Check out today’s Step 2 CK Qmax Question Challenge.
Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).
A 2-year-old girl is brought to the clinic by her mother, who says her daughter is experiencing vaginal discharge and discomfort. Over the past few hours, the mother noticed her daughter holding her genital area and observed bloody spotting on her underwear. The girl is otherwise healthy, lives at home with her parents, and attends day care. The mother mentions that she recently started potty training her daughter. The patient’s temperature is 37.2°C (99.0°F), blood pressure is 110/70 mm Hg, and pulse is 70/min. The girl appears well nourished. On external genital examination, the vulva appears red and irritated, and a reddish tinged, feculent discharge is noted in the introitus. The remaining results of physical examination are benign, with no evidence of bruises, contusions, fractures, or edema noted on her body.
Which of the following is the most appropriate next step in management?
A. Clean the area with soap and water and discuss proper hygiene and potty training tips with parents
B. Contact social services and separate mother from the child
C. Order follicle-stimulating and luteinizing hormone levels
D. Perform speculum examination and culture vaginal discharge
E. Start antibiotic treatment
Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.