OnlineMedEd: Gynecology - "Gyn Infections"

Question 1

What organisms cause cervicitis?

Answer 1

• N. gonorrhoeae
• C. trochomatis
• Trichomonas vaginalis
• Other vaginal flora

Question 2

Why do you do two wet preps of vaginal swabs?

Answer 2

One for KOH (candidiasis) and one for saline (trichomoniasis and bacterial vaginosis)

Question 3

What is the standard of care for candidiasis?

Answer 3

• First: topical antifungals (e.g., clotrimazole)

* Second: oral fluconazole x 1 dose

Question 4

How is the discharge from trichomoniasis different from that of PID?

Answer 4

Trichomoniasis is often green/yellow, while PID is usually just yellow

Question 5

How will cervicitis present different from PID?

Answer 5

Cervicitis will have CMT and discharge but typically not systemic symptoms.

Question 6

Because ______________ takes a long time to result, the PID is often treated empirically with ceftriaxone and doxycycline.

Answer 6

NAAT

Question 7

What are the criteria for PID?

Answer 7

•Pelvic pain without other cause
•Any one of the following: 
- CMT
- Adnexal tenderness
- Uterine tenderness

Question 8

List three categories of PID patients who require inpatient treatment.

Answer 8

• Pregnant
• Severe symptoms (e.g., SIRS)
• Nausea/vomiting to the point where they can’t take meds PO

Question 9

There are two inpatient treatment options for PID: ______________.

Answer 9

• Cefoxitin and doxycycline (“foxy doxy”)

* Gentamicin and clindamycin

Question 10

What is the outpatient treatment guideline for PID?

Answer 10

Ceftriaxone IM and doxycycline or metronidazole