 23. Outpatient PID regimen includes:​ A. Metronidazole alone​ B. Ceftriaxone + doxycycline + metronidazole​ C. Penicillin only​ D. Azithromycin only Answer: B​ Rationale: Triple therapy covers polymicrobial infection. 24. Indication for PID hospitalization:​ A. Mild pain​ B. TOA​ C. No discharge​ D. Normal labs Answer: B​ Rationale: Tubo-ovarian abscess requires admission. 25. Fitz-Hugh-Curtis syndrome involves:​ A. Liver cirrhosis​ B. Perihepatic adhesions​ C. Renal failure​ D. Splenomegaly Answer: B​ Rationale: PID can cause perihepatitis. 26. Major long-term complication of PID:​ A. Dysmenorrhea​ B. Infertility​ C. Fibroids​ D. Ovarian cysts Answer: B​ Rationale: Tubal damage leads to infertility. 27. A woman with high fever, vomiting, rash, and hypotension during menses likely has:​ A. PID​ B. Sepsis​ C. TSS​ D. BV Answer: C​ Rationale: Tampon-associated TSS causes shock and rash. 28. Causative organism of menstrual TSS:​ A. E. coli​ B. Strep pyogenes​ C. Staph aureus​ D. Candida Answer: C​ Rationale: S. aureus produces TSST-1. 29. Characteristic late finding of TSS:​ A. Jaundice​ B. Vesicles​ C. Desquamation of palms/soles​ D. Ulcers Answer: C​ Rationale: Skin peeling occurs after 1–2 weeks. 30. Initial priority in TSS management:​ A. Antibiotics​ B. Steroids​ C. IV fluids and shock management​ D. Surgery Answer: C​ Rationale: Hemodynamic stabilization is first. 31. Antibiotic essential for toxin suppression in TSS:​ A. Vancomycin​ B. Clindamycin​ C. Ceftriaxone​ D. Metronidazole Answer: B​ Rationale: Clindamycin inhibits toxin production. 32. Which vaginitis is associated with pregnancy complications?​ A. Candida​ B. Trichomonas​ C. BV​ D. Gonorrhea Answer: C​ Rationale: BV is linked to PROM and preterm birth. 33. Vaginal pH >4.5 is seen in all EXCEPT:​ A. BV​ B. Trichomoniasis​ C. Candida​ D. PID Answer: C​ Rationale: Candida occurs in acidic pH. 34. A diabetic woman with recurrent yeast infections has:​ A. Uncomplicated VVC​ B. Complicated VVC​ C. BV​ D. Trich Answer: B​ Rationale: Diabetes → complicated candidiasis. 35. Clue cells represent:​ A. Fungal spores​ B. WBCs​ C. Epithelial cells coated with bacteria​ D. Protozoa Answer: C​ Rationale: Clue cells are epithelial cells covered with bacteria. 36. Which infection increases risk of acquiring HIV?​ A. Candida​ B. BV​ C. Trichomoniasis​ D. Physiologic discharge Answer: C​ Rationale: Trichomoniasis causes mucosal inflammation. 37. A woman with lower abdominal pain, adnexal tenderness, and elevated CRP meets:​ A. Definitive PID criteria​ B. Minimum PID criteria​ C. Additional PID criteria​ D. No criteria Answer: C​ Rationale: Elevated CRP is an additional criterion. 38. Thickened, fluid-filled tubes on ultrasound indicate:​ A. Cervicitis​ B. Vaginitis​ C. PID​ D. TSS Answer: C​ Rationale: Imaging finding of PID. 39. Best prevention strategy for STIs:​ A. Douching​ B. Antibiotics​ C. Condom use​ D. Spermicides Answer: C​ Rationale: Barrier protection reduces transmission. 40. Which patient requires immediate admission?​ A. Mild BV​ B. Candida vaginitis​ C. PID with vomiting and fever​ D. Asymptomatic trichomoniasis Answer: C​ Rationale: Severe PID needs hospitalization. If you’d like, I can next prepare a 1-page cram sheet for this whole section (vaginitis → TSS) for last-day review.