A 27-year-old sexually active woman presents to the emergency department with a 5-day history of progressively worsening lower abdominal pain, along with vaginal discharge, fever, and dyspareunia (pain during intercourse). She also reports irregular spotting between menstrual cycles. She has had multiple sexual partners in the past year and inconsistently uses condoms. On examination, she has a low-grade fever (38.3°C/100.9°F) and mild tachycardia. Abdominal palpation reveals tenderness in the lower quadrants, and a bimanual pelvic examination demonstrates: Cervical motion tenderness (Chandelier sign) Bilateral adnexal tenderness Purulent cervical discharge Laboratory findings: Elevated WBC count and C-reactive protein (CRP) Vaginal swab: Positive for Chlamydia trachomatis, negative for Neisseria gonorrhoeae Transvaginal ultrasound: Thickened, fluid-filled fallopian tubes, consistent with salpingitis Which of the following is a complication of this disorder?

A 25-year-old sexually active woman presents to the emergency department with a 5-day history of progressively worsening lower abdominal pain, along with vaginal discharge, fever, and dyspareunia (pain during intercourse). She also reports irregular spotting between menstrual cycles. She has had multiple sexual partners in the past year and inconsistently uses condoms. On examination, she has a low-grade fever (38.3°C/100.9°F) and mild tachycardia. Abdominal palpation reveals tenderness in the lower quadrants, and a bimanual pelvic examination demonstrates: Cervical motion tenderness Bilateral adnexal tenderness Purulent cervical discharge Laboratory findings: Elevated WBC count and C-reactive protein (CRP) Vaginal swab: Positive for Chlamydia trachomatis, negative for Neisseria gonorrhoeae Transvaginal ultrasound: Thickened, fluid-filled fallopian tubes, consistent with salpingitis, but no tubo-ovarian abscess. What is the recommended outpatient antibiotic regimen for the treatment of this disorder?

A 24-year-old sexually active woman presents to the emergency department with a 5-day history of progressively worsening lower abdominal pain, along with vaginal discharge, fever, and dyspareunia (pain during intercourse). She also reports irregular spotting between her menstrual cycles. She has had multiple sexual partners in the past year and inconsistently uses condoms. On examination, she has a low-grade fever (38.3°C/100.9°F) and mild tachycardia. Abdominal palpation reveals tenderness in the lower quadrants, and a bimanual pelvic examination demonstrates: Cervical motion tenderness Bilateral adnexal tenderness Purulent cervical discharge Transvaginal ultrasound reveals thickened, fluid-filled fallopian tubes, consistent with salpingitis, but no tubo-ovarian abscess. Which clinical sign is most specific for the diagnosis of pelvic inflammatory disease (PID)?

A 13-year-old girl presents to her pediatrician for a routine well-child visit. Her mother reports that the patient is healthy and has no significant past medical history. She is up to date on all her childhood vaccinations and has no known allergies. The patient is not sexually active and lives in a household with two siblings, both of whom are older and fully vaccinated. During the visit, the pediatrician discusses the importance of the HPV vaccine for preventing cervical, anal, and oropharyngeal cancers, as well as genital warts. The patient’s mother decides to have her daughter vaccinated against HPV. What is the appropriate dosing schedule for HPV vaccination in a 13-year-old girl?

A girl presents to her pediatrician for a routine well-child visit. Her mother reports that the patient is healthy and has no significant past medical history. She is up to date on all her childhood vaccinations and has no known allergies. The patient is not sexually active and lives in a household with two siblings, both of whom are older and fully vaccinated. During the visit, the pediatrician discusses the importance of the HPV vaccine for preventing cervical, anal, and oropharyngeal cancers, as well as genital warts. The patient’s mother expresses concern about whether her daughter needs the vaccine since she is not currently sexually active. Which of the following is the best recommendation for this mother and girl?

A 27-year-old woman presents to the clinic and reports that she recently completed a 7-day course of antibiotics for a urinary tract infection. She is sexually active with one partner, uses oral contraceptives for birth control, and has no significant medical history. On physical examination, there is erythema of the vulva with thick, white, curdy discharge adherent to the vaginal walls. Vaginal pH is 4.0. A potassium hydroxide (KOH) preparation of the discharge reveals budding yeast and pseudohyphae. Which of the following correctly describes the clinical manifestations of vulvovaginal candidiasis?

A 46-year-old man with a known history of HIV infection presents to the clinic with complaints of painful swallowing (odynophagia) and a burning sensation in his mouth for the past two weeks. He also reports white patches on his tongue and inner cheeks, which he had attempted to scrape off unsuccessfully. He denies fever, chills, nausea, or vomiting but mentioned a 15-pound unintentional weight loss over the past month and persistent fatigue. He is not currently on antiretroviral therapy (ART) and stated he has been lost to follow-up for two years. He reports occasional alcohol use but denies smoking or recreational drug use.His past medical history is significant for several infectious disorders. On examination, the patient appears thin but alert. Oral examination reveals extensive white, curd-like plaques on the tongue, buccal mucosa, and the palate, which are difficult to remove and leave an erythematous, bleeding surface. The rest of the physical examination is unremarkable, with no lymphadenopathy or organomegaly. Laboratory investigations show a CD4+ T-cell count of 74 cells/μL. His viral load is 600,000 copies/mL. A potassium hydroxide (KOH) preparation of the oral lesions reveals budding yeast and pseudohyphae. Concerning the geography of this fungus, which of the following is true?

A 32-year-old woman presented to the outpatient clinic with complaints of vaginal itching and burning that had persisted for the past five days. She described a thick, white, “cottage cheese-like” vaginal discharge and reported significant redness and swelling of the vulva. These symptoms were progressively worsening, causing discomfort during intercourse, although there was no associated foul odor. She denied pain during urination or systemic symptoms such as fever or chills. The patient was sexually active with one partner and reported no recent new sexual contacts. Her last menstrual period occurred two weeks prior. The patient’s medical history was significant for recurrent urinary tract infections, and she had recently completed a 7-day course of antibiotics for cystitis. She denied any chronic medical conditions or regular medications aside from oral contraceptives. She reported no history of similar symptoms in the past. On physical examination, there was notable erythema and edema of the vulva, with some excoriations likely due to scratching. Speculum examination revealed thick, adherent, white plaques coating the vaginal walls. A bimanual examination showed no cervical motion tenderness, uterine tenderness, or adnexal masses. Microscopy of the vaginal discharge using 10% potassium hydroxide (KOH) preparation revealed budding yeast and pseudohyphae. Which of the following is a characteristic feature of this disorder concerning vaginal secretions?