gynae Flashcards
how does atrophic vaginitis present
dryness
dyspareunia
occasional spotting
what signs of atrophic vaginitis
pale and dry appearance
how is atrophic vaginitis treated
- lubricants and moisturisers
- topical oestrogen creams
which organisms are implicated in BV
anaerobic, eg gardnerella vaginalis
explain pathophys of BV
- anaerobic bacteria (eg gardnerella vaginalis) multiply
- aerobic lactobacilli outcompeted, decrease in lactic acid production
- pH increases
what symptoms of BV
“fishy” offensive discharge
thin white homogenous discharge
how is BV diagnosed
- clue cells on microscopy (stippled vaginal epithelial cells)
- vaginal pH > 4.5
how is BV treated
oral metronidazole 5-7 days
topical clindamycin
what complications of BV
preterm labour
low birth weight
chorioamnionitis
late miscarriage
what is candidiasis caused by
80% candida albicans,
20% other candida species
what RF for candida
diabetes
drugs - steroids, antibiotics
pregnancy
immunosuppression
what symptoms of candida
cottage cheese discharge vulvitis - dyspareunia, dysuria itch erythema fissuring satellite lesions
how is candida investigated
usually clinical, high vag swab
how is candidiasis treated
topical clotrimazole pessary oral fluconazole (contraindicated in preg)
what investigation in women with recurrent candidiasis
blood glucose to rule out diabetes
how is recurrent candidiasis treated
induction-maintenance regime with oral fluconazole
(every 3 days for 3 doses) then
dose per week for 6 months
how does chlamydia present in women
cervicitis - discharge, bleeding
dysuria
how does chlamydia present in men
urethral discharge
dysuria
how is chlamydia investigated in men and women
nucleic acid amplification test (NAAT)
for women: vulvovaginal swab
for men: first void urine sample
when should chlam testing be carried out after exposure
2 weeks
what is first line treatment of chlam
doxycycline for 7 days
what is first line treatment of chlam in preg
azithromycin 1g stat
what would you see on pap smear of chlamydia
infected endocervical cells with red inclusion bodies
how should contacts of chlam be treated
treat then test - treat before knowing results of test
what are the complications of chlamydia
pelvic inflammatory disease epididymitis endometritis fitz hugh curtis syndrome ectopic pregnancy infertility reactive arthritis
