gynae

Question 1

how does atrophic vaginitis present

Answer 1

dryness
dyspareunia
occasional spotting

Question 2

what signs of atrophic vaginitis

Answer 2

pale and dry appearance

Question 3

how is atrophic vaginitis treated

Answer 3

• lubricants and moisturisers

- topical oestrogen creams

Question 4

which organisms are implicated in BV

Answer 4

anaerobic, eg gardnerella vaginalis

Question 5

explain pathophys of BV

Answer 5

• anaerobic bacteria (eg gardnerella vaginalis) multiply
• aerobic lactobacilli outcompeted, decrease in lactic acid production
• pH increases

Question 6

what symptoms of BV

Answer 6

“fishy” offensive discharge

thin white homogenous discharge

Question 7

how is BV diagnosed

Answer 7

• clue cells on microscopy (stippled vaginal epithelial cells)
• vaginal pH > 4.5

Question 8

how is BV treated

Answer 8

oral metronidazole 5-7 days

topical clindamycin

Question 9

what complications of BV

Answer 9

preterm labour
low birth weight
chorioamnionitis
late miscarriage

Question 10

what is candidiasis caused by

Answer 10

80% candida albicans,

20% other candida species

Question 11

what RF for candida

Answer 11

diabetes
drugs - steroids, antibiotics
pregnancy
immunosuppression

Question 12

what symptoms of candida

Answer 12

cottage cheese discharge
vulvitis - dyspareunia, dysuria
itch
erythema
fissuring 
satellite lesions

Question 13

how is candida investigated

Answer 13

usually clinical, high vag swab

Question 14

how is candidiasis treated

Answer 14

topical clotrimazole pessary
oral fluconazole (contraindicated in preg)

Question 15

what investigation in women with recurrent candidiasis

Answer 15

blood glucose to rule out diabetes

Question 16

how is recurrent candidiasis treated

Answer 16

induction-maintenance regime with oral fluconazole

(every 3 days for 3 doses) then
dose per week for 6 months

Question 17

how does chlamydia present in women

Answer 17

cervicitis - discharge, bleeding

dysuria

Question 18

how does chlamydia present in men

Answer 18

urethral discharge

dysuria

Question 19

how is chlamydia investigated in men and women

Answer 19

nucleic acid amplification test (NAAT)
for women: vulvovaginal swab
for men: first void urine sample

Question 20

when should chlam testing be carried out after exposure

Answer 20

2 weeks

Question 21

what is first line treatment of chlam

Answer 21

doxycycline for 7 days

Question 22

what is first line treatment of chlam in preg

Answer 22

azithromycin 1g stat

Question 23

what would you see on pap smear of chlamydia

Answer 23

infected endocervical cells with red inclusion bodies

Question 24

how should contacts of chlam be treated

Answer 24

treat then test - treat before knowing results of test

Question 25

what are the complications of chlamydia

Answer 25

pelvic inflammatory disease
epididymitis 
endometritis
fitz hugh curtis syndrome
ectopic pregnancy
infertility
reactive arthritis