Vaginitis Flashcards
what is an inflammation/infection of the vagina that results from either pathogens, allergic reactions, vaginal atrophy, or friction?
vaginitis
signs and sx of vaginitis
irritation/pruritus
pain
malodorous discharge
tenderness with bimanual exam
DDX of vaginitis that has pruritus, vulvovaginal erythema, and white curd discharge that is NOT malodorous?
Vulvovaginal Candidiasis (yeast infection)
DDX of vaginitis that is a sexually transmitted protozoal flagellate. presents with pruritus and malodorous frothy, yellow green discharge?
Trichomonas Vaginalis Vaginitis
Which DDX of vaginitis will have increased malodorous discharge without obvious vulvitis or vaginitis?
Bacterial Vaginosis (BV)
what are some other miscellaneous causes of vaginitis that arent Candidiasis, trichomonas, or BV?
Chlamydia, Gonorrhea, contact dermatitis, chemical irritation
What are some KOH findings with vaginitis?
KOH ( skin lesion KOH exam is a test to diagnose a fungal infection of the skin):
Branched hyphae and budding yeast w Candidiasis
Positive Whiff test with BV (amine or fishy odor)
what are some wet prep findings with vaginitis?
Wet prep (a vaginal smear):
Motile flagella in T vaginalis
Clue cells in BV
besides KOH and Wet Test, what are some other labs you can run for vaginitis?
NAAT (nucleic acid amplification test) urine testing for Chlamydia and Gonorrhea
Vagina pH:greater than 4.5 in T vaginalis or BV
Treatment for volvuvaginal candidiasis?
Fluconazole (Diflucan) 150 mg daily
treatment for Trichmonas:
both partners need:
Metronidazole (flagyl)- an antibiotic w cytotoxic effects towards anaerobic organisms.
treatment for bacterial vaginosis:
Metronidazole (Flagyl) 500 mg BID 7 days
Clindamycin Cream
Metronidazole GEL (NOT PO, will cause Torsades de Pointes)
treatment for Chlamydia
Doxy
treatment for gonorrhea
ceftriaxone (rocephine)
