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NBME 17 Answers

nbme17/Block 0/Question#0 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Gonorrhea ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—waitingonprometric(264)
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This lady likely has pelvic inflammatory disease. PID occurs when sexually transmitted bacteria travel from the vagina to the uterus, fallopian tubes, or ovaries.

Symptoms of PID include--pain in the lower abdomen and pelvis, abnormal vaginal discharge, abnormal vaginal bleeding, pain during intercourse, fever and/or chills, and painful/frequent urination.

Causes of PID most commonly include gonorrhea and chlamydia. Risk factors include sexual activity, esp. with multiple partners or without a condom. Having a history of PID or STI is also a risk factor for PID.

Complications of PID include: ectopic pregnancy, infertility, tubo-ovarian abscess.

Our patient has abdominal pain + fever + vaginal discharge + high WBC count. She also has a hx of ectopic pregnancy 1 year ago, which could mean she had a bout of PID, putting her at risk for a second.

https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594

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waitingonprometric  I forgot to say--> she has PID, therefore, most likely cause of PID from our list of answer choices = gonorrhea. +4
iceberglettuce  In addition, cervical motion tenderness (on exam) is highly suggestive of PID. +1
hchairston  Bacterial vaginosis is not painful, vaginitis is painful. So there is an easy way to r/o bacterial vaginosis. FA 2019 page 181 +



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