Vaginal discharge

Question 1

Trichomonas vaginalis

__ pyriform protozoa, 2-4x larger than ___
incubation time ___ days

Men CM: majority are __
others have __ sx including D, U, E, P
possibly ___ urethral discharge

Women CM: majority are __
sudden onset of ___ or __ foul smelling vag discharge
also have I/B, D/ D/ __ discomfort, U

Vaginal discharge pH is __
__ lesions on cervix, described as ___

Answer 1

flagellated, PMNs
4-28 days

asx
Lower UT sx, dysuria, urethritis, epididymitis, prostatitis
non purulent

asx
frothy white/green
Itch/burn, dysuria, dyspareunia, suprapubic, urgency

elevated
punctate hemorrhagic, strawberry cervix

Question 2

Dx trichomonas vaginalis

frothy/creamy __ discharge assc w ___ on cervix

look for __ on wet mount of vaginal discharge

T vaginalis binds cells lining surfave of ___ and produce ___/____ that cause host cells to ___ and __

results in ___ and ___ flood in

Answer 2

malodorous, punctate hemorrhagic lesions

motile trichomonads

vagina, proteases/cytotoxins, round up/detach

immune response, PMNs

Question 3

Bacterial vaginosis caused by

Gram __. facultative __ __ present in vaginal flora

RF: V___, Multiple/new __, I___

CM: homogenous ___ with __ odor, I/I

Tx with ___

Normal vaginal flora ___ replaced by large number of __/__ anaerobes, resulting ___

semen combines w __ reduce __ of vaginal secretions to cause a strong odor

Answer 3

gardnerella vaginalis

variable, anaerobe rod

vaginal douching, sex partners, IUD

white discharge, fishy, itching/irritation

metronidazole

lactobacilli, facult/obligate, inc pH

vaginal secretions, acidity

Question 4

Dx Bacterial vaginosis
Requires 3 of following

___ discharge that adheres to ___

__ present in wet mount/gram stain

Vaginal fluid pH > __

__ odor before/after addition of __ (aka ___)

can also use __ or __

Answer 4

homogenous white, vaginal walls

clue cells

4.5

fishy, KOH, whiff test

DNA probes/NAAT

Question 5

Candida albicans
__ fungus, normal ___

RF: recent __, new/inc ___, I___

CM: __ vaginal discharge, __ of vulva, erythematous __/__

Dx: __ of vaginal discharge, culture on ___
vaginal pH is ___
additional ___

disruption of ___ or __ allows growth of resident __

look for __ on wet mount

Answer 5

dimorphic, vaginal flora

Ab use, sex partner/act, IC

curd like, pruritis, vagina/labia

wet mount, Sabouraud agar, normal
germ tube test

normal vaginal flora/IS, C albicans

pseudohyphae

Question 6

Germ tube negative candida show no __ in serum/plasma after __ at 37C

C albicans produces __ in serum/plasma after 2-3 hrs at 37C

Answer 6

germ tube prod, 2-3hrs

germ tubes