Question 1

Q: The "whiff test" is positive in which of the following conditions?

Trichomonas vaginitis. **Explanation:** The **Whiff test** (amine test) is a diagnostic maneuver used to identify vaginal infections characterized by the production of volatile amines. It involves adding a drop of 10% Potassium Hydroxide (KOH) to a sample of vaginal discharge. A "positive" result is the immediate release of a pungent, fishy odor. **Why Trichomonas vaginitis is correct:** In **Trichomoniasis**, the anaerobic environment and the presence of the parasite lead to the production of amines (like putrescine and cadaverine). When KOH is added, these amines are volatilized, resulting in a positive whiff test. While the whiff test is most classically associated with **Bacterial Vaginosis (BV)**—where it is a component of the Amsel criteria—it is also frequently positive in Trichomoniasis due to the similar alkaline pH and anaerobic overgrowth. Among the given options, Trichomonas is the only condition that typically yields this result. **Why the other options are incorrect:** * **Candidiasis:** Characterized by a thick, curd-like discharge with a normal (acidic) pH. The whiff test is negative. KOH is used here instead to visualize pseudohyphae and spores. * **Chlamydial infection:** This is primarily a cervicitis. It does not typically alter the vaginal flora or produce volatile amines. * **HSV infection:** Presents with painful vesicles or ulcers; it is a viral infection and does not produce a fishy odor upon addition of KOH. **High-Yield Clinical Pearls for NEET-PG:** * **Amsel Criteria for BV:** (1) Thin, homogenous discharge, (2) pH >4.5, (3) **Positive Whiff test**, (4) Presence of **Clue cells** (most specific). * **Trichomoniasis:** Look for "Strawberry cervix" (colpitis macularis) and motile flagellates on wet mount. * **Vaginal pH:** Normal is 3.8–4.5. pH is elevated (>4.5) in both BV and Trichomoniasis, but remains normal in Candidiasis.

Question

The "whiff test" is positive in which of the following conditions?

Accepted Answer

Trichomonas vaginitis

Answer

Candidiasis

Answer

Chlamydial infection

Answer

Herpes simplex virus (HSV) infection

Gynecological Disorders — MCQs

Gynecological Disorders — MCQs

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