C 20 Vaginitis Flashcards
3 categories of vaginitis:
- hormonal
- irritant
- infectious
hormonal vaginitis aka atrophic vaginitis
found in postmenopausal or postpartum women, occasionally in young girls before puberty.
Irritant vaginitis
due to allergies to substances such as latex in comdoms, spermicides, deodorant, soaps, perfumes, semen , or douches. may also be due to hot tub, mechanical abrasion, sanitary napkins, tampons, toilet tissue, or topical medications.
MOST vaginitis due to vaginal infection.> 90% vaginitis is caused by
bacterial vaginosis, candidiasis, or trichomoniasis. less common infectious causes of vaginitis : gonorrea, chlamydia, mycoplasma, campylobacter, even parasites like pinworms and giardia.
vaginitis is often a disorder of imbalance of normal vaginal flora. many of organisms that are responsible for vaginitis like gardnerella, mycoplasma, staph, E coli and candida are naturally occuring in healthy vagina.
these organisms only become problematic when the DELICATE balance of beneficial bacteria like AEROBIC LACTOBACILLUS is disrupted.
factors that may adversely affect this balance by reducing lactobacilli population such as
lubricants, nonoxynal-9 (spermicide), oral contraceptives (OCs), hormonal changes, and antibiotics.
to properly treat vaginitis and avoid potential treatment complications, it is essential to know the exact diagnosis
true
Bacterial Vaginosis
most common cause of vaginal infections and abnormal vaginal discharge and odor. it can also be one of the infections most resistant to treatment.
Bv consists fo significant polymicrobial overgrowth. it is result of alterations in vaginal ecosystem, rather than an infection caused by any single microorganism
true
BV is characterized by decreased or absent lactobacillus species and increased concetrations of potentially pathogenic bacteria. other characteristics include:
elevated pH >4.5 formation of clue cells odor due to increased vaginal fluid concentrations of diamines, polyamines organic acids.
3 main factors that are responsible for decline of lactobacilli and consequential BV:
- intercourse without condoms: sperm alkalinizes vagina, which depletes lactobacilli
- douching, which also depletes lactobacilli
- the absence of the kind of lactobacilli that produce peroxide. broad-spectrum antibiotics can also eliminate healthy vaginal lactobacilli.
hispanic women 50% more likely than caucasian women to develop BV and African American women twice as likely as caucasian women to have BV. reason?
not clear, may be due to less condom use in hispanic women and increased douching in african american women
potential consequences of untreated or undertreated BV. bacteria can migrate into the uterus and the upper genital tract and cause PID in a minority of women who have infection. BV can cause premature rupture of membranes and premature labor, and it is responsible for 70-80% of all perinatal deaths.
true
goal of treatment is to restore vaginal ph to less than 4.5 and reestablish normal vaginal ecology.
true
if pH remains greater than 4.5 following treatment, more aggressive use of lactobacillus and/or vaginal __ suppositories should be utilized
boric acid.