An 18-year-old male college student is seen in the student health clinic for urinary frequency, dysuria, and urethral discharge. Which of the following is likely to explain his condition?
- Herpes simplex
- Escherichia coli urinary tract infection
- Chlamydial urethritis
- HIV infection
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The answer is c, Chlamydial urethritis.[1-3]
Urethritis in an adolescent male is almost always a sexually transmitted disease (STD), either gonococcal or nongonococcal urethritis (NGU). Chlamydia trachomatis is usually the causative agent in NGU. Less frequently, NGU can be caused by Ureaplasma urealyticum, Trichomonas vaginalis, and yeast. Herpes simplex can cause an NGU, but it is considerably less likely than C. trachomatis. Gonococcal culture and Gram stain are easily available; chlamydial culture may not be. Direct monoclonal antibody tests as well as enzyme immunoassay and molecular probe tests are alternative methods for Chlamydia identification, although they are less sensitive and less specific than chlamydial culture. Urine ligase testing for chlamydia and gonococcus is available. Serologic testing for syphilis should always be done, but in none of its normal presentations is urethral discharge common. Testing for HIV should be offered and safe sexual practices encouraged; HIV does not cause urethral discharge. Urinary tract infection is not associated with a urethral discharge.