North American Registry of Midwives (NARM) Practice Exam

What condition is associated with a pattern of petechiae on the vaginal walls and cervix?

1. Bacterial vaginosis

2. Trichomoniasis

3. Candidiasis

4. Vulvovaginal thrush

The correct answer is: Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. One of its notable clinical manifestations is a pattern of petechiae, which are small, pinpoint red or purple spots, on the vaginal walls and cervix. This occurs due to the inflammatory response elicited by the infection, which can cause capillary rupture and bleeding, leading to the visible petechiae. The petechial pattern associated with trichomoniasis can be an important clinical indicator for midwives and healthcare providers when assessing patients with vaginal discomfort, unusual discharge, or other related symptoms. Recognizing this sign allows for prompt diagnosis and effective treatment, preventing further complications and facilitating better reproductive health outcomes. In contrast, other conditions listed do not typically present with petechiae on the vaginal walls or cervix. Bacterial vaginosis primarily involves a fishy odor and changes in vaginal discharge, candidiasis presents with itching and thick white discharge, and vulvovaginal thrush refers to a yeast infection that usually does not lead to petechiae. Understanding the specific signs and symptoms associated with different conditions helps in accurate diagnosis and management in midwifery practice.