genital symptoms

Question 1

causal organism vulvovaginal candidosis

Answer 1

~70% candida albicans

usually acquired from bowel

Question 2

vulvovaginal candidosis symptoms

Answer 2

often asymptomatic carriage

itch
discharge - classically thick ‘cottage cheese’ but often just increased amount

Question 3

when is vulvovaginal canidosis more likely to happpen

Answer 3

diabetes
oral steroids
immunosuppresion 
pregnancy 
reproductive age group

Question 4

diagnosis of thrush

Answer 4

characteristic Hx
normal pH rules of bac vaginosis - not diagnotic
examination findings: fissuring, erythema with satellite lesions, discharge

Question 5

thrush investigations

Answer 5

gram stained preparation - low sensitivity

culture

CPR?

Question 6

treatment of thrush

Answer 6

clotrimazole 500mg PV once

fluconazole 150mg once

Question 7

bacterial vaginosis

Answer 7

commonest cause abnormal vaginal discharge

imbalance of bacteria

Question 8

symptoms bacterial vaginosis

Answer 8

asymptomatic 50%
watery grey/yellow ‘fishy’ discharge
may be worse after period/sex
sometimes sores/itch from dampness

Question 9

bacterial vaginosis pathogenesis

Answer 9

interplay between 3 different problems
overgrowth of bacteria may be triggering step

overgrowth BV assoc bacteria
reduction of lactobaccili and reduction H2O2 production
raised pH

Question 10

diagnosis of bacterial vaginosis

Answer 10

characteristic Hx
examination: thin, homogenous discharge

pH: alkaline ~7.5

Question 11

treatment bacterial vaginosis

Answer 11

metronidazole (oral, vaginal gel)

clindamycin (vaginal)

Question 12

pain syndromes

Answer 12

vestibulodynia 
vulvodynia 
chronic pelvic pain syndrome 
lymphocoele
congenital cyst 
torn frenulim 
penile carcinoma