Vaginitis

Question 1

What hx should be taken for a patient with vaginitis?

Answer 1

LMP
Recent sexual activity (use of condoms, lubricants)
Use of contraceptives, tampons, douches
Changes in medications or use of antibiotics

Question 2

Patient presents with vaginal irritation, discharge, pain and bimanual exam shows pelvic inflammation, cervical motion tenderness and adnexal tenderness, what condition might they have?

Answer 2

Vaginitis

Question 3

What labs and findings should you expect in a patient with Vaginitis?

Answer 3

KOH: candidiasis, amine or fishy odor (whiff test)
Wet Prep: Motile flagella in T. vaginitis, clue cells
GC, Vaginal pH

Question 4

Patient with pruritis, vulvovaginal erythema and white curd-like discharge is likely?

Answer 4

Vulvovaginal candidiasis (yeast infection)

Question 5

Pruritus and a malodorous frothy, yellow-green discharge occur along with diffuse vaginal erythema is likely?

Answer 5

Trichomonas vaginalis vaginitis

Question 6

What is strawberry cervix and what condition is it correlated to?

Answer 6

Red macular lesions on the cervix
Trichomonas vaginalis vaginitis

Question 7

How is trichomonas vaginalis vaginitis contracted?

Answer 7

Sexually transmitted protozoal flagellate

Question 8

What does trichomonas vaginalis vaginitis effect in men and women?

Answer 8

Women: skene ducts, vagina, lower urinary tract
Men: Lower genitourinary tract

Question 9

What is bacterial vaginosis (BV)?

Answer 9

Polymicrobial disease that is not sexually transmitted, chronic in nature

Question 10

What causes bacterial vaginosis (BV)?

Answer 10

Overgrowth of Gardnerella and other aerobes

Question 11

Patient presents with malodorous discharge without obvious vulvitis or vaginitis, what condition might they have?

Answer 11

Bacterial vaginosis

Question 12

What medication should be given for vulvovaginal candidiasis?

Answer 12

Fluconazole (Diflucan) 150mg daily for 1 day

Question 13

What medication should be given for trichmonas vaginalis vaginitis?

Answer 13

Both partners to be treated
Metronidazole (flagyl) 2g PO x 1 or 500mg BID x 7 days

Question 14

What medications should be given for bacterial vaginosis?

Answer 14

Metronidazole (flagyl) 500mg BID x 7 days
Clindamycin vaginal cream 5g daily for 7 days

Question 15

What medications should be given for chlamydia?

Answer 15

Doxycycline 100mg bid x 7 days

Question 16

What medications should be given for gonorrhea?

Answer 16

Ceftriaxone (Rocephin) 500mg IM

Question 17

What education should be provided for patients with vaginitis?

Answer 17

Avoid non absorbent garments
Avoid douching
Delay intercourse until treatment is completed