Vaginal Disorders Flashcards
Vulvovaginal candidiasis: etiology
- common
- candida albicans
Vulvovaginal candidiasis: clinical presentation
- vulvar pruritis*
- burning, external dysuria
- Thick curd-like vaginal discharge*
Risk factors: antibiotics, immunocompromise
How is candidiasis diagnosed?
- clinical evaluation
- wet prep (saline and KOH)
- *budding yeast and hyphae**
Vulvovaginal candidiasis: uncomplicated treatment
topical azole (ex. clotrimazole), OTC for 1-3 days
Vulvovaginal candidiasis: complicated
- > 4 episodes in a year
- severe
- uncontrolled DM
- immune compromise
Tx: topical azole for 7-14 days
or
oral fluconazole
Vulvovaginal candidiasis: pregnancy
topical azole 7 days
or
Fluconazole, one dose
Does male partner need to be treated for candidiasis?
No, unless he has balanitis (inflammation of the glans)
If a patient has recurrent or difficult to treat yeast infection what do you need to screen for?
- Diabetes
- HIV
Bacterial vaginosis: organism
Gardnerella vaginalis
Bacterial vaginosis: clinical presentation
- fishy odor**
- white/gray discharge
Bacterial vaginosis: risk factors
- new or multiple sex partners
- Douching
Bacterial vaginosis diagnosis
clinical criteria (amsel’s criteria) - need 3 or more of the 4
- Thin white homogenous discharge
- Clue cells on microscopy (vaginal epithelial cells studded with adherent coccobacilli)
- Vaginal pH >4.5
- Fishy odor with adding KOH solution (+ whiff test)
What is the gold standard lab for diagnosis bacterial vaginosis?
gram stain (but rarely used)
Bacterial vaginosis: tx
Metronidazole (Flagyl) for 7 days
-avoid alcohol
Atrophic vaginitis: etiology
- loss of estrogen
- epithelial thinning
- DRYNESS*
- loss of elasticity
