GYN infections

Question 1

what is vulvovaginits

Answer 1

inflammation of the vulva and vagina this is the most benign of all diseases

Question 2

what causes vulvovaginits

Answer 2

tichamonas, BV, Candida

Question 3

what is cervisitis

Answer 3

inflammation of the cervix

Question 4

what causes cervisitis

Answer 4

gonorrhea and chlamydia

Question 5

how do we diagnose vulvovaginits

Answer 5

speculum and wet prep.

Question 6

what is a wet prep

Answer 6

saline and KOH prep. swab for both and use same swab. this is used for ALL the infections

Question 7

Risk factors for candida

Answer 7

diabetes, steroids or recent abs

Question 8

how does candida present

Answer 8

thick, white discharge that is sticky and adherent. NO ODER WITH CANDIDA. itchy.

Question 9

what does candida look like on a KOH

Answer 9

hyphae will be present

Question 10

what do we use to treat candida

Answer 10

antifungal over the counter topical. can use oral fluconisol

Question 11

what does Bacterial vaginitis look like

Answer 11

this is the most common cause. thin, copious, gray-white discharge with fishy oder.

Question 12

How is Bacterial vaginitis diagnosed

Answer 12

seeing clue cells on saline prep. Positive whiff test on KOH test.

Question 13

how to treat Bacterial vaginitis

Answer 13

metrinidazol topical then oral

Question 14

what is ping-ponging?

Answer 14

associated with trichamonis. have to treat both partners.

Question 15

what does trichamonis look like

Answer 15

strawberry cervix (cervical erythema), yellow-green, frothy discharge. Organisms with flagella that are motile. 
vaginal itching

Question 16

How to treat trichamonis

Answer 16

metranidazol. Oral and both partners.

Question 17

What causes cervicitis

Answer 17

gonorrhea, clamydia, and the vaginosis organisms: tichamonas, BV, Candida

Question 18

How does cervicitis present

Answer 18

cervical motion tenderness, mucopurolent discharge. But usually the patient doesnt know they have it outside of the discharge. PID

Question 19

How to diagnose cervicitis

Answer 19

PCR for G/C and wet prep. f

Question 20

How to treat cervicitis?

Answer 20

treat empirically with ceftriaxone (G), azithromycin or doxycycline (C). Doxy is generally the correct answer because it is cheaper.

Question 21

what is the diagnositc criteria Pelvic Inflammatory disease

Answer 21

pelvic/abdominal pain with no other cause with 1) cervical motion or adnexal or uterine tenderness.

Question 22

what causes PID

Answer 22

1/3 gonorrhea, 1/3 chlamydia., vaginal flora 1/3.

Question 23

how does PID present

Answer 23

fever, WBC on wet prep. mucopurolent discharge. generally clinical diagnosis.

Question 24

treatment for PID (2)

Answer 24

In patient (severity, nausea, pregnant): ceftrixone and Doxy IV, unless pregnant or contraindications (clindmycin/gentamycin)
Outpatient: ceftriaxone (gonorrhea) + doxy (chlamydia) + metranidozol (anaerobes).

Question 25

Why not use oral cephalasporins or floroquinolones for the treatment of PID

Answer 25

because the resistance is too high?

Question 26

what are the treatments for refractory PID and what are the indications

Answer 26

surgery if TOV abscess. Or “wash out” for peritonitis. Also, if refractory to AB treatment, look to surgical repair.