A. Vaginal Infections Flashcards
What are the 3 main vaginal infections listed in order of prevalence?
BV
Candida/Yeast
Trich
What are the different subtypes of Candidiasis listed in order or prevalence?
Albicans
Tropicalis
Glabrata
[Think GTA]
Which subtypes of Candidiasis tend to be more resistant to treatment & therefore present as chronic infections more often?
Tropicalis & Glabrata
What are the risk factors for Candidiasis?
- Immunocomprimised
- Preg/Oral contraceptives (increase glycogen)
- Diabetes
- Antibiotics like doxycycline or tetracycline for acne (kill normal flora)
- Corticosteroids
Which of the 3 vaginal infections present with pruritis & erythema?
Candida & sometimes Trich (NOT BV)
Which vaginal infection presents with a green/yellow frothy discharge? Cottage cheese discharge? Thin gray discharge?
Trich
Candida
BV
Which vaginal infection has a fishy smell? What can increase the intensity of the smell?
BV
Bases (KOH or semen)
What is normal vaginal pH? Which vaginal infection(s) has/have normal pH? Altered pH?
Normally acidic ~4
Normal = candida
High (less acidic) = BV & Trich
Which vaginal infection presents with Satellite Lesions?
Candida
What are symptoms of Candida?
Vuvla & vaginal erythema/pruritis/edema
Satellite lesions in groin
Cottage cheese discharge
Lab findings for Candida?
Normal pH
Hyphae & budding yeast on KOH
Culture only done with recurrent
Which vaginal infection(s) use(s) KOH in the lab for diagnosis?
BV
Candida
Preventative measures for Candida?
No bubble baths
No douching (additives)
Good hygiene
Cotton underwear (instead of nylon which doesn’t breathe)
Candida Treatment?
[On Test]
Topical Miconazole (monostat) or Clotrimazole Single dose oral Fluconazole (Diflucan)
Which of the vaginal infections tend to create symptoms in the entire groin region? Which can have systemic symptoms?
Candida
BV
How is trichomonas spread?
True STD Extremely contagious (1 encounter = 90%) Incubation period = hours
Which vaginal infections present with similar symptoms to UTI?
Trich
What are the symptoms in Trich?
\+/- Erythema/pruritis Strawberry Cervix (punctate hemorrhages) Yellow-green frothy discharge Dysuria Dyspareuria
What are the lab findings for Trich?
High pH
Motile organisms with tail on saline prep
Seen on pap smear
How often are cultures used for vaginal infections?
Rarely
Only if chornic Candidiasis
What are the sensitivities of the different Trich lab tests?
~70% Pap & saline
~90% culture (rarely done)
What microorganisms from vaginal secretion or PAP smear can appear motile?
Trich
Sperm
Trich treatment?
Single 2g dose of Metronidazole (higher compliance that longer course)
What preventative measures should be taken with Trich?
Treat partner
Use condoms until the end of treatment
Which drug has serious side effects related to alcohol consumption?
Metronidazole
Blocks breakdown of alcohol –> build up of acid aldehyde –> really sick
What are the subtypes of BV listed in order of prevalence?
Tends to be polymicrobial
Anaerobes
Gardinella Vaginalis
Mobiluncis
Mycoplasma
What is the main defense against BV normally?
Lactobacilli normal flora –> acid enviroment
Risk factors for BV?
Anything that effects the vaginal enviroment or normal flora
Menses
Douching
Intercourse
Antibiotics
Symptoms of BV?
Fishy odor
Thin gray discharge
Lab tests for BV?
+ amine/whiff test with KOH
Saline microscopy –> clue cells, less lactobacilli, increased cocci & bacilli
High pH
Which vaginal infection presents with Clue cells?
BV
Complications of BV?
PID
Postoperative pelvic pain
Preterm delivery
Intrapartum/postpartum infection
BV treatment?
Oral metronidazole twice daily for 7 days
Present with green-yellow frothy discharge, pruritis & increased pH. Treatment?
[On Test]
Trich –> single dose (4 pills) of metronidazole
What tests are generally done for trich in a primary care setting?
[On test]
Saline & PAP
NOT culture
Thin gray discharge, fishy odor & no inflammation/pruritis. Diagnosis?
[On test]
BV
Which vaginal infection(s) use(s) saline in the lab for diagnosis?
BV & Trich
Diagnostic test for Candida?
[On test]
KOH prep looking for hyphae & budding yeast
