DrVirgo
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A 25 y/o G2 P1 white female at 8 weeks gestation presents with profuse vaginal discharge for the past 4 days. She is sexually active and reports that she was treated for Trichomonas infection 3 months ago. Speculum exam reveals a grayish foul-smelling discharge without erythema or edema of the vaginal walls or vulva. Saline wet drop examination reveals numerous epithelial cells coated with organisms but there are no WBCs. Based on these findings what is the most appropriate treatment for this patient?
A. Oral Metronidazole
B. Clindamycin cream
C. Oral Doxycycline
D. Fluconazole cream
E. Clotrimazole cream
(Hint: diagnosis is BV with Garnerella vaginalis)
-Which of these drugs are safe in pregnancy and which are not?
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| NE
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A
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd...
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| DrVirgo
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Correct answer: B.
According to UW: Systemic Metronidazole is teratogenic in the first trimester.
Metro or clindamycin cream in pregnancy is ok
However Kap says: "Metronidazole is safe to use during pregnancy, including the first trimister"
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| NE
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Kaplan is right so the q has 2 right answers:
"From 7 studies six were prospective and included 253 women exposed to the drug in the first trimester of pregnancy; one was retrospective and reported on 1083 exposed women. CONCLUSION: Metronidazole does not appear to be associated with an increased teratogenic risk."
If I have to choose the best option I would chose topical treatment anyway but is a tricky q.
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| robin082006
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Trust in Kaplan,
Kaplan notes are written by famous professors of famous universities.
I heard that UW are written by doctors who are experienced by USMLE exams, that'why its content is very similar to the real exam, but some information is vague and not consistent with the book.
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| DrVirgo
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Thanks NE and Robin.
I do trust the notes, infact they are my main source of study material, it's just that I have found mistakes before so I like to confirm with other sources: UW, Harrisons, and you guys! 
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| robin082006
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You will find some mistakes when doing UW, and lots of vague questions.
People says UW harder than Kaplan, I don't think so. It is harder than Kaplan because its questions do not give enough info for diagnosing a disease
vice versa, Kaplan questions are very standard.
I finished both qbanks and realized this.
Good luck.
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| DrVirgo
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Thanks Robin, I agree with you that sometimes UW doesn't give enough info for answering the question... They expect us to make great leaps and just "assume" certain things. They also include many small details or factoids which are really extraneous information or minute details which is really frustrating at times... Thus this is why the questions are harder for me at least. Q-bank is more straight forward and they don't really ask anything thats outside the notes... So i like to mix uw with q-bank to get a more diverse set of questions. just my opinion.
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| Geroo
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I'm doing usmle world only do u think that kaplan qbank is a must?
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