I am going to answer the sample USMLE Step 1 Questions with Explanation. These questions are available at USMLE.org
Q- A 55-year-old woman comes to the clinic because of a 2-month history of increasingly severe vaginal pain and itching during sexual intercourse. She avoids intercourse with her husband because of the symptoms. She has been in a monogamous relationship with her husband for the past 25 years. She has type 2 diabetes mellitus. Her vital signs are within normal limits. Pelvic examination shows edematous and erythematous vaginal mucosa with white discharge. A photomicrograph of a vaginal smear is shown.
Which of the following is the most likely causal infectious agent?
(A) Candida albicans
(B) Chlamydia trachomatis
(C) Herpes simplex virus
(D) Human papillomavirus
(E) Trichomonas vaginalis
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Answer
The patient presents with symptoms consistent with vulvovaginal candidiasis (VVC), likely caused by Candida albicans. Symptoms include severe vaginal pain and itching, particularly during intercourse. Exam reveals edematous, erythematous vaginal mucosa with white discharge which is consistent with candidiasis. Risk factors include type 2 diabetes which predisposes to fungal infection. Vaginal smear shows budding yeast cells and pseudohyphae confirms this diagnosis of vulvovaginal candidiasis.
The correct answer is A