WBR0700

Author	[[PageAuthor::Mohamed Moubarak, M.D. [1]]]
Exam Type	USMLE Step 3
Main Category	Emergency Room
Sub Category	Infectious Disease
Prompt	A 27 years old female comes to ER, complaining of dysuria and mucopurulent discharge per urethra, she had these symptoms for 5 days. She is sexually active, with no other medical problems. On examination, there is no other positive finding, except for the mucopurulent discharge. What is the most likely diagnosis?
Answer A	Chlamydia
Answer A Explanation	Incorrect Chlamydia infection is characterized by watery or mucoid urethral discharge.
Answer B	Gonorrhea
Answer B Explanation	Incorrect Gonorrheal infection is characterized by purulent discharge.
Answer C	Chlamydia /Gonorrhea
Answer C Explanation	Correct Coexistence of Chlamydia and gonorrhea infection is the usual case, with characteristic mucopurulent discharge.
Answer D	Syphilis
Answer D Explanation	Incorrect Syphilis is characterized by papular lesion on genitalia, which later on ulcerate.
Answer E	Lympho granuloma venerum
Answer E Explanation	Incorrect Patients usually presented by bilateral inguinal lymph node with draining sinus.
Right Answer	C
Explanation	Chlamydia and gonorrhea infection are very often coexist, differentiation between them clinically is difficult. Treatment should be directed to both of them. Educational Objective: References:
Approved	No
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