American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is indicated by copious, malodorous, pale yellow or gray frothy discharge with vulvar itching, burning, and postcoital bleeding?

1. Bacterial vaginosis

2. Trichomoniasis

3. Candidiasis

4. Chlamydia infection

The correct answer is: Trichomoniasis

The described condition is indicative of trichomoniasis, which is characterized by copious, malodorous, pale yellow or gray frothy discharge. This discharge often accompanies symptoms such as vulvar itching, burning, and can include postcoital bleeding. Trichomoniasis is caused by the protozoan parasite Trichomonas vaginalis, which can lead to inflammation and a range of distinctive symptoms, often making the discharge appear frothy and unpleasant. Patients with trichomoniasis may also experience vulvovaginal irritation, which contributes to the itching and burning sensations. The malodorous nature of the discharge is a key distinguishing feature, often prompting patients to seek medical attention. Additionally, the association with postcoital bleeding points toward inflammation of the vaginal walls or cervix due to the infection. While other conditions such as bacterial vaginosis or candidiasis can cause vaginal discharge and similar symptoms, the specific characteristics of the discharge in this case—namely its frothy, malodorous quality—are strongly associated with trichomoniasis. Candidiasis typically leads to a thick, white, cottage cheese-like discharge and is not associated with a foul odor or postcoital bleeding. Chlamydia infection may also cause vaginal