GYN Infections

Question 1

MCC of Vulvovaginitis + sx

Answer 1

Candida, Gardnerella(BV), Trichomonas

Sx: pruritis, odor, discharge

Question 2

workup for vulvovaginitis

What would you see for each to dx?

Answer 2

normal saline slide & KOH prep slide

1. Candida = Hyphae on KOH tx antifungal topical or fluconazole
2. Gardnerella(BV) = clue cells on saline + fishy on KOH, tx metro
3. Trichomonas = motile flagellated on saline, tx both partners w/metro

Question 3

2 MCC of cervicitis + sx

Answer 3

Cla + Gon

sx: yellow-green discharge, cervical motion tenderness = do wet mount + KOH + PCR

Question 4

Tx for Cla + Gon

Answer 4

Cla = doxy or azith
Gon = IM Ceftriaxone

Question 5

PID sx + MCC

when do you admit?

Answer 5

MCC: Gon, Cla + vaginal flora

sx: pelvic pain, sick patient!, cervical discharge, cervical motion tenderness, uterine tenderness, adnexal tenderness (like cervicitis + other sx)

**if NV, Fever = admit

Question 6

Inpatient tx for PID

Answer 6

1. Cefoxitin + doxy

2. Clinda + Genta

Question 7

Outpatient tx for PID

Answer 7

1. Ceftriaxone IM + Doxy + Metro
2. Cefox + probenecid + doxy + metro

• proben = prevents drug from being pee’d out
• metro treats for anaerobes!