Common Vaginal and Pelvic Problems Flashcards
What are the 4 common pathologies of the Vulva
- Vulvitis (candida)
- Bartholin’s Cyst
- Condyloma Accuminata
- Herpes Simplex
What are four clinical features of Vulvitis
- Satellite Rash
- Microabscesses
- White discharge
- Pruritus
What is the organism that commonly causes Vulvitis and how is it treated
Candida
(Topical Antifungal)
What is the clinical manifestation of Bartholin’s Cyst
swelling of posterior 1/3rd of vulva
Is a non-tender Bartholin gland sweeling a cyst or an abscess?
Cyst
Is a tender Bartholin gland swelling a cyst or an abscess?
An Abscess
Which organisms commonly cause Bartholin’s abscess
E.coli
Gonorrhea (less commonly)
What is the treatment for Bartholin’s Cyst?
Incision and Drainage
Marsupialization
Word Catheter drain
What is the clinical presentation of Condyloma Acuminata
Raised lesions
pruritus (often associated)
What HPV serotypes commonly cause genital warts
HPV 6, 11 (low risk types)
What are the three treatment option for genital warts
Podophylin (cytotoxin)
Cauterization (burn them off)
ALDARA (imiquimod)
What is the clinical presentation of Herpes Simplex
Vessicles, Blisters followed by ulceration
True or False
Herpes Simplex is self-limiting and recurrent
True
What is the treatment for HSV (herpes Simplex Virus)
Antiviral (Acyclovir)
List four factors that increase vaginal discharge
- pre mentruation
- at Ovulation
- use of OCPs
- Use of IUDs
What are the components of a physiological vaginal discharge?
Cervical mucous
Bartholin gland secretion
Glycoprotein layer
Bacterial flora
Desquamated cells
Normal Vaginal flora has was number of bacteria
10^8- 10^9 per gram of fluid
Which bacteria makes up normal vaginal flora?
Lactobacilli
Lactobacilli produce lactic acid maintaining the vaginal pH at what level
<4.5
List 5 non-infective pathological causes of vaginal discharge
Ectropion (cervical cells extended to the outer cervix)
External devices: tampon, condom
Neoplasms
Polyps
Allergy/dermatitis
List 7 details from the patient h/o that will assisted in diagnosing the cause of pathological discharge
- Duration
- irritation
- odour
- cyclical pattern
- recurrence
- sexual history
- partners symptoms
What is the commonenst cause of pathological discharge from the vagnina
Bacterial Vaginosis
Describe the discharge seen in Bacterial Vaginosis
Homogenous grey
Fishy odour
No inflammation
Describe the discharge seen in Vaginitis (Candida)/ Monilia/ Yeast
Adherent curdy white discharge
What are 3 clinical features of vaginitis
dyspareunia
pruritus
external dysuria
Describe the discharge seen in Trichomoniasis
- Malodorous
- frothy yellow-green
What are the clinical features seen in Trichomoniasis
Strawberry cervix
frothy yellow green discharge
How is trichomoniasis treated
- Metronidazole
2 g po OD
What type of discharge is seen in cervicitis
Mucopurulent
What is the cause of cervicitis
Chlamydia
Gonorrhea (less commonly)
What is the recommended treatment for Bacterial Vaginosis?
Metronidazole 500mg bd x 7days
What is the recommended treatment for Trichomoniasis?
Metronidazole 2g po od
What is the recommended treatment regimen for Candidiasis?
Topical Azole drugs
Clomitrazole (3 or 7 day regimen)
Oral azole (1-5 days)
Fluconazole, Itraconazole
What is the recommended treatment for Cervicitis (Chlamydia)
Doxycyclin 100mg bd x7 days
Azithromycin 1g po od
What is the recommended treatment for Cervicitis (Gonorrhea)
Ceftriaxone 125mg IM single dose
List the 5 types of Uterine fibroids
- Pedunculated
- Intracavitary
- Intramural
- Submucous
- Subserous
