Bacterial vaginosis

Question 1

aerobic or anaerobic bacteria?

Answer 1

anaerobic

Question 2

cause

Answer 2

loss of lactobacilli

Question 3

is BV an STI?

Answer 3

no

Question 4

lactobacilli

Answer 4

main component of health vaginal bacterial flora

produce lactic acid - pH under 4.5

Question 5

lactobacilli in BV

Answer 5

reduced which allows for pH to rise

alkaline - anaerobes multiply

Question 6

anaerobic bacteria associated with BV

Answer 6

gardnerella vaginalis
mycoplasma hominis
prevotella

Question 7

risk factors

Answer 7

multiple sexual partners 
excess vaginal clearing - douching, washes 
recent antibiotics 
smoking 
copper coil

Question 8

who does BV occur less frequently in?

Answer 8

combined pill

condoms

Question 9

important when taking a history

Answer 9

fishy smelling discharge

use of soaps and douching

Question 10

discharge

Answer 10

fishy smelling

watery grey or white

Question 11

symptoms making BV less likely

Answer 11

itch, irritation and pain

Question 12

speculum exam

Answer 12

not always required when symptoms are typical

discharge, high vaginal swab

Question 13

investigations

Answer 13

vaginal pH

charcoal vaginal swab - microscopy (SOLVS or high vaginal swab)

Question 14

microscopy findings

Answer 14

clue cells
epithelial cells from cervix that have bacteria stuck inside
gardnerella vaginalis

Question 15

antibiotic of choice

Answer 15

metronidazole - oral or gel

Question 16

important advice about antibiotics

Answer 16

not to take alcohol with metronidazole

disulifram-like reaction with N&V, flushing, shock

Question 17

What can BV increase the risk of?

Answer 17

catching other sti’s eg HIV, chlamydia and gonorrhoea

Question 18

complications in pregnant women

Answer 18

miscarriage 
preterm delivery 
PROM
post-partum endometritis
chorioamnionitis
low birth weight