Vaginitis

Question 1

what are the three causes of vaginitis

Answer 1

bacterial vaginosis (BV)
Vulvovaginal Candidiasis (VVC)
Trichomoniasis

Question 2

describe the vaginal environment

Answer 2

normal bacterial flora is dominated by lactobacilli which produce lactic acid and prevent vaginitis

Question 3

describe role of lactobacilli

Answer 3

• lactic acid helps maintain normal vaginal pH of 3.8-4.2 (acidic)
• some produce hydrogen peroxide (microbicide)

Question 4

what is vaginitis characterized by

Answer 4

vaginal discharge, vulvar itching, irritation, odor

Question 5

what is the most common vaginitis

Answer 5

1) bacterial vaginosis (40-45%)
2) vulvovaginal candidiasis (20-25%)
3) trichomoniasis (15-20%)

Question 6

describe what a clue cell is

Answer 6

bacteria adhered to cells

*indicates bacterial vaginosis

Question 7

why is a specimen collected and looked at on a slide

Answer 7

indicates if have enough lacto bacilli or too many yeast buds (foot print)

Question 8

what does douching do

Answer 8

decreases vaginal odor

BUT also eliminates all bacteria (good and bad)

Question 9

how is the specimen examined

Answer 9

-NaCl wet mount- salt
KOH wet mount- potassium hydroxide: produces a strong pungent odor if positive (Whiff test)
-vaginal pH to determine if acidic or alkaline

Question 10

ss of bacterial vaginosis

Answer 10

fishy smell, discharge, itchy

Question 11

bacterial vaginosis pH and reaction to KOH (Whiff) test

Answer 11

4.5 pH

positive test

Question 12

treatment of bacterial vaginosis

Answer 12

metronidazole (Flagyl): gel or PO

OR clindamycin cream

Question 13

what is metronidazole aka

Answer 13

Flagyl

Question 14

what is important to remember when taking Flagyl

Answer 14

no alcohol 72 hrs before or after treatment d/t antibiotic killing all bacteria (causes pt to become violently ill with alcohol)

Question 15

ss of candidiasis

Answer 15

itch, discomfort, dysuria, thick discharge

Question 16

discharge of candididasis

Answer 16

thick, clumpy white (cottage cheese)

Question 17

clinical findings of candidiasis

Answer 17

inflammation and erythema

Question 18

pH and reaction to KOH test of candidiasis

Answer 18

less than 4.5 pH

negative test

Question 19

treatment of candidiasis

Answer 19

“azole”

• Fluconazole aka diflucan
• keep environment dry (no leggings or thongs)

Question 20

what vaginitis is sexually transmitted

Answer 20

trichomoniasis

Question 21

ss of trichomoniasis

Answer 21

hurts to urinate, itch, discharge, but 70% are asymptomatic!

Question 22

discharge of trichomoniasis

Answer 22

frothy, gray or yellow green

Question 23

clinical findings of trichomoniasis

Answer 23

greater than 4.5 pH

often positive test

Question 24

treatment of trichomoniasis

Answer 24

Metronidazole (Flagyl)

Trinidazole

Question 25

trichomoniasis can lead to _______ if left untreated

Answer 25

PID