Vaginitis Flashcards
True/False
Inflammation and infection of the vagina are uncommon gynecologic complaints
FALSE
Common
Vaginitis can result from..
(a) Pathogens
(b) Allergic reactions to vaginal contraceptives or other products
(c) Vaginal atrophy
(d) Friction during coitus
Vaginitis History should include..
(a) Onset of the LMP
(b) Recent sexual activity and use of any latex products or lubricants
(c) Use of contraceptives, tampons, or douches
(d) Recent changes in medications or use of antibiotics
Signs and symptoms of what issue?
(1) Vaginal irritation or pruritus
(2) Pain
(3) Unusual or malodorous discharge
(4) Bimanual exam may show
- –(a) Pelvic inflammation
- –(b) Cervical motion tenderness
- –(c) Adnexal tenderness
Vaginitis
What issue?
(a) Pregnancy, diabetes, and use of broad spectrum antibiotics or
corticosteroids predispose patients to this issue.
(b) Heat, moisture, and occlusive clothing also contribute to the risk.
(c) Pruritus, vulvovaginal erythema, and a white curd-like discharge that is NOT malodorous.
Vulvovaginal Candidiasis (yeast infection)
What issue?
(a) Sexually transmitted protozoal flagellate
(b) Infects the vagina, Skene ducts, and lower urinary tract in women
(c) Infects the lower genitourinary tract in men
(d) Pruritus and a malodorous frothy, yellow-green discharge occur, along with diffuse vaginal erythema.
(e) Strawberry cervix- red macular lesions on the cervix in severe cases
Trichomonas Vaginalis Vaginitis
What issue?
(a) Polymicrobial disease that is NOT sexually transmitted; chronic in nature
(b) An overgrowth of Gardnerella and other anaerobes
(c) Increased malodorous discharge without obvious vulvitis or vaginitis
Bacterial Vaginosis (BV)
True/False
You can work up labs for vaginitis operationally
False
Laboratory workup for Vaginitis
- KOH
- Wet prep
- NAAT urine testing for chlamydia and gonorrhea
- Vaginal pH
Treatment
Vulvovaginal Candidiasis
(a) Fluconazole (Diflucan) is an antifungal
1) Dose: 150 mg daily for 1 day
Treatment
Trichmonas vaginalis Vaginitis
Treatment of both partners is recommended
Metronidazole (Flagyl) Dose: 2 g PO x1 or 500 mg BID x7 days
(is an antibiotic with cytotoxic effects towards anaerobic organisms)
Treatment Bacterial Vaginosis (BV)
(a) Metronidazole (Flagyl) 500 mg BID x7 days
(b) Clindamycin vaginal cream (Clindagel, Cleocin T lotion) –
- –1) Dose: 2%, 5g once daily for 7 days
(c) Metronidazole gel (0.75%, 5g vaginal twice daily for 5 days)
Treatment
Chlamydia
Doxycycline
Dose: 100 mg BID X 7 days
Treatment
Gonorrhea
Ceftriaxone (Rocephin)
Dose: 500 mg IM x 1 dose
Patient education for Vaginitis
(a) Avoid nonabsorbent undergarments
(b) Avoid douching
(c) Delay sexual intercourse until treatment is complete and symptoms resolve
