Part 1 Gyn. Infections

Question 1

What are the symptoms of Bacterial Vaginosis?

Answer 1

Thin, milky white discharge with a fishy odor after sex

Question 2

What are the results of the pH and whiff test with Bacterial Vaginosis?

Answer 2

pH > 4.5

(+) KOH Whiff test

Question 3

On a NaCl wet mount with Bacterial Vaginosis, what will be seen?

Answer 3

Clue cells

Question 4

With Bacterial Vaginosis, there is a shift in the normal vaginal flora from Lactobacilli to ______

Answer 4

Coccobacilli that thrive with an increase pH

Question 5

What is the typical organism that causes Bacterial Vaginosis and what is it associated with?

Answer 5

Gardnerella Vaginalis

– Associated with increased sexual activity and STIs

Question 6

What are 3 drugs to treat Bacterial Vaginosis?

Answer 6

1. Metronidazole
2. Tinidazole
3. Clindamycin

Question 7

What are 3 drugs to treat Bacterial Vaginosis?

Answer 7

1. Metronidazole
2. Tinidazole
3. Clindamycin

Question 8

MOA for Metronidazole and Tinidazole?

Answer 8

They are activated by reduction of the nitro group and then they cause DNA DAMAGE

Question 9

What should you avoid and why when taking Metronidazole or Tinidazole?

Answer 9

Alcohol

= Disulfuram like reaction with flushing, headache and N/V

Question 10

MOA for Clindamycin?

Answer 10

(-) 50s protein synthesis at the ribosome to stop peptide elongation

Question 11

What is a possible complication of taking Clindamycin?

Answer 11

Pseudomembranous Colitis due to the overgrowth of C. Diff.

Question 12

Which drug when treating Bacterial Vaginosis canNOT penetrate the CSF, but can also treat toxic shock and PID?

Answer 12

Clindamycin

Question 13

What are the symptoms of Vulvovaginal Candidiasis?

Answer 13

Thick, clumpy, white discharge that looks like cottage cheese
– Inflammation and erythema of the vulva too

Question 14

What are the results of the pH and the Whiff test with Vulvovaginal Candidiasis?

Answer 14

pH < 4.5

(-) KOH Whiff test

Question 15

With Vulvovaginal Candidiasis, what is seen on NaCl and KOH wet mounts?

Answer 15

NaCl = WBC
KOH = pseudohyphae

Question 16

What are 4 risk factors for Vulvovaginal Candidiasis?

Answer 16

DM
Estrogen
Immunosuppression
Recent Antibiotic use

Question 17

With the treatment of Vulvovaginal Candidiasis, what type of treatment should be prescribed if the patient is pregnant?

Answer 17

TOPICAL

Question 18

The treatment for Vulvovaginal Candidiasis is anything that ends in?

Answer 18

-AZOLE

Question 19

What is an oral drug for the treatment of Vulvovaginal Candidiasis?

Answer 19

Fluconazole

Question 20

What is the MOA for Fluconazole and what does it treat?

Answer 20

(treats vulvovaginal candidiasis)

= (-) conversion of lanosterol to ergosterol

Question 21

How is Fluconazole given and why should it be avoided in pregnancy?

Answer 21

Orally

==> BIRTH DEFECTS

Question 22

What is a potential complication when using Fluconazole?

Answer 22

QT interval prolongation

Question 23

Fluconazole has many ____

Answer 23

DRUG REACTIONS

Question 24

How does Fluconazole have many drug interactions? What does it do?

Answer 24

It is a substrate and an inhibitor of CYP3A4

= Increases the concentration of other drugs

Question 25

What is the most common NONviral STI?

Answer 25

Trichomoniasis

Question 26

What are the symptoms of Trichomoniasis?

Answer 26

Vaginal irritation and yellow-green discharge

– Strawberry cervix too

Question 27

What are the results of the pH and Whiff test with Trichomoniasis?

Answer 27

pH > 4.5

(+) KOH Whiff test

Question 28

What will be seen on NaCl wet mount with Trichomoniasis?

Answer 28

Flagellated pear shaped protozoan

Question 29

What are the 2 possible drugs to treat Trichomoniasis?

Answer 29

Metronidazole

Tinidazole

Question 30

What are the 2 possible drugs to treat Trichomoniasis?

Answer 30

Metronidazole

Tinidazole