Part 1 Gyn. Infections Flashcards
What are the symptoms of Bacterial Vaginosis?
Thin, milky white discharge with a fishy odor after sex
What are the results of the pH and whiff test with Bacterial Vaginosis?
pH > 4.5
(+) KOH Whiff test
On a NaCl wet mount with Bacterial Vaginosis, what will be seen?
Clue cells
With Bacterial Vaginosis, there is a shift in the normal vaginal flora from Lactobacilli to ______
Coccobacilli that thrive with an increase pH
What is the typical organism that causes Bacterial Vaginosis and what is it associated with?
Gardnerella Vaginalis
– Associated with increased sexual activity and STIs
What are 3 drugs to treat Bacterial Vaginosis?
- Metronidazole
- Tinidazole
- Clindamycin
What are 3 drugs to treat Bacterial Vaginosis?
- Metronidazole
- Tinidazole
- Clindamycin
MOA for Metronidazole and Tinidazole?
They are activated by reduction of the nitro group and then they cause DNA DAMAGE
What should you avoid and why when taking Metronidazole or Tinidazole?
Alcohol
= Disulfuram like reaction with flushing, headache and N/V
MOA for Clindamycin?
(-) 50s protein synthesis at the ribosome to stop peptide elongation
What is a possible complication of taking Clindamycin?
Pseudomembranous Colitis due to the overgrowth of C. Diff.
Which drug when treating Bacterial Vaginosis canNOT penetrate the CSF, but can also treat toxic shock and PID?
Clindamycin
What are the symptoms of Vulvovaginal Candidiasis?
Thick, clumpy, white discharge that looks like cottage cheese
– Inflammation and erythema of the vulva too
What are the results of the pH and the Whiff test with Vulvovaginal Candidiasis?
pH < 4.5
(-) KOH Whiff test
With Vulvovaginal Candidiasis, what is seen on NaCl and KOH wet mounts?
NaCl = WBC KOH = pseudohyphae
What are 4 risk factors for Vulvovaginal Candidiasis?
DM
Estrogen
Immunosuppression
Recent Antibiotic use
With the treatment of Vulvovaginal Candidiasis, what type of treatment should be prescribed if the patient is pregnant?
TOPICAL
The treatment for Vulvovaginal Candidiasis is anything that ends in?
-AZOLE
What is an oral drug for the treatment of Vulvovaginal Candidiasis?
Fluconazole
What is the MOA for Fluconazole and what does it treat?
(treats vulvovaginal candidiasis)
= (-) conversion of lanosterol to ergosterol
How is Fluconazole given and why should it be avoided in pregnancy?
Orally
==> BIRTH DEFECTS
What is a potential complication when using Fluconazole?
QT interval prolongation
Fluconazole has many ____
DRUG REACTIONS
How does Fluconazole have many drug interactions? What does it do?
It is a substrate and an inhibitor of CYP3A4
= Increases the concentration of other drugs
