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.
How is C. Albicans of the vagina diagnosed?
Microscopy with KOH and visualization of hyphae and budding yeast
How does Trichmoniasis present in women?
Around 70% of women are asymptomatic with the remaining 20% ranging from mild scant watery discharge to foul, frothy, green discharge.
What is the most curable commonly transmitted disease?
Trichmonis!
Who is the carrier population with trichmonis?
Men are the primary asymptomatic carriers of the disease.
What is it?!!?!?
Small pear shaped trophozite
Trichmonas
A mobile, anaerobe.
When diagnosing a disease you note a “Strawberry cervix” What is it most likely?
Trichmonas caused by destruction of epithelial cells followed by neutrophil infiltration.
How is trichmonis diagnosed and treated?
Trichmonis is diagnosed by visibly seeing the swimming protozoa in the urine. Both patients are to be treated with metronidazole.
TNF alpha and TNF beta in response to TSST-1 toxin are associated with what syndromes?
Hypotension and shock. Staph aureus species replicate within tampons in the vagina.
What are four main symptoms with TSS?
Hypotension
Orthostatic syncope
Systolic BP 38.9
Late skin desquamation of palms and feet.
What is the treatment for Toxic shock syndrome?
Broad treatment with vancomycin or penicillin.
What percentage of females fail to mount a response to TSS?
50% of women fail to ammount an antibody response!
Name that discharge!
White Grey
Bacterial Vaginosis
Name that discharge!
Thick, white, cottage-cheese-like odorless
C. albicans
Name that discharge!
Frothy, yellow-green, foul smelling
C. trachomatis
Name that discharge!
Mucopurulent
C. Trachomatis
N. gonorrhoeae
Name that discharge!
Thin, white/grey, fishy odor
Bacterial vaginosis
