Lecture 35 - Gynecological Infections Flashcards
Lower gynecological infections are considered as those that infect the ____, the ____, and the _____.
Vulva
Vagina
Cervix
The three main causes of vaginitis are ______ vaginosis, ______, and _______. Wet mount is still the standard for diagnosis, but it does not have high specificity. ______ is much more specific, but it is also much more expensive.
Bacterial Vaginosis
Trichomoniasis
Candidiasis
NAAT (Nucleic Acid Amplification Test)
Bacterial vaginosis produces _____ (color) thin discharge that coats the vagina. It also tends to produce a _____ odor, especially during or after intercourse.
By contrast, Trichomoniasis produces a ____/____ (colors) thin discharge that can be frothy.
Keep in mind the normal pH of the vagina is acidic (3.4-4.2). As is becomes less acidic, what are the likely infections?
Gray thin discharge
Fishy
Yellow/Green
pH 4-5 –> Candidiasis
pH 5-6 –> Bacterial vaginosis
pH 6-7 –> Trichomoniasis
Trichomoniasis and Candidiasis both cause mucosal _______, while Bacterial vaginosis does not.
What is the classic appearance of the cervix with trichomoniasis?
Erythema
“Strawberry cervix”
Why does the pH tend to increase with Bacterial and Trichomonas infections?
Normally, Lactobacilli are the predominant bacteria, and they produce H2O2 –> makes the environment acidic. As they get outcompeted by invading bacteria or Trichomonas, there’s less production of H2O2 –> increased pH.
Of Candida, Bacterial vaginosis, and Trichomonas, which have a positive whiff test, and how is it performed?
Bacterial vag and Trich both have positive wiff –> KOH added to wet mount, and as it becomes more basic, the give off amines that produce the fish smell.
Amsel’s criteria for diagnosis of bacterial vaginosis are as follows:
- Thin homogenous discharge adhering to vaginal walls
- pH > _____
- Release of fishy odor on adding ____% KOH
- _____ cells on microscopy
Keep in mind you need 2 of the above 4 for a positive diagnosis.
pH > 4.5
10%
Clue cells
________ cervicitis can be caused by N. gonorrheae, Chlamydia trachomatis, and/or Mycoplasma spp. It is a clinical diagnosis that requires gross visualization of mucopurulent discharge and easily induced cervical ______ (friable cervix –> simply touching/swabbing causes ______). Another criterium that makes it a more specific diagnosis is visualization of > ______ WBCs per high power field.
Mucopurulent cervicitis
Bleeding
Bleeding
> 10 WBCs
Are women or men more susceptible to Chlamydia infection on penetrative sex?
Women (80% chance of infection, while men only have 25% chace)
CDC recommends screening ALL women once per year who under the age of _____ who are sexually active.
25
Why are young women more likely to be infected with Chlamydia or Gonorrhea than an older woman?
Younger women tend to have greater cervical surface area.
Fitz Hurtz Curtiz syndrome is characterized by Peri-______ adhesions resultant from PID.
Peri-hepatic adhesions
Endometritis typically occurs following ______.
Is it more common after vaginal or cesarean?
Delivery
Cesarean
Though used to clean the vagina, frequent ______ is a risk factor for infection and subsequent PID.
Douching
Contraception has a protective effect for PID. _______ (hormone) increases the protective cervical mucous.
Progesterone
