GYN infections Flashcards
what is vulvovaginits
inflammation of the vulva and vagina this is the most benign of all diseases
what causes vulvovaginits
tichamonas, BV, Candida
what is cervisitis
inflammation of the cervix
what causes cervisitis
gonorrhea and chlamydia
how do we diagnose vulvovaginits
speculum and wet prep.
what is a wet prep
saline and KOH prep. swab for both and use same swab. this is used for ALL the infections
Risk factors for candida
diabetes, steroids or recent abs
how does candida present
thick, white discharge that is sticky and adherent. NO ODER WITH CANDIDA. itchy.
what does candida look like on a KOH
hyphae will be present
what do we use to treat candida
antifungal over the counter topical. can use oral fluconisol
what does Bacterial vaginitis look like
this is the most common cause. thin, copious, gray-white discharge with fishy oder.
How is Bacterial vaginitis diagnosed
seeing clue cells on saline prep. Positive whiff test on KOH test.
how to treat Bacterial vaginitis
metrinidazol topical then oral
what is ping-ponging?
associated with trichamonis. have to treat both partners.
what does trichamonis look like
strawberry cervix (cervical erythema), yellow-green, frothy discharge. Organisms with flagella that are motile. vaginal itching
How to treat trichamonis
metranidazol. Oral and both partners.
What causes cervicitis
gonorrhea, clamydia, and the vaginosis organisms: tichamonas, BV, Candida
How does cervicitis present
cervical motion tenderness, mucopurolent discharge. But usually the patient doesnt know they have it outside of the discharge. PID
How to diagnose cervicitis
PCR for G/C and wet prep. f
How to treat cervicitis?
treat empirically with ceftriaxone (G), azithromycin or doxycycline (C). Doxy is generally the correct answer because it is cheaper.
what is the diagnositc criteria Pelvic Inflammatory disease
pelvic/abdominal pain with no other cause with 1) cervical motion or adnexal or uterine tenderness.
what causes PID
1/3 gonorrhea, 1/3 chlamydia., vaginal flora 1/3.
how does PID present
fever, WBC on wet prep. mucopurolent discharge. generally clinical diagnosis.
treatment for PID (2)
In patient (severity, nausea, pregnant): ceftrixone and Doxy IV, unless pregnant or contraindications (clindmycin/gentamycin) Outpatient: ceftriaxone (gonorrhea) + doxy (chlamydia) + metranidozol (anaerobes).
Why not use oral cephalasporins or floroquinolones for the treatment of PID
because the resistance is too high?
what are the treatments for refractory PID and what are the indications
surgery if TOV abscess. Or “wash out” for peritonitis. Also, if refractory to AB treatment, look to surgical repair.
