Female GU Infectious Disorders Flashcards
What is vaginitis?
- inflammation or infx of vaginal canal
- change in flora, pH, discharge
Symptoms of Vaginitis
- asymptomatic to significant discomfort
- pruritus, burning, irritation
- odor
- color/consistency
- volume
What are risk factors for candida?
- DM
- recent abx use
- OCPs
- pregnancy
- corticosteroid therapy
- occlusive clothing (increases moisture)
S/S of Candida
- white, thick discharge
- intense pruritus
- dysuria
- vulvar/labial erythema, excoriation, edema
- white d/c often without odor
Dx of Candida
- characteristic S/S
- normal pH 3.5-4.5
- hyphae/spores on KOH, wet prep or culture
Tx of Candida
- antifungal therapy: topical miconazole qhs 1-7 days or oral fluconazole
- vaginal hygiene
What causes bacterial vaginosis?
- overgrowth of anaerobic bacteria
- decrease or absence of lactobacillus
- increase in Gardnerella, Mobiluncus
- possibly STI related
- douching, vaginal irritants
- smoking
S/S of Bacterial Vaginosis
- non-irritating d/c
- thin gray/white/yellow d/c
- foul/fishy odor
Dx of Bacterial Vaginosis
- abnormal d/c: thin, gray/white with foul odor
- abnormal pH > 4.5
- positive whiff test KOH
- wet prep shows clue cells
Tx of Bacterial Vaginosis
- antibiotic: metronidazole gel intravaginal or PO; oral or topical clindamycin
- vaginal hygiene
- abstain from sex 1 wk after tx
What causes trichomoniasis?
- STI
- protozoan Trichomonas vaginalis
Risk Factors for Trichomoniasis
- multiple sex partners
- history of STIs
- lack of condom use
- lower socioeconomic status
S/S of Trichomoniasis
- persistent, profuse, frothy d/c
- vulvar pruritus
- foul odor
- dysuria
- inflamed labia, perineum, vagina
- small petechiae on cervix/vaginal wall (strawberry spots)
Dx of Trichomoniasis
- wet mount shows increased PMNs with motile flagellate
- KOH whiff
- pH > 4.5
Tx of Trichomoniasis
- antibiotic: systemic metronidazole
- treat pt and partner
- vaginal hygiene and pelvic rest
What can a wet mount test for?
- trichomonas
- clue cells (bacterial vaginosis)
- yeast
What can a KOH test for?
-easier to visualize hyphae/spores of candida
What can whiff test screen for?
-if anaerobic bacteria present (bacterial vaginosis), foul odor occurs
Which condition(s) has a very high pH?
- bacterial vaginosis
- trichomoniasis
- both are > 4.5
Which condition(s) have normal-high pH?
-candida
Which condition has a white, thick discharge without odor and intense pruritus?
-candida
Which condition has a thin, gray/white/yellow discharge with a foul, fishy odor?
-bacterial vaginosis
Which condition has a persistent, profuse, frothy d/c with foul odor and vulvar pruritus?
-Trichomoniasis
Which condition has hyphae and spores?
candida
