BACTERIAL VAGINOSIS

Question 1

What is bacterial vaginosis

Answer 1

Change in vaginal bioflora from lactobacilli to other
No inflammatory response

Question 2

Causes of bacterial vaginosis

Answer 2

1) VAGINAL PH CHANGE
2) ANTIBIOTICS USE
3) INTRAUTERINE DEVICE (IUD)
4) UNSAFE SEX
5) CHANGE IN VAGINAL BIOFLORA
6) DOUCHING
7) INFECTION
MYCOPLASMA HOMINIS
PEPTOSTREPTOCOCCUS
GARDNERELLA VAGINALIS
Gram negative
PREVOTELLA SP
Anaerobic gram negative
MOBILUNCUS
BACTERIODES SP
CLOSTRIDIUM SP

Question 3

Signs and symptoms or clinical manifestations of bacterial vaginosis

Answer 3

Increased vaginal discharge
Vaginal odor (fishy smell)
Vulvar irritation
Dysuria
Dyspareunia
Decreased estrogen

Question 4

Diagnosis of bacterial vaginosis

Answer 4

1) AMSEL CRITERIA
2) GRAM STAINING
3) MICROSCOPY
4) VAGINAL EXAM
No inflammation
Increased vaginal wall reflexes
Normal labia, introitus, cervix & cervical discharge
5) NUGENT’S CRITERIA >7

Question 5

Treatment of bacterial vaginosis

Answer 5

METRONIDAZOLE 500mg twice a day for 7days
CLINDAMYCIN 2% CREAM for 7days

Question 6

What is the normal vagina flora?

Answer 6

LACTOBACILLI

Question 7

What does the AMSEL CRITERIA include

Answer 7

Clue cells on a saline smear
pH>4.5
Thin, gray, homogeneous vaginal discharge
Positive whiff test

Question 8

What is a positive whiff test?

Answer 8

mixing vaginal fluid with a drop of KOH on a microscope slide causes release of volatile amines from the vaginal fluid.

Question 9

What is the NUGENT’S CRITERIA

Answer 9

Lactobacillus (score0-4)
Bacteroides/Gardnerella (score 0-4)
Mobiluncus (score0-2)

SO RESULTS OF:
0-3: Normal
4-6: Intermediate bacterial count
7-10: BV

Question 10

DIFFERENTIAL DIAGNOSIS OF BV

Answer 10

CHLAMYDIA
GONORRHEA
HERPES SIMPLEX VIRUS
CANDIDIASIS
CERVICITIS
TRICHOMONIASIS
VAGINITIS

Question 11

What is the main diagnostic criteria for BV

Answer 11

AMSEL’S CRITERIA 3 out of 4