A 20-year-old woman presents to the gynecology clinic with complaints of intermittent vaginal spotting and watery vaginal discharge for the past two months. She denies significant pelvic pain, fever, or a history of sexually transmitted infections. Her mother took diethylstilbestrol (DES) during pregnancy to prevent miscarriage. On pelvic examination, a 2 cm exophytic, irregular, and friable lesion is observed on the anterior vaginal wall near the cervix. No adnexal masses or lymphadenopathy are found. Histopathology: Cells with glycogen-rich cytoplasm Hobnail cells in a tubular and papillary growth pattern Which of the following histological features is characteristic of this carcinoma?
A 43-year-old woman presents to the gynecology clinic for routine follow-up after an abnormal Pap smear. She is asymptomatic and denies abnormal vaginal bleeding, discharge, or pelvic pain. A colposcopy and biopsy of the cervix reveal clear cell adenocarcinoma of the cervix. The physician reviews the risk factors for her condition. Clear cell adenocarcinoma of the cervix and vagina is most commonly associated with which of the following risk factors?
A 28-year-old sexually active woman presents to the clinic with frothy, greenish-yellow vaginal discharge with a foul odor, along with vulvar itching and burning. On pelvic examination, a friable cervix with a strawberry appearance is noted. A wet mount reveals motile trichomonads, and nucleic acid amplification testing (NAAT) confirms Trichomonas vaginalis infection. The patient declines treatment for the condition despite counseling. Which of the following complications is associated with untreated trichomoniasis in women?
A 27-year-old woman presents with vaginal itching and unusual discharge for the past two weeks. She describes the discharge as frothy, yellow-green, and foul-smelling. She reports dyspareunia (pain during intercourse) and mild dysuria. She has had multiple sexual partners over the past six months without consistent condom use. On speculum examination, there is frothy, yellow-green discharge in the vaginal canal, erythema of the vaginal walls, and a strawberry cervix (punctate hemorrhages). A wet mount shows motile, flagellated organisms, confirming the diagnosis of trichomoniasis. What is the recommended first-line treatment for trichomoniasis in adults?
A 32-year-old woman presents with vaginal itching and an unusual discharge for the past two weeks. The discharge is described as frothy, yellow-green, and foul-smelling. She also reports dyspareunia (pain during intercourse) and mild dysuria. She has had multiple sexual partners over the past six months without consistent condom use. On speculum examination, there is frothy, yellow-green discharge, erythema of the vaginal walls, and a strawberry cervix with punctate hemorrhages. A wet mount reveals motile, flagellated organisms. Which organism is the most likely cause of her symptoms?
A 32-year-old man presents to the clinic with a painless ulcer on his penis that appeared two weeks ago. He reports unprotected sexual intercourse with multiple partners in the past month. He denies fever, rash, or systemic symptoms. On physical examination: Single, non-tender ulcer with clean edges and a firm base on the penile shaft (chancre). No lymphadenopathy. Serologic testing: Positive rapid plasma reagin (RPR) test with a titer of 1:32. Reactive treponemal antibody test, confirming primary syphilis. The patient is treated with the first-line antibiotic for syphilis, which is intramuscular Penicillin G Benzathine. What is the mechanism of action of this antibiotic?
A 35-year-old woman with a history of intrauterine device (IUD) placement presents with fever, abdominal pain, and vaginal discharge. Imaging confirms a tubo-ovarian abscess (TOA). Which of the following pathogens is most likely to be involved in this condition?
A 28-year-old woman presents to the emergency department with severe lower abdominal pain, fever, tachycardia, and hypotension. A diagnosis of pelvic inflammatory disease (PID) with a ruptured tubo-ovarian abscess is suspected. What is the most appropriate immediate treatment for this patient?
Which of the following is the first-line treatment for a hemodynamically stable patient diagnosed with a tubo-ovarian abscess (TOA) due to pelvic inflammatory disease (PID)?
A 27-year-old woman presents with lower abdominal pain, fever, and foul-smelling vaginal discharge. On pelvic examination, she has cervical motion tenderness and a palpable adnexal mass. Transvaginal ultrasound reveals a complex, thick-walled adnexal mass with internal echoes. Which of the following is the most likely diagnosis?
