Vaginal Infections

Question 1

What is Lactobacillus sp.?

Answer 1

-normal flora of mouth, stomach, GI track, GU tract
Facultative or strict anaerobic
-gram (+) rod
-Facultative or strict anaerobic rod

Question 2

Man, which infections produce a discharge?

Answer 2

bacterial vaginosis (not std
candidiasis (NOT std
Trichomonas (ahhhh std)

Question 3

If they are taking a cervical sample, what are they looking for?

Answer 3

AN STD! mother fucker

Question 4

And if they are taking a vaginal sample, what are those mofos looing for>

Answer 4

A vaginal infection

Question 5

bacterial vaginosis (not std
candidiasis (NOT std
Trichomonas (ahhhh std)
common, rare, what are they ahhhh!

Answer 5

bacterial vaginosis (most common)
candidiasis (2nd most common)
Trichomonas (rare)

Question 6

How would BV present clinically?

What are the characteristics of BV? Ahhhh!

Answer 6

-NO pain, NO itching (pruritus), NO trouble taking a piss (dysuria)

-watery (not heavy) discharge adheres to vaginal wall (does not smelly good)
putrescine, cadaverine, trimethylamine

-a bit of a basic ph compared to normal!

Question 7

Are there any specific tests we could use to detect bacterial vaginas, which is nasty fucking stuff ahhhhh

Answer 7

yeah a positive amine test would be one way to know

‘whiff test’ (fishy smell)

Question 8

IF you havent got a clue then what the fuck are you?

Answer 8

BV
Clue cell - so many bacteria, but NO pmns becaue the immune system doesnt see it as a threat so doesnt respond
-slide #20

Question 9

What are the Causative agents of BV?

Answer 9

• Gardnerella vaginalis (not an STD!)
• mycoplasmas

-anaerobes –
Peptostreptococci
Bacteroides spp.
Mobiluncus spp.

Question 10

How to diagnose Gardnerella vaginalis

Answer 10

gram variable

-see the clue cell and you know!

Question 11

mycoplasma, how to treat?

Answer 11

wellp you could not treat this infection with a beta lactam (penicillin)
because they work by disrupting the cell wall (mycoplasma has no gosh damn cell wall and therefore is not seen on a gram stain

Question 12

Mobiluncus and other anaerobes

Answer 12

• -Classified as gram positive
• susceptible to vancomycin
• -Lack endotoxin
• Obligate anaerobic
• gram variable curved
• rod with tapered ends

Question 13

signs and symptoms of Streptococcus agalactiae

Answer 13

• Vaginal colonization:
• bladder infections
• premature delivery,
• prolonged membrane rupture
• postpartum fever

Question 14

Causative agents of Group B Strep

Answer 14

Streptococcus agalactiae

Question 15

special tests for group B strep?

Answer 15

beta hemolytic

gram stain - gram (+) cocci in chains

Question 16

characteristics of streptococcus agalactiae

Answer 16

polysaccharide capsule and antibodies that are protective

lancefield grouping: group B

Question 17

complication of Group B strep

Answer 17

it can be transmitted to infant during birth (in thebirth canal)
-since the organism is encapsulated (and babies have no immune system) the organism can get into the brain and cause meningitis

Question 18

characteristics of neonatal disease

Answer 18

-early onset (less than 7 day old kid) of:
Bacteremia
Pneumonia
Meningitis

-these are severe consequences (result of the baby aspirating the organism)

Question 19

organism responsible for causing VVC (Vulvovaginal candidiasis)

Answer 19

Candida albicans (its a fungus)

the source is primarily endogenous so its an opportunistic infection

Question 20

describe signs and symptoms of VVC

Answer 20

• cottage cheese discharge
• itching/burning sensation
• swelling of labia and vulva (but cervix is normal)
• erythema (redness of skin)

Question 21

What are the indicators of Candida albicans?

Answer 21

• germ tube production!
• stains gram (+)!
• pseudohyphae and budding yeast on the gram stain
• pseudohyphae on cornmeal agar
• only a few PMNs seen
• THIS IS THE ONLY ORGANISM WE TALK ABOUT that grows on Sabouraud dextrose agar!!!

Question 22

Why are candida infections easy to treat.

Answer 22

THEY arent! its a fungal infection which is a EUKaryotic organism - so tough to treat without harming host

Question 23

Who is likely to get candida infections (of any type not just albicans)?

Answer 23

*immunocompromised individuals (systemic infections)
Thrush – HIV (dentists recognize)
Esophagitis - HIV
infants - diaper rash
Nail infection – dishwasher

Question 24

What organism causes huge amounts of a frothy green discharge?

Answer 24

Trichomoniasis vaginalis (causes the trichomoniasis infection)

Question 25

what do folks with trichomoniasis complain about all day long?

Answer 25

sore vaginas and urethras (painful sexing = dyspareunia)
and that waterfall discharge (even males show a sight discharge)
itchy vag (vulvar pruritus)
bad smelling vag
hurts to pee (dysuria)

note: strawberry cervix and hemorrhages on cervix and vagina

Question 26

How can we diagnose trichomoniasis?

Answer 26

on the wet prep see the protozoan and a large number of PMNs (immune system reacts bc its NOT part of normal flora)

CANT be seen on a gram stain (just like chlamydia)

Question 27

name some characteristics of trichomoniasis vaginalis

Answer 27

• Anaerobic
• its a flagellated protozoan
• its an STD! people with multiple partners are at risk!