STDs Flashcards
Most common types of vaginitis
- bacterial vaginosis (most common cause)
- vulvovaginal candidiasis
- trichomoniasis (most prevalent nonviral STI)
Bacteria that causes bacterial vaginosis
gardnerella vaginalis
What is bacterial vaginosis linked to
=premature rupture of membranes
- post op gyn infection
- premature delivery
- STDs/HIV
Trichomoniasis is assosicated with
- preterm rupture of membranes and preterm delivery
- HIV leads to increased risk
What two things need to be present for bacterial vaginosis to occur
overgrowth of bacteria species normally present
AND
decrease of loss of protectine lactobacilli
Role of hydrogen peroxide in the vagina
helps maintain a low pH which inhibits bacteria overgrowth
When does symptomatic clinical candidiasis infection occur
with the excessive growth of yeast
Caues of candidiasis
disruption of normal vaginal ecology or host immunity
Trichomonas vaginalis is the only ___ that infects the genital tract
protozoan
Risk factors for bacterial vaginosis
- african american
- new sexual partner
- douching
- no condoms
- absence/ decrease lactobacilli (H2O2 producing)
Risk factors for candidiasis
- diabetes
- immunosuppression
- abx use
- prolonged exposure to damp underwear
- non cotton underwear
- douching
Risk factors for trichomoniasis
- multiple sexual partners
- low socioeconomic status
- hx of STI
- no condom
Signs and sx of bacterial vaginosis
- can be asymptomatic
- malodorous or fishy smell
- pruritic discharge
- thin, milky white discharge
Signs and sx of candidiasis
- pruritic discomfort
- dysuria
- thick cottage cheese like discharge
Signs and sx of trichomoniasis
- can be asymptomatic
- pruritic discharge sometimes green, yellow/green, frothy
- strawberry cervix
Vaginal PH of <4.5 would be ___. >4.5 would be ___
- candidiasis or normal
- BV or trichomoniasis
Bacterial vaginosis on wet prep
- clue cells
- no/few WBCs
Candidiasis on wet prep
few to many WBCs
Triachomoniasis on wet prep
- motile flagellated protozoa
- mmany WBCs
What is Amsel Criteria use to diagnose? What is it?
bacterial vaginosis
Must have at least three of the following
-pH >4.5
-presence of >20% per HPF of clue cells on wet mount
-positive amine or “whiff” test
-homogenous, non viscous, milky white discharge adherent to vaginal walls
Tx of bacterial vaginosis
- metronidazole 500mg BID for 7 days
- metronidazole gel 0.75% for 5 days
- clindamycin 2% cream for 7 days
Candidiasis tx
-fluconazole 150mgx1
repeat in 72 hours for severe cases
Tx for trichomoniasis
-metronidoazole 2g PO single dose OR metronidazole 500mg BID x7 days OR -tinidazole 2g PO single dose
Symptoms of chlamydia/gonorrhea in women
- dysuria
- mucopurulent discharge
- cervical motion tenderness
- pruritis
- tender uterus
- PID sx
- intermenstrual bleeding
Symptoms of gonorrhea in men
- dysuria
- white, yellow or green discharge
- +/- penile edema
Symptoms of chlamydia in men
- mucoid or watery urethral discharge
- clear discharge sometimes seen only when milking the penis
Treatment of gonorrhea
ceftriaxone 250mg IM (single dose) PLUS azithro 1g PO single dose or doxy 100mg PO BID for 7 days
Treatment of chlamydia
azithro 1g PO single dose
OR
Doxy 100mg PO BID x 7 days