GUI II Flashcards
What family of bacteria primarily permanently house the anterior urethra and vagina?
Those of the Lactobacillus family
What causes the vaginal pH to be around 4-5?
The lactobacilli ferment glycogen within the vagina and produce lactic acid.
What main compound inhibits the growth of other bacteria in the vagina?
Lactobacilli produced lactic acid.
What three happenings can change the microflora of womens vagina?
Menstration, Age (Estrogen), and historectomy.
Which microbes are more likely to line the vagina following a historectomy?
Bacteroides fragilis
And
Aerobic Eschericia coli / Enterococcus species.
Bacterial Vaginosis is caused by overgrowth of which sort of microbes?
It is seen following an overgrowth of anaerobic species and a subsequent drop of Lactobacillus.
Is Bacterial Vaginosis considered a sexually transmitted disease?
While sexual factors do increase the risk of contracting BV, it is not considered a sexually transmitted disease.
What characteristics must be met to obtain a positive Amsel Criteria when diagnosing BV
1) Positive Whiff Test (KOH)
2) Visualization of Clue Bodies
3) Vaginal pH > 4.5
4) Grey/ White Discharge
If 3/4 met tests positive for Bacterial Vaginosis
What is the Nugent score based on?`
This is a numerical score based on size quantification of bacteria within the vagina.
Measures:
Large gram + rods (Lacto Bacillus)
Small Gram - variable rods (G vaginalis or Bacteroides spp.)
Curved gram-variale rods (Mobiluncus)
What is the scale range of the Nugent score?
0-3 Normal
4-6 Intermediate mixed morphotypes
7-10 Absence of Lactobacilli.
What is the treatment for bacterial Vaginosis?
Oral metronidazole - Inhibits nucleic acid synthesis
For anaerobes and parasites.
Clindamycin - Kill Gram - and anaerobes
What is uncomplicated vs complicated vulvovaginal candidiasis?
Uncomplicated is sporadic or infrequent mild-to-moderate symptoms in otherwise healthy patients.
Complicated: recurrent (Four or more episodes in 1 year) or severe VVC, non- albicans candidiasis, or the patient has uncontrolled diabetes, debilitation, or immunosupression.
Is C. albicans considered a normal flora resident?
Yes it is considered a normal resident of the GI, vagina, and urethra, skin/finger toe nails.
Vulvovaginal candidiasis is characterized by what features?
Characterized by pruritus and a thick, odorless, white vaginal discharge.
What is the treatment for Candida albicans?
1-3 regimen of topical azole
7-14 days of a topical regimen of oral fluconazole 3 days a part for complicated cases.