This page is dedicated to organizing various examples of standardized exam questions whose answer is bacterial vaginosis. While this may seem a odd practice, it is useful to see multiple examples of how bacterial vaginosis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 22 year old woman comes to the clinic with complains of foul-smelling vaginal discharge. She explains that she has recently been sexually active with a new partner for the past few weeks. On physical exam she has thin, whitish/gray vaginal discharge. There is no discharge form the cervical os, and there is no adnexal or cervical motion tenderness. The rest of the patient’s exam is unremarkable. The pH of the vaginal fluid is 5.0. The addition of KOH to the vaginal discharge produces a fish odor. A wet mount of the fluid reveals many epithelial cells that have visibly adherent bacteria on them. No neutrophils are seen on wet mount. What is the patient’s likely diagnosis?
Explanation: elevated vaginal pH + positive “whiff” test + “clue cells” = bacterial vaginosis
Question # 2
A 27 year old G2P1 woman is at 13 weeks gestation when she comes to the clinic. She complains of foul smelling vaginal discharge. She is sexually active and explains that she has not had any previous issues. Speculum examination reveals a grayish, foul-smelling vaginal discharge. There is no erythema or edema noted on the vaginal walls or the vulva. The patient denies any cervical or adnexal tenderness during the exam. A saline wet mount reveals the presence of numerous epithelial cells coated with bacteria. There are no white blood cells seen. What is the most likely diagnosis in this patient?
Explanation: “clue cells” seen on wet prep = bacterial vaginosis
Question # 3
A 23 year old woman comes to the clinic because of difficulty vaginal itching and discharge. She has been sexually active with 2 male partners this past year, and always uses condoms for contraception. Physical examination shows a unremarkable external genitalia and a gray thin vaginal discharge with a pH of 5.1. A wet mount of the vaginal discharge shows the presence of squamous epithelial cells that are coated with bacteria. What is the likely diagnosis in this patient?
Explanation: “clue cells” seen on wet prep = bacterial vaginosis (other clues present but this detail is all you need to get this question correct).
Page Updated: 10.05.2016