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Women's Health > Infections of the Vagina and Vulva > Flashcards

Infections of the Vagina and Vulva Flashcards

1
Q

which type of organism predominates infections of the vagina and vulva?

A

anaerobes

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2
Q

what is the vaginal pH range?

A

3.5-4.5

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3
Q

what is the patho of bacterial vaginosis?

A

decreased hydrogen peroxide-producing lactobacilli
increased anaerobic gram - rods

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4
Q

what is the gold standard diagnostic for bacterial vaginosis?

A

gram stain

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5
Q

what is the criteria for bacterial vaginosis?

A

amsel’s diagnostic criteria

2/4:
clear, creamy, thin discharge
odor
pH > 4.5
clue cells

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6
Q

patient presents with clear, creamy, thin discharge with an odor and pH > 4.5. Dx? treatment?

A

bacterial vaginosis

metronidazole

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7
Q

patient presents for the 3rd time with clear, creamy, thin discharge with an odor and pH > 4.5. Dx? treatment? (3)

A

bacterial vaginosis

intravaginal boric acid + metronidazole
condom use 3-6 mo

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8
Q

what is the most prevalent nonviral STD worldwide?

A

trichomoniasis

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9
Q

a patient presents with foul, thin, yellow/green discharge. On PE, there are strawberry spots on the cervix, and an elevated vaginal pH. Dx? treatment?

A

trichomoniasis

metronidazole

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10
Q

what diagnostic is used for trichomoniasis?

A

NAAT

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11
Q

when to retest for trichomoniasis? why?

A

3 weeks - 3 months after treatment

check if patient has gotten reinfected by her partner

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12
Q

patient presents with vulvar pruritis, burning, erythema, and edema with excoriations. Vaginal discharge looks like curd/cottage cheese that is adhered to the vaginal walls. Dx? treatment (2) for first occurrence and no comorbidities?

A

candidiasis

1 dose of 150mg fluconazole
topical antifungal

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13
Q

what are 3 risk factors for candidiasis?

A

diabetes mellitus
immunosuppression
pregnancy

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14
Q

a patient presents with vulvar itching and white discharge. Vaginal pH is 3.6 and KOH prep and wet mount are negative. what is the next best step in evaluation?

A

culture for yeast

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15
Q

what is the gold standard diagnostic for candidiasis?
what are 2 other options?

A

culture

KOH prep
PCR

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16
Q

patient with a history of diabetes presents with vulvar pruritis, burning, erythema, and edema with excoriations. Vaginal discharge looks like curd/cottage cheese that is adhered to the vaginal walls. Dx? treatment?

A

candidiasis

150mg fluconazole q 72 hours for 2-3 doses

17
Q

patient presents for the 4th time this year, with vulvar pruritis, burning, erythema, and edema with excoriations. Vaginal discharge looks like curd/cottage cheese that is adhered to the vaginal walls. Dx? treatment?

A

Candidiasis

topical / oral fluconazole x 10-14 days, then
weekly 150mg fluconazole x 6 months

18
Q

a patient presents with burning, severe pain, dysuria, fever, headache, and myalgias. they had a vesicle that ulcerated and become crusty. Dx? treatment? (4)

A

herpes simplex virus

antiviral
antipyretic
pain meds
suppressive therapy for type 2

19
Q

what is the preferred test to diagnose HSV?
what will be present in serologic testing of HSV?

A

NAAT

IgG antibody assays

20
Q

patient presents with an isolated, nontender ulcer with raised rounded borders. 6 weeks later, they notice a maculopapular rash on their palms and soles of feet. Dx? treatment?

A

syphilis

penicillin

21
Q

what is the gold standard diagnostic for syphilis?

A

direct detection of spirochetes with blood test

22
Q

patient presents with soft, irregular margins and a friable base, tender inguinal lymphadenopathy. The buboes suppurate and form fistulas. Dx? 2 treatment options?

A

chancroid

PO azithromycin / IM ceftriaxone

23
Q

what is the diagnostic used for chancroid?

A

NAAT

24
Q

patient presents with small painless papule that leads to regional lymphadenopathy, and then anogenitorectal fibrosis. Dx? treatment?

A

lymphogranuloma venereum (LGV)

doxycycline

25
Q

patient presents with flat papules. Dx? treatment? (2)

A

genital warts (HPV)

excision / cryotherapy
topical imiquimod

26
Q

what to test for if we see genital warts on a patient?

A

syphilis

27
Q

a patient presents with multiple 2-5 mm, flesh-colored papules with central umbilication. Dx? treatment?

A

molluscum contagiosum

cryotherapy

28
Q

which are considered STIs? (6)

A

trichomoniasis
herpes simplex virus
syphilis
chancroid
lymphogranuloma venereum
HPV (genital warts)

29
Q

what are NOT considered STIs? (3)

A

bacterial vaginosis
candidiasis
molluscum contagiosum

Women's Health (20 decks)

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