Vaginitis Flashcards
vaginitis
inflammation of the vagina, often caused by infxn
sx of vaginitis
discharge, itching, odor, dyspareunia, dysuria, urinary frequency
what are the 3 tx most associated w/ discharge?
bacterial vaginosis, trichomoniasis (STD), vulvovaginal candidiasis
signs and sx of BV
thin, grey, white mucus,
- fishy odor, esp after sex or menses
- pH >4.5
dx of BV
+ whiff test (gross)
clue cells, no WBC
what causes the stinkiness of BV?
anaerobes
tx of BV
metronidazole
2) clindamycin
3) tinidazole
trichomoniasis s/sx
severe pruritis -discharge, often malodorous -dysruia -dyspareunia (painful sex) -greenish-yellow, frothy dischage -
hallmark signs of tric.?
- petechiea or “strawberry markings” on the cervix
- motile flagellated protozoans on wet prep (*warming slide makes them easier to see)
tx of Tric
1) metronidazole 2 gm po
2) tinidazole
**treat partners and go back and look for other STis
ADR of metronidazole
NVD, metallic taste, dark red-brown urine
serious: sz, neruopathies, leukopenia, SJS, TEN
vulvovag. candidiasis (VVC)
NOT an STD
VVC s/sx
- pruritis, burning
- cottage cheese discharge
- dyspareunia
- erythema
- curdy, white discharge
- not malodorous (**normal PH)
what will you see on a wet prep of VVC?
spores, hypahea, KOH, culture
*pseudohyphea or budding yeast
what can lead to VVC?
• Hormonal changes (Pregnancy, OCPs, menopause) • Oral corticosteroid treatment • Oral antibiotics • Nylon underwear, exercise clothing, tight pantyhose, tight jeans, hot weather • Obesity
if recurrent or multiple VVC? think ?
- Hyperglycemia, diabetes
* Immunocompromised state (HIV)
what are some OTC tx?
imidazoles (but increasing reisistance is seen)
oral fluconazole
rx VVC tx?
- butoconazole
- nystatin
- terconazole
- clotrimazole
- terconazole,
- miconazole
Atrophic vaginitis?
not an ifxn, but need to rule it out
-atrophic mucosa is vulnerable to infxn
who may get this atrophic vaginitis?
amenorrheic women (bc decreased estrogen)
- alos, postmenopasal, lactating, extreme exercise
- progesterone tx w/o estrogen
s/sx of AV?
- Pruritus, burning
- Vaginal dryness
- Dyspareunia
- Possibly spotting
- Not associated with odor unless concomitant infection
- Pale, thin vaginal mucosa
- Absence of discharge
- Loss of vaginal rugation (no wrinkles)
- Wet prep negative
how to tx AV?
estrogen replacement, systemic or topical
