Exam 2 - BV Flashcards
BV can be a symptom for what other conditions?
- STI
- Infectious vaginitis
- Cervicitis
- Disruption in normal vaginal flora
- Vaginal irritation
- Atrophic vaginitis
- Psychomatic iatrogenic
- Foreign body
Common organisms causing BV
- Gardnerella
- Haemophilus
- Cornyobactum
True/false: BV is the most common cause of vaginal infection in women of reproductive age
True
How does gardnerelle/haemophilus/cornyobactum cause BV?
Changes microflora in vagina –> diminished/absent lactobacilli –> overgrowth of anaerobic bacteria
Is BV spread through sexual activity?
No
BV: risk factors
- Smoking
- Douching
- Menstruation
- Sex without condom
- Low level of education
- Oral/anal sex
BV: adverse effects
- Preterm birth
- PROM in pregnancy
- Low birth weight
- Increased risk of post op infection
- Endometritis
- Lead to other STIs
BV: signs and symptoms
- Vaginal itching or irritation
- Fishy odor (especially after contact with semen)
- Painful intercourse
- Usually asymptomatic; found incidentally on PE
BV: physical exam findings
- Thin, white or gray homogenous vaginal discharge
- Irritated vaginal mucosa or introitus
- Possible cervicitis
BV: lab findings
Via specimen analysis with wet prep and KOH slides
- Whiff test after KOH applied to slide
- Use 40 powered objective lens
-
Clue cells (in normal saline slide)
- Bacteria surrounding cells (obliterating edges/borders)
- 20% of epithelial cells are covered
Has research shown that treatment can prevent adverse effects associated with BV?
No
Unclear whether treatment can prevent PROM, preterm labor, chorioamnionitis, postpartum endometritis
BV: treatment
- Metronidazole 500mg PO BID for one week OR metronidazole 250mg PO TID for one week
- Clindamycin 300mg PO once daily for one week
How can probiotics help patients with BV?
Probiotics can help reestablish normal vaginal flora and reduce BV during drug therapy
- Effective with lactobacillus crispatus
BV: patient education regarding drug therapy
Metronidazole
- Alcohol during treatment can cause Antabuse (disulfiram) effect –> avoid alcohol comsumption 1-3 days after
- Metallic taste, N/V
Clindamycin
- Weaken latex condoms and diaphragms
BV: general patient education
- Abstain from intercourse during treatment, douching, oral and anal sex (increases risk)
- Condoms can reduce risk of BV by preventing contact with alkaline semen
- All women with BV should be tested for HIV and other STIs
- Relapses/recurrent infections common
