American Board of Internal Medicine (ABIM) Certification Practice Exam

Which symptom is not typically associated with Trichomonas infection?

1. Itching

2. Foul-smelling discharge

3. Abdominal pain

4. Painless lesions

The correct answer is: Painless lesions

Trichomonas infection, caused by the protozoan Trichomonas vaginalis, primarily presents with specific symptoms in infected individuals. The most common symptoms include itching, foul-smelling discharge, and abdominal pain, especially in women. Itching often occurs due to irritation of the vaginal or urethral lining as the organism disrupts the normal flora. A foul-smelling discharge is noted as Trichomonas can produce a discharge that is often described as frothy or profuse and has a distinct odor. Abdominal pain can also manifest, particularly in cases where there is associated vaginitis or pelvic inflammatory disease. Painless lesions are not characteristic of Trichomonas infections. Lesions are more typical of other sexually transmitted infections such as herpes or syphilis, which can present with painful or painless ulcers, while lesions associated with Trichomonas are relatively uncommon and usually not a defining feature of the infection. Thus, the absence of painless lesions in the presentation of Trichomonas infection identifies them as a symptom not typically associated with this particular infection.