Female GU Infectious Disorders

Question 1

What is vaginitis?

Answer 1

• inflammation or infx of vaginal canal

- change in flora, pH, discharge

Question 2

Symptoms of Vaginitis

Answer 2

• asymptomatic to significant discomfort
• pruritus, burning, irritation
• odor
• color/consistency
• volume

Question 3

What are risk factors for candida?

Answer 3

• DM
• recent abx use
• OCPs
• pregnancy
• corticosteroid therapy
• occlusive clothing (increases moisture)

Question 4

S/S of Candida

Answer 4

• white, thick discharge
• intense pruritus
• dysuria
• vulvar/labial erythema, excoriation, edema
• white d/c often without odor

Question 5

Dx of Candida

Answer 5

• characteristic S/S
• normal pH 3.5-4.5
• hyphae/spores on KOH, wet prep or culture

Question 6

Tx of Candida

Answer 6

• antifungal therapy: topical miconazole qhs 1-7 days or oral fluconazole
• vaginal hygiene

Question 7

What causes bacterial vaginosis?

Answer 7

• overgrowth of anaerobic bacteria
• decrease or absence of lactobacillus
• increase in Gardnerella, Mobiluncus
• possibly STI related
• douching, vaginal irritants
• smoking

Question 8

S/S of Bacterial Vaginosis

Answer 8

• non-irritating d/c
• thin gray/white/yellow d/c
• foul/fishy odor

Question 9

Dx of Bacterial Vaginosis

Answer 9

• abnormal d/c: thin, gray/white with foul odor
• abnormal pH > 4.5
• positive whiff test KOH
• wet prep shows clue cells

Question 10

Tx of Bacterial Vaginosis

Answer 10

• antibiotic: metronidazole gel intravaginal or PO; oral or topical clindamycin
• vaginal hygiene
• abstain from sex 1 wk after tx

Question 11

What causes trichomoniasis?

Answer 11

• STI

- protozoan Trichomonas vaginalis

Question 12

Risk Factors for Trichomoniasis

Answer 12

• multiple sex partners
• history of STIs
• lack of condom use
• lower socioeconomic status

Question 13

S/S of Trichomoniasis

Answer 13

• persistent, profuse, frothy d/c
• vulvar pruritus
• foul odor
• dysuria
• inflamed labia, perineum, vagina
• small petechiae on cervix/vaginal wall (strawberry spots)

Question 14

Dx of Trichomoniasis

Answer 14

• wet mount shows increased PMNs with motile flagellate
• KOH whiff
• pH > 4.5

Question 15

Tx of Trichomoniasis

Answer 15

• antibiotic: systemic metronidazole
• treat pt and partner
• vaginal hygiene and pelvic rest

Question 16

What can a wet mount test for?

Answer 16

• trichomonas
• clue cells (bacterial vaginosis)
• yeast

Question 17

What can a KOH test for?

Answer 17

-easier to visualize hyphae/spores of candida

Question 18

What can whiff test screen for?

Answer 18

-if anaerobic bacteria present (bacterial vaginosis), foul odor occurs

Question 19

Which condition(s) has a very high pH?

Answer 19

• bacterial vaginosis
• trichomoniasis
• both are > 4.5

Question 20

Which condition(s) have normal-high pH?

Answer 20

-candida

Question 21

Which condition has a white, thick discharge without odor and intense pruritus?

Answer 21

-candida

Question 22

Which condition has a thin, gray/white/yellow discharge with a foul, fishy odor?

Answer 22

-bacterial vaginosis

Question 23

Which condition has a persistent, profuse, frothy d/c with foul odor and vulvar pruritus?

Answer 23

-Trichomoniasis

Question 24

Which condition has hyphae and spores?

Answer 24

candida

Question 25

Which condition has clue cells?

Answer 25

bacterial vaginosis

Question 26

Which condition has strawberry spots?

Answer 26

Trichomoniasis