Reproductive tract infections Flashcards
when does cloudy, sticky or slightly yellow discharge occur?
several days before ovulation
when does heavy-egg white, stretchy thin consistency discharge appear?
1-3 after ovulation
when does clear, watery discharge appear?
just before period
what kind of cells are present in BV?
clue cells
which types of vaginal problems can you see using a wet mount?
BV, rich, yeast
what will KOH cause if there is BV or trick?
a fishy odor
What will the pH of vagina be in BV, Trich or atrophic vaginitis?
> 4.5
normal vaginal pH
3.8-4.5
KOH, wiff test, amine test are all the same thing?
yes
where is vaginal sample collected for a gram stain?
anterior or lateral walls of vagina
where do you collect for GC/C?
cervical os, leave swab in for 20-30 seconds
will a yeast infection change the pH alone?
no
Hyphae and pseudohyphae are what?
immature yeast
complicated or uncomplicated yeast infections:
mild to moderate vulvovaginal candidiasis and likely to be C.albicans and non-immunocompromised women
uncomplicated
what kind of anti fungal ok in pregnancy?
“azoles”
gold standard for BV test?
gram stain
what 3 symptoms must have along with the gram stain to diagnose BV
thin, white discharge, clue cells, pH >4.5, or fishy odor
do clue cells have a well defined boarder?
no
which test is comparable to gram stain?
BV Bluetest
is BV treatment PO or intravaginal with pregnancy?
PO
Trich s/s
yellow-green discharge, odor, parities (itchy), discharge worse with menstration
are patients usually symptomatic with trich?
no
Trich treatment
flagly 2gm POx1 OR Tinidazole 2gm POx1 OR flatly 500mg PO BIDx7 days
when should you treat a symptomatic pregnant patient with trich?
at anytime during pregnancy
when should you treat an asymptomatic pregnant patient with trich?
after 37 weeks
when do you retest with trich/GC/C?
3 months
which medication for trich should you avoid in pregnancy? and what if they are breastfeeding
Tinidazole
If not pregnant and breastfeeding, defer breastfeeding for 72hrs after Tinidazole given
who should be screen annually for GC/C
<24 year olds and women at risk
what is the recommendation for screening men for GC/C
individual bases
GC/C s/s in men
watery discharge, dysuria, epididymitis, unilateral testicular swelling and tenderness
GC/C s/s in women
dysuria, vag discharge, bleeding between periods, post coital bleeding, mucopurulent cervical discharge
Nucleic acid amplification test (NAAT) is used for which STI?
Chlamydia
culture and gram stain is used for which STI?
Gonorrhea
treatment for Gonorrhea in pregnancy?
cephalosporin or azithromycin
treatment for chlamydia in pregnancy?
azithromycin or amoxicillin
Expedited partner treatment can’t be used in which types of people d/t high risk of HIV?
Gay men with gonorrhea
how long after treatment for GC should patient abstain from sex?
7 days
How many days post treatment should you do a Test of Cure for complicated Gonorrhea (Pharyngeal)
14 days (also doNAAT)
women with PID should also get taste for
GC/C and HIV
what happens to a women body with PID
tubal scarring which can eventually cause scarring
s/s PID
cervicalmotion tenderness, dyspareunia, abnormal bleeding, uterine and adnexal tenderness
In order to diagnose PID, you need pelvic/abdominal pain which no other cause and one of the following 3 symptoms
- cervical motion tenderness
- uterine tenderness
- adnexal tenderness
what kind of diagnostics can be used to diagnose PID other than s/s?
endometrial biopsy, MRI, transvaginal US
If a patient with PID does not show significant improvement within 72 hours then what do you do?
hospitalize
if a pregnant patient has PID do you hospitalize?
yes
