NR602 Week 7 i-Human Case Actual Exam 2026/2027
– Infectious Vulvovaginitis – Final Diagnosis –
Chamberlain University – Detailed Rationales – Pass
Guaranteed – A+ Graded
History Taking & Differential Diagnosis
Q1: A 24-year-old graduate student presents to the clinic complaining of increased
vaginal discharge for the past week. She describes the discharge as thick, white, and
clumpy, like cottage cheese, with intense itching and burning. She recently finished a
course of amoxicillin for a sinus infection. Which of the following organisms is most
likely responsible for her symptoms?
A. Gardnerella vaginalis
B. Candida albicans
C. Trichomonas vaginalis
D. Prevotella bivia
Correct Answer: B
Rationale: The description of thick, white, cottage cheese-like discharge combined with
intense pruritus and recent antibiotic use is classic for vulvovaginal candidiasis, most
commonly caused by Candida albicans. Gardnerella vaginalis causes bacterial
vaginosis with thin, gray discharge and minimal itching, while Trichomonas causes
frothy, yellow-green discharge. Prevotella is associated with BV but not with this
presentation.
Q2: When obtaining a focused history for a patient with suspected infectious
vulvovaginitis, which of the following elements is most critical to ask about when trying
to differentiate between bacterial vaginosis and a candidal infection?
A. Recent international travel history
B. History of cesarean section delivery
C. Characteristics of vaginal discharge and odor
,D. Family history of ovarian cancer
Correct Answer: C
Rationale: The characteristics of discharge (color, consistency, odor) along with
associated symptoms like itching versus odor are the primary differentiators between
BV (thin, gray, fishy odor) and candidiasis (thick, white, curdy, no odor). Travel history,
delivery method, and family cancer history do not contribute to differentiating these
common infections.
Q3: A 32-year-old woman presents with vaginal itching and a thin, grayish-white
discharge. She mentions that she has been douching twice weekly to "feel clean" and
has had two new sexual partners in the past month. Which of these risk factors most
significantly predisposes her to bacterial vaginosis?
A. Use of oral contraceptive pills
B. Frequent douching practices
C. Having only two lifetime sexual partners
D. Regular exercise routine
Correct Answer: B
Rationale: Frequent douching disrupts the normal vaginal flora and significantly
increases the risk of bacterial vaginosis by altering the vaginal pH and removing
protective lactobacilli. While multiple partners can increase STI risk, douching is a direct
behavioral risk factor for BV. Oral contraceptives and exercise are not risk factors for BV.
Q4: During the history taking portion of your i-Human case, you learn that a patient is
currently in her luteal phase of the menstrual cycle and has uncontrolled diabetes with
recent antibiotic use for a UTI. Which type of vulvovaginitis is she at highest risk for
developing given this combination of factors?
A. Bacterial vaginosis
B. Vulvovaginal candidiasis
C. Desquamative inflammatory vaginitis
D. Atrophic vaginitis
Correct Answer: B
Rationale: Uncontrolled diabetes (hyperglycemia), recent antibiotic use, and the luteal
phase (increased progesterone) all create environments favorable for Candida
overgrowth. These are well-established risk factors for vulvovaginal candidiasis.
, Atrophic vaginitis occurs in hypoestrogenic states, and desquamative inflammatory
vaginitis is rare and not associated with these factors.
Q5: A patient reports that her vaginal symptoms worsen during her menses and improve
mid-cycle. She also notes dyspareunia and postcoital bleeding. Which condition should
be highest on your differential diagnosis list given this pattern?
A. Trichomoniasis
B. Cytolytic vaginosis
C. Bacterial vaginosis
D. Candidiasis
Correct Answer: A
Rationale: Trichomoniasis often worsens during menses due to changes in vaginal pH
and bleeding, and it commonly causes dyspareunia and postcoital bleeding due to the
inflammatory nature of the infection and possible cervical involvement (strawberry
cervix). Candidiasis typically worsens premenstrually, not during menses.
Q6: Which of the following history findings would be most concerning for a mixed
infection involving both bacterial vaginosis and vulvovaginal candidiasis?
A. Patient reports thin, gray discharge with fishy odor but also experiences severe vulvar
itching and burning
B. Patient has regular 28-day menstrual cycles with mild cramping
C. Patient uses barrier contraception consistently with a long-term partner
D. Patient maintains a low-carbohydrate diet and exercises regularly
Correct Answer: A
Rationale: Mixed infections present with overlapping features—in this case, the thin gray
discharge with odor suggests BV, while the severe itching and burning suggest
candidiasis. The combination of these symptom clusters raises suspicion for
concurrent infections rather than a single pathogen.
Q7: When taking a sexual history for a patient presenting with suspected
trichomoniasis, which question is most essential to ask in order to guide treatment
decisions?
A. "What is your favorite sexual position?"
B. "Do you have any history of sexual trauma?"
C. "Are your partners male, female, or both, and can they be contacted for treatment?"
– Infectious Vulvovaginitis – Final Diagnosis –
Chamberlain University – Detailed Rationales – Pass
Guaranteed – A+ Graded
History Taking & Differential Diagnosis
Q1: A 24-year-old graduate student presents to the clinic complaining of increased
vaginal discharge for the past week. She describes the discharge as thick, white, and
clumpy, like cottage cheese, with intense itching and burning. She recently finished a
course of amoxicillin for a sinus infection. Which of the following organisms is most
likely responsible for her symptoms?
A. Gardnerella vaginalis
B. Candida albicans
C. Trichomonas vaginalis
D. Prevotella bivia
Correct Answer: B
Rationale: The description of thick, white, cottage cheese-like discharge combined with
intense pruritus and recent antibiotic use is classic for vulvovaginal candidiasis, most
commonly caused by Candida albicans. Gardnerella vaginalis causes bacterial
vaginosis with thin, gray discharge and minimal itching, while Trichomonas causes
frothy, yellow-green discharge. Prevotella is associated with BV but not with this
presentation.
Q2: When obtaining a focused history for a patient with suspected infectious
vulvovaginitis, which of the following elements is most critical to ask about when trying
to differentiate between bacterial vaginosis and a candidal infection?
A. Recent international travel history
B. History of cesarean section delivery
C. Characteristics of vaginal discharge and odor
,D. Family history of ovarian cancer
Correct Answer: C
Rationale: The characteristics of discharge (color, consistency, odor) along with
associated symptoms like itching versus odor are the primary differentiators between
BV (thin, gray, fishy odor) and candidiasis (thick, white, curdy, no odor). Travel history,
delivery method, and family cancer history do not contribute to differentiating these
common infections.
Q3: A 32-year-old woman presents with vaginal itching and a thin, grayish-white
discharge. She mentions that she has been douching twice weekly to "feel clean" and
has had two new sexual partners in the past month. Which of these risk factors most
significantly predisposes her to bacterial vaginosis?
A. Use of oral contraceptive pills
B. Frequent douching practices
C. Having only two lifetime sexual partners
D. Regular exercise routine
Correct Answer: B
Rationale: Frequent douching disrupts the normal vaginal flora and significantly
increases the risk of bacterial vaginosis by altering the vaginal pH and removing
protective lactobacilli. While multiple partners can increase STI risk, douching is a direct
behavioral risk factor for BV. Oral contraceptives and exercise are not risk factors for BV.
Q4: During the history taking portion of your i-Human case, you learn that a patient is
currently in her luteal phase of the menstrual cycle and has uncontrolled diabetes with
recent antibiotic use for a UTI. Which type of vulvovaginitis is she at highest risk for
developing given this combination of factors?
A. Bacterial vaginosis
B. Vulvovaginal candidiasis
C. Desquamative inflammatory vaginitis
D. Atrophic vaginitis
Correct Answer: B
Rationale: Uncontrolled diabetes (hyperglycemia), recent antibiotic use, and the luteal
phase (increased progesterone) all create environments favorable for Candida
overgrowth. These are well-established risk factors for vulvovaginal candidiasis.
, Atrophic vaginitis occurs in hypoestrogenic states, and desquamative inflammatory
vaginitis is rare and not associated with these factors.
Q5: A patient reports that her vaginal symptoms worsen during her menses and improve
mid-cycle. She also notes dyspareunia and postcoital bleeding. Which condition should
be highest on your differential diagnosis list given this pattern?
A. Trichomoniasis
B. Cytolytic vaginosis
C. Bacterial vaginosis
D. Candidiasis
Correct Answer: A
Rationale: Trichomoniasis often worsens during menses due to changes in vaginal pH
and bleeding, and it commonly causes dyspareunia and postcoital bleeding due to the
inflammatory nature of the infection and possible cervical involvement (strawberry
cervix). Candidiasis typically worsens premenstrually, not during menses.
Q6: Which of the following history findings would be most concerning for a mixed
infection involving both bacterial vaginosis and vulvovaginal candidiasis?
A. Patient reports thin, gray discharge with fishy odor but also experiences severe vulvar
itching and burning
B. Patient has regular 28-day menstrual cycles with mild cramping
C. Patient uses barrier contraception consistently with a long-term partner
D. Patient maintains a low-carbohydrate diet and exercises regularly
Correct Answer: A
Rationale: Mixed infections present with overlapping features—in this case, the thin gray
discharge with odor suggests BV, while the severe itching and burning suggest
candidiasis. The combination of these symptom clusters raises suspicion for
concurrent infections rather than a single pathogen.
Q7: When taking a sexual history for a patient presenting with suspected
trichomoniasis, which question is most essential to ask in order to guide treatment
decisions?
A. "What is your favorite sexual position?"
B. "Do you have any history of sexual trauma?"
C. "Are your partners male, female, or both, and can they be contacted for treatment?"
