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  #1  
Old 05-30-2012
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ObGyn Yellow-tinged mucopurulent cervical discharge

A 27-year-old woman who is sexually active complains of a malodorous vaginal discharge and a sore throat. Examination reveals an erythematous oropharynx and a yellow-tinged mucopurulent cervical discharge.
A. Chancroid
B. Chlamydia
C. Gonorrhea
D. Granuloma inguinale
E. Herpes simplex virus
F. Human papilloma virus
G. Molluscum contagiosum
H. Syphilis
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  #2  
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Originally Posted by tyagee View Post
A 27-year-old woman who is sexually active complains of a malodorous vaginal discharge and a sore throat. Examination reveals an erythematous oropharynx and a yellow-tinged mucopurulent cervical discharge.
A. Chancroid
B. Chlamydia
C. Gonorrhea
D. Granuloma inguinale
E. Herpes simplex virus
F. Human papilloma virus
G. Molluscum contagiosum
H. Syphilis
C.....????
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Originally Posted by tyagee View Post
A 27-year-old woman who is sexually active complains of a malodorous vaginal discharge and a sore throat. Examination reveals an erythematous oropharynx and a yellow-tinged mucopurulent cervical discharge.
A. Chancroid
B. Chlamydia
C. Gonorrhea
D. Granuloma inguinale
E. Herpes simplex virus
F. Human papilloma virus
G. Molluscum contagiosum
H. Syphilis
C,cant exclude B
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C.....????

Creamy white or yellow, odourless
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B. Chlamydia
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m clueless.
mcc is chlamydia though.
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Originally Posted by Novobiocin View Post
Creamy white or yellow, odourless

I doubted between B and C.....and finally chose C......
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I have a query......I got to know that gonococci can also cause infection of oropharynx though this is very rare.....but we also know MCC of vaginal discharge in developed countries is chlamydia......the above ques has both sore throat and vaginal discharge.....why answer cannot be gonococci.....??????
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Originally Posted by K06100 View Post
I have a query......I got to know that gonococci can also cause infection of oropharynx though this is very rare.....but we also know MCC of vaginal discharge in developed countries is chlamydia......the above ques has both sore throat and vaginal discharge.....why answer cannot be gonococci.....??????
CLINICAL MANIFESTATIONS OF GONORRHEA IN WOMEN
Cervical infection
Urethritis
Anorectal infection and proctitis
Oropharyngeal infection
Other mucosal sites of infection
Pelvic inflammatory disease

Risk factors for pharyngeal gonorrhea include [65,66]:

A history of fellatio or cunnilingus
A sexual partner with gonorrhea
Pregnancy

Gram stain of pharyngeal secretions cannot be used for the diagnosis of gonorrhea because non-pathogenic Neisseria species occur in the oropharynx. Culture remains the most practical method of diagnosing oropharyngeal gonorrhea.

CLINICAL MANIFESTATIONS OF Chlamydia
Cervicitis
Dysuria-pyuria syndrome due to urethritis
Perihepatitis (Fitzhugh-Curtis syndrome)
Pelvic inflammatory disease

uptodate
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  #10  
Old 05-31-2012
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Originally Posted by K06100 View Post
I have a query......I got to know that gonococci can also cause infection of oropharynx though this is very rare.....but we also know MCC of vaginal discharge in developed countries is chlamydia......the above ques has both sore throat and vaginal discharge.....why answer cannot be gonococci.....??????
There are many distractors in a question step. Sore throat is probably a dstractor. Anyway, it does not matter since you have follow the rule(s): Findings have more weight than history (although specific history has more weight than non-specific findings).
Specific findings/investigations have the most weight.

In the above question: The history/finding of malodorous vaginal discharge & yellow-tinged mucopurulent cervical discharge are quite specific. The findings on throat exam are non-specific--anything can cause erythematous oropharynx but only Chlamydia among the choices can cause malodorous vaginal discharge most commonly.
They might not even be linked but they put that in there knowing how our mind works. No-where in the question does it says that she is having oral sex.

Last edited by Novobiocin; 05-31-2012 at 07:22 AM.
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Originally Posted by bisho View Post
CLINICAL MANIFESTATIONS OF GONORRHEA IN WOMEN
Cervical infection
Urethritis
Anorectal infection and proctitis
Oropharyngeal infection
Other mucosal sites of infection
Pelvic inflammatory disease

Risk factors for pharyngeal gonorrhea include [65,66]:

A history of fellatio or cunnilingus
A sexual partner with gonorrhea
Pregnancy

Gram stain of pharyngeal secretions cannot be used for the diagnosis of gonorrhea because non-pathogenic Neisseria species occur in the oropharynx. Culture remains the most practical method of diagnosing oropharyngeal gonorrhea.

CLINICAL MANIFESTATIONS OF Chlamydia
Cervicitis
Dysuria-pyuria syndrome due to urethritis
Perihepatitis (Fitzhugh-Curtis syndrome)
Pelvic inflammatory disease

uptodate

thanx for sharing .....

but how does this explain my query.....???question vignette has --
1.sexually active
2.malodorous and mucopurulent discharge
3.sore throat
4.erythematous oropharynx

based on these 4 , explain why chlamydia and not gonococci is answer ?????
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Originally Posted by Novobiocin View Post
There are many distractors in a question step. Sore throat is probably a dstractor. Anyway, it does not matter since you have follow the rule(s): Findings have more weight than history (although specific history has more weight than non-specific findings).
Specific findings/investigations have the most weight.

In the above question: The history/finding of malodorous vaginal discharge & yellow-tinged mucopurulent cervical discharge are quite specific. The findings on throat exam are non-specific--anything can cause erythematous oropharynx but only Chlamydia among the choices can cause malodorous vaginal discharge most commonly.
They might not even be linked but they put that in there knowing how our mind works.

Yep...I think this is a type of question where u dont have to think on the basis of info in the vignette but by the MCC .......!!!!!
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u dont hv to pick certain ans at the end, cuz in the real life or real exam u will never encounter question like this.
though kkeep in mind chlamydia is more common
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Chlamydial Pharyngitis?

Quote:
Among 118 women who were sexual contacts of men with nongonococcal urethritis, the practice of fellatio correlated with symptoms of a sore throat. Oropharyngeal cultures for Chlamydiu trachomatis were negative in all women, including 11 women who practiced fellatio and whose partners were known to have nongonococcal urethritis due to C. trachomatis. The study does not support a major role for C. trachomatis as a cause of sore throat in women who practice fellatio.
Current Concepts in Bacterial Sexually Transmitted Diseases

Quote:
Chlamydial infection is a cause of acute proctitis in homosexual men who practice receptive rectal intercourse, and pharyngeal infection with C. trachomatis has been demonstrated in 3% to 6% of men and women with a history of recent orogenital contact [16,17]. Chlamydial genital infections are closely related to infection with gonorrhea in clinical manifestations. Both organisms can infect the transitional epithelium of the urethra and can extend to the epididymis, the endocervix, the endometrium, salpinx, peritoneum, and the rectum [18,19]. They can produce extensive subepithelial inflammation, epithelial ulceration, and scarring.
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  #15  
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Originally Posted by bisho View Post
u dont hv to pick certain ans at the end, cuz in the real life or real exam u will never encounter question like this.
though kkeep in mind chlamydia is more common
ok .....I'll remember ......thanx
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