Bacterial Vaginosis Flashcards
Definition – bacterial vaginosis? Discharge? Test? Microscopy findings? Treatment?
Excessive anaerobic bacteria in the vagina without inflammatory response
alkaline discharge; whiff test (KOH); clue cells; metronidazole
Three common infectious causes of vaginitis/vaginosis?
Bacterial vaginosis, trichomonas, candida
Candida vulvovaginitis? Discharge? Vaginal pH? Microscopy findings? Treatment
vaginal or vulvar infection caused by Candida,
Curd-like /lumpy discharge
PH < 4.5; pseudohyphae; fluconazole or imidazole cream
Trichomonas vaginitis - Discharge? pH? Test? Microscopy findings?
Frothy green discharge and intense inflammatory response
PH >4.5; semi positive Whiff test; Trichomonads
Fishy odor of bacterial vaginosis exacerbated by? (Why?)
Menses or intercourse; semen/blood is alkaline
Mechanism of KOH test?
Release of amines, causing fishy odor
Clue cells?
Coccoid bacteria adherent to external epithelial cells
Bacterial vaginosis is associated with what conditions?
- Genital tract infection – endometritis, PID
2. Pregnancy complications – preterm delivery, PPROM
Special instructions for patients taking metronidazole?
Avoid alcohol to prevent disulfiram reaction
Trichomonas can infect where?
- Vagina
- Urethra
- Skene glands
Unique sign of trichomonas infection?
Punctuate lesions on the cervix (strawberry cervix)
Treatment for Trichomonas? If resistant? If still resistant?
One time 2 g metronidazole for patient and partner
Seven days of treatment
Tinidazole (anti-protozoal agent)
Risk factors for candidal vaginitis (and mechanism)?
- Antibiotics – Lactobacilli and vagina inhibit fungal growth. diminished numbers after abx treatment
- Diabetes – suppresses immune function
Unique finding in Candida versus bacterial vaginosis/trichomonas?
Vaginal pH is normal (less than 4.5)
Treatment for vaginal candidiasis?
Oral Diflucan or topical imidazoles (terconazole, miconazole)
