Vaginal Discharge Flashcards
What are causes of vaginal discharge?
Candida, Bacterial vaginosis, Trichomonas vaginalis, Herpes, Gonorrhoea, Chlamydia, Physiological, Retained foreign body
What are infective STI causes of vaginal discharge?
Trichomonas vaginalis, Chlamydia, Gonorrhoea, Herpes, Mycoplasma genitalium
What are non-sexually transmitted of infection?
Bacterial vaginosis, vulvovaginal candiasis
What might be associated symptoms of vaginal discharge?
Abnormal bleeding, abdo pain, fever, dysuria, vulval pain, vulvovaginal soreness/itching
What are typical symptoms of candida?
Cottage cheese-like clumpy discharge, vulval itching, irritation, soreness, swelling, external dysuria, no odour
What are typical symptoms of BV?
Fishy-smelling discharge, no associated itching, irritation or swelling
What are typical symptoms of TV?
Fishy-smelling discharge, associated itching, irritation or swelling
What are examination findings of candida?
White curdy discharge, vaginal inflammation - erythema, fissuring, swelling, vulval inflammation
What are examination findings of BV?
White/grey homogenous discharge coating vaginal walls, +/- odour - no inflammation
What are examination findings of TV?
Profuse frothy yellow homogenous discharge with associated inflammation
What are the tests for candida?
High vaginal swab from discharge/vaginal wall
What are the tests for BV?
High vaginal swab from discharge/vaginal wall
What are the tests for TV?
TV testing, NAAT where available from discharge/posterior fornix
What is the treatment of candida?
Fluconazole 150mg stat or clotrimazole 500mg pessary stat
What is the treatment of BV?
Metronidazole 400mg BD for 1 week or 2g stat clindamycin vaginal cream
What is the treatment of TV?
Metronidazole 400mg BD 5-7/7
Which causes of vaginal discharge have a pH >4.5?
BV, TV
What are risk factors?
Sex - UPSI, MSM
Contraception - IUD
Lifestyle - smoking, vaginal douching
Menstruation
Black ethnicities
What are complications of BV/TV associated with prengnancy?
Late miscarriage
Preterm birth
Preterm premature rupture of membranes
Postpartum endometritis
What is the impact of BV in pregnancy?
Late miscarriage
Preterm birth
Preterm premature rupture of membranes
Postpartum endometritis
What is treatment of recurrent BV?
Intravaginal metronidazole gel (0.75%) x2 weekly
Intravaginal probiotic lactobacilli gel
What is the most common cause of vulvovaginal candidiasis?
Candida albicans
What are symptoms of vulvovaginal candidiasis?
Vulval itch
Vaginal discharge
Vulval soreness
External dysuria
Superficial dyspareunia
What is treatment of vulvovaginal candidiasis?
Topical imidazoles e.g. clotrimazole pessary 500mg stat
Systemic imidazoles e.g. fluclonazole 150mg stat
Anti-fungals e.g. Nystatin vaginal tablets
