USMLE Step 1

A 43 year-old female comes into the office complaining of a green vaginal discharge for 4 days. She states that it has been extremely itchy and is very concerned because her husband says, "it smells like a dead animal down there." What is the best drug to treat her condition?

A) Miconazole
B) Doxycycline
C) Ceftriaxone
D) Metronidazole
E) Penicillin G

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Answer: D Metronidazole. This woman has Trichomoniasis. Trichomoniasis vaginalis characteristics include yellow, green discharge, pH >4.5, putrid odor, severe pruritus, and excoriations from scratching. Treatment should also be started on sexual partners.