candidiasis /vag thrush

Question 1

candida infection associated with

Answer 1

Candida infection is associated with pregnancy, antibiotic use and immunosuppression.

Question 2

sx

Answer 2

Symptoms in women: itching, white curdy or lumpy discharge, sour milk odour, dysuria, superficial dyspareunia, pruritus, tenderness, burning sensation

Examination in women: redness, fissuring, swelling, intertrigo, thick white discharge

Symptoms in men: soreness, pruritus, redness

Examination in men: dry, dull, red glazed plaques and papules

Question 3

microscopy

Answer 3

presence of blastospores, pseudohyphae and neutrophils is indicative of Candida infection species.
Culture is recommended for recurrent vulvovaginal candidiasis

Question 4

mx

Answer 4

Oral (-azoles) e.g. fluconazole, itraconazole

Intravaginal e.g. clotrimazole pessary

Vulval e.g. topical clotrimazole cream

Common regimes:

Fluconazole oral capsule 150mg as a single dose, generally first line reccomended treatment unless patient factor’s contraindicate use of oral agents, or the patient prefers topical treatment.
Clotrimazole intravaginal pessary 500mg as a single dose
Clotrimazole intravaginal vaginal cream (10%) 5g as a single dose
Clotrimazole intravaginal pessary 200mg at night for 3 consecutive nights

Question 5

are oral therpaies used in preg

Answer 5

yes

Question 6

intravgainal and topical treatments can damage what contraceptive methods

Answer 6

latex condoms and diaphrgams

Question 7

Sx of trichomonas

Answer 7

Symptoms in women: can be asymptomatic, but classically profuse, frothy, yellow vaginal discharge. There can also be vulval irritation and dyspareunia present.

Symptoms in men: Can cause non gonococcal urethritis, can be asymptomatic

On examination in women: Commonly normal, strawberry cervix is a rare sign

Question 8

Tx of trichomonas

Answer 8

Oral metronidazole. Either 400–500mg twice a day for 5–7 days, or 2g as a single oral dose

Question 9

aids defining illnesses

Answer 9

AIDS defining illnesses
Candidiasis of the oesophagus, bronchi, trachea or lungs
Cervical cancer invasive
Cryptococcosis
Cryptosporidiosis
CMV disease including CMV retinitis
HIV encephalopathy
Histoplasmosis
Kaposi’s sarcoma

Lymphoma (Burkitt’s, immunoblastic, primary, cerebral)
Mycobacterium Tuberculosis or any other species of Mycobacterium
Pneumocystis pneumonia
Recurrent Pneumonia
Progressive multifocal leukoencephalopathy

Question 10

short of breath with HIV think Pneumocystis Pneumonia this is treated with

Answer 10

co-trimoxazole