Cervical D/O Flashcards
What does spinnbarkheit mean? (what is it describing?)
The “stringiness” of cervical mucus
What is the DDx for infectious discharge?
Bacterial Vaginosis (BV) Trichomonas vaginalis (Trich) Neisseria gonorrhoeae (GC) Chlamydia trachomatis (Chl) Vulvovaginal Candidiasis (VVC) Herpes Simplex Virus 1 or 2 (HSV 1 or 2)
What is the normal pH for the vaginal canal?
Where should you get a sample for the pH test?
3.8-4.2
Midway in the vaginal sidewall
What is the most common STD test that is used?
NAAT (nucleic acid amplification test)
**get sample before contamination with KY jelly for bimanual exam
What may you be checking for during a bimanual exam?
Endometriosis
PID
Tubo ovarian abscess
____ is the most common cause of vaginal discharge in woman of childbearing years
BV (bacterial vaginosis)
Describe BV (bacterial vaginosis).
A polymicrobial syndrome resulting from replacement of normal flora (lactobacillus) with anaerobic bacteria
What are some sx of BV (bacterial vaginosis)?
Patients can be asymptomatic, or they can have watery, white/grey discharge
NO pruritus/UTI sx/Pain
Foul fishy odor
What is the pH for BV (bacterial vaginosis) ?
Would the whiff test be (-/+)?
What would be seen on the wet mount?
pH 4.5+
+ Whiff test
Clue cells on saline wt mount
What is the goal of tx for BV (bacterial vaginosis)?
How would this be achieved?
Restore vaginal homeostasis
Various preparations with the following meds:
Metronidazole (no alcohol!) –> Antabuse effect
Clindamycin
Tinidazole
What are some pt education tidbits you may tell a pt when treating them for BV (bacterial vaginosis)
No alcohol!
Clindamycin can decrease efficacy of condoms and diaphragms
____ is an infection caused by the protozoan T. vaginalis
Trichomonas Vaginalis (Trich)
What are sx of Trichomonas Vaginalis (Trich)?
The pt may be asymptomatic Copious yellow/gray/green discharge, may be frothy Possibly mixed with blood Malodorous Often have vulvar pruritus and dysuria
Upon exam, how will the cervix look if a pt is infected w/ Trichomonas Vaginalis (Trich)?
May have vulvar/vaginal erythema and inflammation
“Strawberry cervix”
What is the pH for Trichomonas Vaginalis (Trich)?
What is seen on the wet prep?
pH 4.5+
Wet prep saline w/ numerous WBCs and motile Trichomonads
What can you use to tx Trich?
Metronidazol - no alcohol!!
Tinidazole
*partner needs tx too, EPT
___ is the 2nd most commonly reported communicable dz in the US
GC
What are the most common ages for GC infection?
What population is at a higher risk for GC infection?
Women 20-24 y/o, 15-19 y/o; Men 20-24 y/o
African American >12: 1 Caucasian
___ is the most commonly reported bacterial infection in the US
What are the most common ages to be infected?
Chlamydia
Women 15-24 y/o; Men 20-24 y/o
African American 6:1 Caucasian
What are the sx of GC/Chlamydial infections in Males vs. Females?
Male: dx usually earlier, urethritis, epididymitis, purulent discharge, dysuria
Females: mucopurulent discharge, asymptomatic, cervical friability or edema
What is seen on a wet prep for GC/Chlamydial infections?
++WBC
Bacteria
T/F Routine annual screening is recommended in ALL sexually active females <25y/o for GC and Chlamydia
T
T/F Routine screening of all pregnant women in 3rd trimester for GC and chlamydia
F; test in 1st trimester
When do you screen women >25 y/o for GC/Chlamydial infections?
Screening of sexually active women >25 with risk factors