Vaginal Discharge Flashcards
What are the usual characteristics of vaginal discharge caused by candidiasis (thrush). Comment on itching/pain, smell colour of discharge, consistency, pH and diagnosis.
Itching/pain ++
May smell ‘yeasty’ but not particularly offensive
Colour = White
Consistency = Curdy
pH less than 4.5
Diagnosis = Clinical, or by microscopy and culture
What are the usual characteristics of vaginal discharge caused by bacterial vaginosis. Comment on itching/pain, smell colour of discharge, consistency, pH and diagnosis.
No itching / pain Offensive, fishy odour Colour = White / Yellow Consistency = Thin, homogenous pH >4.5 Diagnosis = Microscopy
What are the usual characteristics of vaginal discharge caused by trichomoniasis. Comment on itching/pain, smell colour of discharge, consistency, pH and diagnosis.
Itching/pain +++ Smell may be offensive Colour = Yellow / green Consistency = Thin, homogenous pH > 4.5 Diagnosis = Microscopy and culture
What is the usual treatment for candidiasis in a symptomatic, non-pregnant woman?
Single dose topical ‘azole’ e.g. clotrimazole 500mg
What is the causative organism of candidiasis?
Overgrowth of candida albicans
List some risk factors for candidiasis
Pregnancy COCP Diabetes mellitus Immunosuppression e.g. in HIV Use of broad-spectrum antibiotics
Which oral agent can be given for the treatment of candidiasis?
Oral fluconazole 150mg (avoid in pregnancy)
What is the pH of physiological discharge?
Low (Less than 4.5)
List 4 reasons why physiological discharge may increase
Mid-cycle
Pregnancy
COCP
Cervical ectropian
What condition typically gives a ‘yeasty’ smelling vaginal discharge, which is ‘curdled’ in consistency
Candidiasis (thrush)
What is the pH of candidiasis?
Low (less than 4.5)
Foul ‘fishy’ smelling, grey, thin homogenous discharge indicates which diagnosis?
Bacterial vaginosis
What is the treatment for bacterial vaginosis?
Metronidazole orally
Clindamycin topical cream
How is bacterial vaginosis diagnosed?
Vaginal swab for gram stain. Microscopy shows ‘clue cells’.
What are clue cells?
Indicative of bacterial vaginosis. Microscopy shows squamous epithelial cells with irregular borders because the outlines are being obscured by sheets of bacteria.
