10 GYN infections

Question 1

Toxic shock syndrome

1. sx
2. dx
3. tx

Answer 1

1. very sick. Fever>102, N/V/diarrhea,

specific sx: erythematous macular rash, desquamation of palms/soles

2. all other tests negative. Do speculum exam, find tampon.
3. Naf for Staph. Or Vanc. (remember, it’s the toxin and not the bug causing sx)

Question 2

Candida vulvovaginitis:

risk factors (4)

Answer 2

1. DM
2. OCPs
3. steroids
4. recent Abx

Question 3

Cervicitis

1. sx
2. dx
3. tx

Answer 3

1. cervical motion tenderness, cervical d/c, no PID sx (no abd pain, no fever/leukocytosis)
2. PE, PCR (GC/Chlam), wet prep if d/c
3. Ceftriaxone + Doxy

Question 4

Acute PID

1. sx
2. dx
3. tx

Answer 4

“cervicitis plus”

1. Abdominal pain, fever/leukocytosis, CMT, coital pain, cervical d/c, N/V
2. PE, GC/Chla PCR
3. Ceftriaxone + Doxy

Question 5

Chronic PID

1. sx
2. dx
3. tx

Answer 5

1. chronic abd pain, adnexal mass (abscess). CMT, Adnexal tenderness. Fever
2. You feel adnexal mass (abscess). Get U/S or CT to see it
3. Vaginal flora, so use Amp-Gent-MTZ. If sx don’t improve, drain abscess. If peritonitis, ex-lap.

Question 6

Trich

1. discharge
2. microscope
3. pH
4. tx

Answer 6

1. Yellow-green, frothy
2. motile, flagellated protozoa. Saline prep
3. >5
4. Metronidazole, PO only. Both partners!

Question 7

BV/Gardnerella

1. discharge
2. microscope
3. pH
4. tx

Answer 7

1. Gray-white discharge. Fishy odor, KOH whiff test makes odor worse.
2. Clue cells, saline prep
3. >5
4. metronidazole, topical before systemic.

Question 8

Candida

1. discharge
2. microscope
3. pH
4. tx

Answer 8

1. ‘cottage cheese’ sticky white, adherent to wall
2. KOH prep, pseudohyphae
3. pH 4 (normal for vagina)
4. topical antifungal (eg fluconazole), then oral