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Clinical part B > Vaginal Conditions > Flashcards

Vaginal Conditions Flashcards

1
Q

what happens to the vagina at puberty

A

due to estrogen, vaginal lining changes to stratified squamous epithelium whihc contains glycogen

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2
Q

what is the glycogen used for

A

lactobacillus use the glycogen to form lactic acid to create an acidic environment 3.5-5.5
the acidity helps maintain the normal vaginal flora and inhibits growth of pathogenic organisms

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3
Q

what happens to the vagina after menopause

A

thinning of the vaginal lining occurs and lacto bacilli decline bc less glycogen causing the ph to rise

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4
Q

what factors influence the vaginal flora, ph and glycogen

A 
aging 
menstrual cycle hormone fluctuations
diseases 
diabetes - glucose peed out 
meds
douching - wash away normal flora
number of sexual partners - increases exposure to organisms
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5
Q

what shouldnt vaginal discharge cause

A

irritation
burning
itching

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6
Q

what are some adverse effects of douching

A

disrupts normal flora increasing the risk of irritation or infection
risk of genital tract infections, ectopic pregnancy, cervical cancer
prevent detection of infection

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7
Q

why do you avoid douching in pregnancy

A

preterm births
low birth weight infants
decreased fertility

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8
Q

when should you avoid use of douching

A

as a contraceptive
for infections
1-2 days before gynecologic exam
at least 3 days after last dose of a vaginal antifungal medication

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9
Q

problems with genital towelettes

A

may contain perfumes, astringents, emollints and antiinfectives which may lead to irritation or allergic reactions

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10
Q

what works better than cleanser or towelettes

A

mild soap and water

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11
Q

risks of using feminine deodorant sprays

A

mask an infection
cause irritation
allergic reaction

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12
Q

non pharms to prevent vaginal irritation

A

wear cotton underwear bc dries out quickly
avoid tight fighting and synthetic clothing
change pads and tampons regularly
avoid vaginal sprays and deodorants
change out of damp wear
avoid long exposure to hot conditions where you sweat
wipe front to back

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13
Q

what is bacterial vaginosis

A

imbalance in normal vaginal flora

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14
Q

cause of bacterial vaginosis

A

increased growth in organisms normally found in genital tract and a decrease in lactobacilli

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15
Q

complications of bacterial vaginosis

A

second trimester miscarriage
pre term birth
pelvic inflammatory disease

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16
Q

risk factors for bacterial vaginosis

A

sexually active
new sexual partner
IUD
douching

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17
Q

is bacterial vaginosis sexually transmitted

A

no

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18
Q

signs and symptoms of bacterial vaginosis

A 
thin, off white yellow or grey discolored discharge
vaginal pH5-6 
fishy odour 
may be asymptomatic 
minimal itchign
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19
Q

in asymptomatic bacterial vaginosis who do you treat

A

high risk pregnancy

prior to iud insertion or gynecological procedures

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20
Q

treatments for bacterial vaginosis

A

oral metronidazole or clindamycin
clindamycin 2% cream
metronidazole 0.75% gel
*all prescription so a referral

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21
Q

does the male partner need to be treated in bacterial vaginosis

A

no

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22
Q

when is a bacterial vaginosis recurrent

A

occurs 1-3 months of previous treatment

must be confirmed by physician

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23
Q

which treatment is preferred for bv in pregnanct patients

A

oral

topical may cause adverse outcomes to newborn

24
Q

what is trichomoniasis

A

sexually transmitted infection caused by a protozoa

25
Q

complications of trichomoniasis

A

low birth weight

tubal infertility

26
Q

risk factors for trichomoniasis

A

multiple or new sexual partner
nonuse of barrier contraception
presence of other STIs

27
Q

signs and symptoms of trichomoniasis

A

large amounts of white or yellow frothy discharge
redness of vulva and cervix
vaginal ph over 6

28
Q

symptomsof trichomoniasis

A

no odor
vaginal discharge
itching
may be asymptomatic

29
Q

trichomoniasis treatment

A

oral metronidazole

30
Q

do you treat sexual partners as well in trichomoniasis

A

yes regardless of symptoms

31
Q

causes of vulvovaginal candidiasis

A

candida albicans
normal vaginal flora when there is a change in the vaginal environment
not sexually transmitted

32
Q

signs and symptoms of vulvovaginal candidiasis

A 
white clumpy discharge
inflammation/redness 
ph under 4.5 
severe itchign 
pain during intercourse
no odor 
stinging, burning 
may be asymptomatic
33
Q

risk factors for vulvovaginal candidiasis

A 
antibiotics
hormone ingestion 
chemotherapy 
menses (rare before and after menopause)
pregnancy 
stress
immunocompromised
diabetes
tight clothign 
irritant
34
Q

goals of treatment for vulvovaginal candidiasis

A

relieve signs and symptoms of the infection
eradicate the infection
prevent recurrence
prevent misdiagnosis and therefore delay in treatment

35
Q

when can you self treat vcv

A

uncomplicated - not recurrent
previously diagnosed as VVC to confirm its not other things
mild-moderate symptoms
not pregnant bc if so have to confirm that it is not another infection that is dangerous for the infant
over 12
had less than 3 episodes in the past year
no signs within the last 3 months

36
Q

red flags for vcv

A

first episod e
under 12
pregnancy
fever, pain in lower abdomen back or shoulder
corticosteroids or immunosuppressive drugs
diabetes
HIV
recurrent (less than 2 months, 4 infections in 12 months)

37
Q

non pharms for vcv

A

avoid vaginal deodorants, douching, harsh soaps, perfumed products to prevent irritation
avoid tight clothign and synthetic underwear
recommend cotton underwear

38
Q

side effects of clotrimazole

A

itching
burning
bloatin
irritation

39
Q

products of clotrimazole available

A

canestan 1 - ovule or cream
canesten 3 - tablet or cream
canesten 6- cream

40
Q

side effects of miconazole nitrate

A 
itching 
burnign
headaches
allergic contact dermatitis 
skin rashes
41
Q

miconazole products

A

monistat 1 - ovule
monistat 3 - ovules or cream
monistat 7 - ovules or cream

42
Q

expected improvement for imidazoles

A

relief in 1-2 days

week for complete relief

43
Q

use of imidazoles

A

once daily at bedtime
dont use tampons for 3 days after
dont use condoms or diaphragms during or 3 days after because oil based and may cause them to fail

44
Q

side of effects of fluconazole

A 
headache 
nausea
abdominal pain 
dyspepsia 
dizziness
45
Q

contraindications of fluconazole

A

pregnancy
under 12
unless doctor recommended

46
Q

products available for fluconazole

A

1 oral capsule

47
Q

side effects of butoconazole

A

irritation
burning
itching
contains mineral oil

48
Q

can you use butoconazole in pregnancy

A

second and third trimester but studies lacking

49
Q

products available for butoconazole

A

gynazole cream prescription only

50
Q

side effects of terconazole

A 
headache 
abdominal pain 
burnign 
itching 
fever
chills
51
Q

can you use terconazole in pregnancy

A

avoid durign first trimester

52
Q

products available with terconazole

A

cream and ovules

prescription only

53
Q

monitoring parameters for vcv

A

improvement of symptoms in 2-3 days
resolutionof symptoms in 7 days
referral if symptoms dont resolve in 7 days or symptoms worsen
recurrence of symptoms within 2 months

54
Q

what is wrong with vagisil

A

contain local anesthetics that are supposed to relieve irritation and itching
dont treat cause of itchign and can cause local reactions

55
Q

who is at risk of toxic shock syndrome

A

menstruating women using tampons
contraceptive sponge, diaphragm, cervical cap
surgical wound infection

56
Q

symptoms of toxic shock syndrome

A 
sudden high fever
diarhhea
vomit 
dizzy 
weak 
muscla ache
fainting 
rash in palms of hand and soles of the feet
57
Q

what do you do if someone is experiencing toxic shock syndrom

A

immediate medical attention can be fatal

Clinical part B (15 decks)

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