Conditions Of The Vagina

Question 1

What are the common pathogens causing vaginitis?

Answer 1

Candida
Bacterial vaginosis
Trichonomalis vaginalis 0

Question 2

How does Candida access the vagina to cause infection?

Answer 2

1) normal organism (change in normal vaginal flora)
2) cross from rectum
3) sexually transmitted

Question 3

What are risk factors for vulvovaginal candidiasis?

Answer 3

Diabetes mellitus
Antibiotic use
Increased oestrogen levels
Immunosuppression
Sexual behaviour

Question 4

What are the signs and symptoms of vulvovaginal candidiasis?

Answer 4

Symptoms
>vulvar pain, soreness, irritation
>vulvar pruritis
>dysurea or dyspareunia

Signs
>erythema of vulvovaginal mucosa
>vulvar excoriation/fissures
>white thick clumpy discharge =cottage cheese (if present. May have no discharge)

Question 5

How do you diagnose Candida valvovaginitis?

Answer 5

> microscopy - Wet mount of discharge (add 10% KOH to destroy cells and fascilitate recognition of budding yeast)
Culture
vag pH usually normal (4-4.5)

Question 6

How do you treat Candida vulvovaginitis?

Answer 6

Antifungals (oral/vaginal)

Question 7

What is the normal pH of the vagina?

Answer 7

3.5 - 4.2

Question 8

What is bacterial vaginosis?

Answer 8

A polymicrobial clinical syndrome in which normal hydrogen peroxide producing lactobacilli (which maintain normal pH) are replaced by anaerobes (G vaginalis, mycoplasma, prevotella sp)