CC: “a very bad smelling discharge from my vagina” x3w S: …
CC: “a very bad smelling discharge from my vagina” x3w S: 29 y/o f, gravida 1, para 2 HPI: Hx 3w bad smelling discharge from vagina; thick, white; seems heavier in mornings. Social Hx: lives c boyfriend + 1 child in home, not working, denies exposure to smoke and denies smoking. Reports 1 regular sex partner and 7 lifetime partners. Experiences painful intercourse and severe cramping during menstruation. States sometimes uses condoms, but knows the importance of them. Med hx: + for 1 c-section delivery of twins, dx of Chlamydia in 2012, 2006, 2008, and dx of Gonorrhea in 2007. Pregnancy hx: twins at 21 weeks via C-section due to complications with pregnancy Menstrual hx: LMP “two weeks ago” c “heavy but normal flow” x5-7d, no bleeding/spotting since then, last PAP unknown, no mammogram O: PELVIC: ext. genitalia and vaginal walls pink, cervix intact, thick white foul spelling discharge noted in vaginal canal, lower pelvic tenderness noted on bimanual exam, uterus smooth and within normal limits, ovaries not palpable LABS: Gonorrhea and Chlamydia culture—results pending A: Dx: Bacterial vaginosis P: MEDICATION: antibiotic 500mg bid for 1 week Which of the following was one of the objective findings?