Vaginal Infections Lecture Powerpoint Flashcards

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1
Q

Pathogen most often responsible for bacterial vaginosis

A

Gardnerella vaginalis

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2
Q

KOH wet mount

A

Lab technique to view sample of discharge removed of skin cells but not fungus

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3
Q

Vaginal pH

A

> 5 indicates bacterial vaginosis or trichomonas infection

<4.5 indicates physiologic discharge or fungal infection

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4
Q

Atrophic vaginitis

A

Inflammation of vagina and outer urinary tract due to thinning of tissues due to lack of estrogen

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5
Q

Atrophic vaginitis symptoms

A

Dryness, itching, soreness, painful intercourse, sores and cracks, painful urination but no wbc in urine dip, incontinece

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6
Q

Atrophic vaginitis treatment

A

Vaginally administered estrogens

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7
Q

Lichen planus/psoriasis of vagina

A

Inflammatory, autoimmune disorder of skin and mucus membranes

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8
Q

Lichen planus/psoriasis of vagina symptoms

A

Glassy, bright red erosions and ulceration involving vulva and vagina

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9
Q

Lichen planus/psoriasis of vagina treatment

A

Corticosteroid ointment fluocinonide or clobetasol, or topical macrolide such as tacrolimus and pimecrolimus

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10
Q

Vulvovaginal candidiasis

A

Yeast of infection that affects all women from menarche to menopause, 40% of vulvovaginitis is caused by candida

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11
Q

Vulvovaginal candidiasis symptoms

A
  • Intense vulvar itching
  • Thick curd vaginal discharge
  • erythema of vulva
  • thick white patches
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12
Q

Intertrigonal candida infection

A

The spreading of a candida infection into the folds of skin creating a rash like appearance often under the breasts or in the thighs

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13
Q

1 cause of recurrent candida infections

A

Diabetes mellitus

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14
Q

Candida differential diagnosis (4)

A
  • Trichomonas vaginalis
  • Gonorrheal vaginalis
  • Pinworm vaginitis
  • contact dermatitis
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15
Q

Candida Lab studies

A
  • KOH
  • Culture
  • Vaginal pH <4.5
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16
Q

Fluconazole (diflucan)

A

150 mg po once, preferred treatment for candida, works on C. albicans

17
Q

Miconazole nitrate (monistat)

A

1 suppository at night x3, or cream at night x7, treatment for C. albicans

18
Q

Butoconazole nitrate (femstat)

A

vaginal cream at night x3, treaetment for C. albicans

19
Q

Terconazole (terazol)

A

1 suppository or vaginal cream at night x3, used for C. tropicalis

20
Q

Nystatin

A

Used to treat C. glabrata

21
Q

3 candida species and how they appear on wet mount

A

C. albicans - hyphae and buds
C. tropicalis - hyphae
C. glabrata - buds

22
Q

Topical gentian violet

A

An aqueous solution painted onto the vagina weekly to treat candida infection and prevent their recurrence over a year by applying over 2-3 weeks but will shed purple into underwear

23
Q

Watery, bad smelling discharge is characteristic of ____, while frothy, bubbling discharge is characteristic of ____

24
Q

BV often co-occurs with…

A

yeast infections

25
BV signs and symtpoms
Unpleasant vaginal odor, thick grey white vaginal discharge
26
BV differential (6)
- N. gonorrhea - Chlamydia - Trichomonas - e. coli - staph - fungal
27
Amsel's diagnostic criteria for BV (3/4 of em)
- thin homogenous discharge - fishy odor - clue cells present on microscopy - vaginal pH greater than 4.5
28
BV treatment (3)
- Metronidazole - Clindamycin - Metrogel
29
On azole treatment for BV, educate patients on...
...cannot drink alcohol on an azole
30
BV possible complications
- don't treat in first trimester of pregnancy - PID - intrauterine infections
31
Trichomoniasis epidemiology
-often in young and middle aged adults, rare until onset of sexual activity
32
Trichomoniasis sypmtoms female
- strawberry cervix - vaginal frothy discharge - odor
33
Trichomoniasis symptoms male
- many asymptomatic | - urethral discharge
34
Trich risk factors
- multiple sex partners | - hot tubs
35
Trich differential
- vaginal candidiasis - BV - chlamydia urethritis
36
Trich labs
- Wet prep | - Vaginal pH >4.5
37
Trich DOC
metronidazole