RN Nursing · Urinary Tract Infections · Practice question
An NP is assessing a patient who reports a change in their vaginal discharge and post-coital bleeding, which of the following suspected genital infections can lead to pelvic inflammatory disease (PID), tubal factor Infertility, and ectopic pregnancy?
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✓
Chlamydia.
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Syphilis.
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Trichomoniasis.
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Bacterial vaginosis.
Answer & explanation
Correct: Chlamydia.
Chlamydia trachomatis is the most common cause of the serious reproductive complications described: pelvic inflammatory disease, tubal factor infertility, and ectopic pregnancy. Chlamydia often presents with changes in vaginal discharge and post-coital bleeding due to cervicitis, and because it is frequently asymptomatic in early stages, it frequently goes untreated. Ascending infection from the cervix to the uterus, fallopian tubes, and pelvic structures causes PID. Repeated or untreated episodes lead to tubal scarring, which impairs normal ovum transport — resulting in tubal factor infertility and dramatically increasing the risk of ectopic implantation. Syphilis, caused by Treponema pallidum, presents with distinct stages including painless chancre and systemic manifestations; it does not characteristically lead to tubal factor infertility or ectopic pregnancy. Trichomoniasis, a protozoan infection, causes frothy, malodorous discharge and vulvovaginal irritation, but it does not ascend to cause PID or tubal damage in the way chlamydia does. Bacterial vaginosis is a disruption of normal vaginal flora and is associated with preterm labor in pregnancy, not with PID or ectopic pregnancy as a direct cause. Chlamydia is therefore the pathogen most closely linked to all three reproductive sequelae listed.
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