Vaginal Infections Flashcards
What is the primary bacteria composing the vaginal normal flora?
Lactobacillus
The primary bacterial species of the vaginal normal flora is gram ____ and, converts glycogen to _______, and produces H2O2
Gram+ rod
lactic acid
The pH of a normal vagina is in what range?
3.8-4.2
_________ is a major influence on the pH of the vagina
Estrogen (hi estr = hi glycogen = hi acid)
10% KOH is added to a sample of vagina discharge. It smells like fish. What is your ddx?
Bacterial vaginosis or
Trichomoniasis
(+ Whiff test)
What is the basic cause of bacterial vaginosis?
decrease in Lactobacilli
increase in pathogenic bacteria
(change in PROPORTION)
The #1 cause of bacterial vaginosis is?
Gardnerella vaginalis
A female pt presents with GRAYISH STINKY discharge from her vagina. It is THIN and STICKS to the walls of the mucosa. It began as an itch. What will be the appearance of her epithelial cells?
covered in Gardnerella bacteria (fuzzy borders)
aka CLUE CELLS
A microscopic slide of vaginal epithelium reveals epithelial cells that are darker and have ‘fuzzy’ borders. The causative agent is a gram ____
variable
coccobacillus
What are some risk factors for Garnerella vaginosis?
recent antibiotic use (disrupt NF)
bubble baths
lo Estrogen
IUDs, douching
3 out of the 4 Amsel criteria must be present to diagnose bacterial vaginosis. What are the 4?
thin gray discharge
+ Whiff test
pH >4.5
Clue cells on microscopy
A pregnant mother must worry about __________ if she has bacsterial vaginosis
pre-term labor, low birth weight baby
A microscopic slide of vaginal epithelium reveals epithelial cells that are darker and have ‘fuzzy’ borders. What is the DOC for this bacteria?
Metronidazole
just tx lady
What is the hallmark of the discharge seen in Candida/yeast infections?
thick, odorless, curd-like discharge
A female patient presents with white mucoid colonies growing on her vagina. It is extremely itchy and irritating. What Is the next best test?
KOH prep (lyse bacteria, isolate yeast)
Vulvovaginal candidiasis is most commonly treated with _________ rather than ______ since it is a localized infection
Fluconazole (oral)
Amphotericin B
Treatment for systemic Candidiasis will ___________ Ergosterol, while tx for localized Candidiasis will _________ Ergosterol
Amphotericin B: Binds ergosterol, forms pores
Fluconazole: inhibits ergosterol synthesis
Trichomonas vaginalis will cause _______ discharge, just like Gardnerella/BV
Foul smelling
What is the characteristic anatomy of the protozoa that causes stinky vaginal discharge?
4 axial flagella (swimming)
1 intracellular flagellum
ruffled, leaf looking cell
Infection with Trichomonas is typically _______ in women and ______ in men
symptomatic
asymptomatic
A woman presents with FROTHY, STINKY, yellow discharge from her vagina. What are you looking for on her cervix?
Strawberry cervix (trichomonas)
A lady presents with STINKY vaginal discharge. No clue cells are present on LM. What is the causative organism?
Trichomonas vaginalis
A patient presents with STINKY discharge. What is your treatment plan?
metronidazole
if Garnerella: just tx lady
if Trichomonas: tx partners
