Fungal infections general

Question 1

Vulvovaginal candidiasis common presentation?

Answer 1

Thick white cottage cheese-like discharge, dysuria, irritation

Question 2

Do you treat asyptomatic vulvovaginal candidiasis?

Answer 2

Nope

Question 3

Uncomplicated vulvovaginal candidiasis treatment options?

Answer 3

Clotrimazole 1% cream 7-14 days
Micronazole 100mg suppository once daily for 7 days, 200mg is for 3 days, 1200 for 1 day
Fluconazole 150mg orally once daily

Question 4

Treatment of complicated vulvovaginal candidiasis

Answer 4

Topical Azole F7-14D
Fluconazole 150mg PO twice (one dose followed by a dose 3 days later)

Non-C. albicans infection:
7-14 days with nonfluconazole azole (topical or oral)
Boric acid 600mg vaginally OD F3W

Question 5

Onychomycosis classifications

Answer 5

Distal lateral subungual onychomycosis = most common, nail bed and underside of nail

Superficial white onychomycosis = surface of nail, white islands in nail

Proximal subungal onychomycosis = affects the part of nail closes to the joint (idk dude thats a bad description but imagine it fucking up the area around where the nail grows out from)

Question 6

When to use topicals in onychomycosis?

Answer 6

Distal and lateral subungual with minimal involvment
Superficial white onychomycosis
CI to orals

Question 7

Onychomycosis topicals?

Answer 7

efinaconazole 10% for 48 weeks

Circlopirox F48W

Question 8

Oral antifungals for onychomycosis?

Answer 8

Terbinafine 250mg OD F3M -> agent of choice for dermatophytes

Itraconazole 200mg once daily F3M (non dermatophytes)
200mg BID F1W every month for 3 pulses for toenails, 2 pulses for fingernails