A 35-year-old woman visits the office with complaints of yellowish vaginal discharge and increased urinary frequency for a week. She also complains of pain during urination. Past medical history is irrelevant. She admits to having multiple sexual partners in the past few months. Physical examination is within normal limits except for lower abdominal tenderness. Urine culture yields Chlamydia trachomatis. What is the most appropriate next step in the management of this patient?
AAcyclovir
BDoxycycline
CMetronidazole
DClindamycin
EBoric acid
A 28-year-old woman comes to the physician because of a 4-day history of lower abdominal pain and pain with urination. Five months ago, she was treated for gonococcal urethritis. She recently moved in with her newlywed husband. She is sexually active with her husband and they do not use condoms. Her only medication is an oral contraceptive. Her temperature is 37.5°C (99.7°F) and blood pressure is 120/74 mm Hg. There is tenderness to palpation over the pelvic region. Pelvic examination shows a normal-appearing vulva and vagina. Laboratory studies show: Leukocyte count 8,400/mm3 Urine pH 6.7 Protein trace WBC 60/hpf Nitrites positive Bacteria positive Which of the following is the most likely causal organism?
AEnterococcus faecalis
BKlebsiella pneumoniae
CNeisseria gonorrhoeae
DEscherichia coli
EStaphylococcus saprophyticus
A 24-year-old man presents with a painless genital ulcer for the past 2 weeks. He reports that he recently has been having unprotected sex with multiple partners. Past medical history is unremarkable. On physical examination, a single ulcer is present on the dorsal shaft of the penis which is circumscribed, indurated, and partially healed. There is moderate inguinal lymphadenopathy but no buboes. Which of the following tests would confirm the most likely diagnosis in this patient?
APerform a darkfield microscopic examination of a swab from the chancre
BSwab the chancre and perform a saline wet mount
CFluorescent treponemal antibody absorption (FTA-ABS) test
DFrei test
EVenereal Disease Research Laboratory (VDRL) test
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