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Repro Images + Micro > Vaginitis and vaginosis > Flashcards

Vaginitis and vaginosis Flashcards

1
Q

Opportunistic caused of vaginitis/vaginosis

A

Candida albicans and glabrata
Gardnerella vaginalis
Mobiluncus

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2
Q

Disruption of what kind of normal flora promotes growth of Candida, Gardnerella, and Mobiluncus?

A

Lactobacilli, flora that help maintain and acidic pH and produce H2O2

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3
Q

List some factors associated with opportunistic vaginitis/vaginosis.

A

Abx, douching, tight underwear, onset of menses, initial use of IUD, pregnancy, sex

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4
Q

Besides the vagina, where else are Candida, Gardnerella, and Mobiluncus found?

A

Intestine

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5
Q

Is trichomonas sexually transmitted?

A

YES! NOT part of normal flora

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6
Q

What else does trich cause besides vaginitis/osis?

A

Urethritis in males

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7
Q

White discharge

A

Candida or BV

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8
Q

Yellow discharge

A

Trich

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9
Q

Clumpy discharge

A

Candida

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10
Q

Discharge uniformly coats vagina

A

BV

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11
Q

Fishy smell

A

BV

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12
Q

Lactobacilli predominate in microscopy

A

Normal

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13
Q

Normal vaginal pH

A

4.5

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14
Q

Discharge pH > 4.5

A

BV, trich

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15
Q

Leukocytes in discharge

A

Candida, trich

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16
Q

Clue cells

A

BV (Gardnerella coating epithelial cells)

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17
Q

Scant discharge

A

Candida

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18
Q

Profuse discharge

A

Trich

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19
Q

Frothy discharge

20
Q

Dysuria

A

Candida, trich

Cystitis, pyelo, cervicitis

21
Q

Vulvar itching

A

Candida, trich

22
Q

No erythema

A

Normal, BV

23
Q

Introitus

24
Q

Colpitis macularis

A

“Strawberry cervix” = trich

25
Q

Vulvar fissure

A

Candida

normally open but can look closed d/t Candidiasis-induced edema

26
Q

Mycelia/pseudomycelia on microscopy

A

Candida

mass of branching hyphae

27
Q

Leukocytes in the urine

28
Q

WBC/RBC casts in the urine

29
Q

Suprapubic pain

A

Cystitis, pyelo

30
Q

Fever

31
Q

Mucopurulent discharge

A

Cervicitis

32
Q

Flank/back pain

33
Q

> 10^5 bacteria in the urine

A

Cystitis. pyelo

34
Q

(T/F): BV and Candidiasis cannot be passed from a female to a male

A

False; they can be sexually transmitted but generally are d/t overgrowths

35
Q

Candidiasis vs. trichomoniasis

A

Both will have dysuria, discharge, vulvar erythema and itching, but Candida will produce scant, clumpy, white discharge with pH ~ 4.5 while trich will produce abundant, yellow, frothy discharge with pH > 4.5

36
Q

Candida vs. BV

A

Both will have white, clumpy discharge but BV D/C will be stanky with pH > 4.5; Candida will cause vulvar edema and erythema and have leukocytes on microscopy

37
Q

BV vs. trichomoniasis

A

Both will cause discharge, pH > 4.5, and can be smelly but BV will cause adherent white discharge with Clue cells while trich causes yellow, frothy discharge with leukocytes and vulvar erythema

38
Q

Clear discharge

39
Q

Use KOH in diagnosis

A

Candida - to isolate

BV - for whiff test

40
Q

What causes malodorous smell of BV discharge during whiff test?

A

KOH causes amine release, which has a fishy smell

41
Q

Usually the only sx of BV is:

42
Q

Can be cultured

A

Candida or trich if clinical signs suggest infection but other tests are negative

43
Q

Tx candidiasis

44
Q

Tx trich

A

Metronidazole

45
Q

Tx BV

A

Metronidazole or clindamycin

46
Q

Required tx of partner

47
Q

A patient returns to your office with persistent white vaginal discharge and vulvar itching despite stated compliance with a 7 day course of imidazole prescribed 9 days ago. What might be the problem?

A

Infection with Candida glabrata, which is associated with treatment failure “not uncommonly”

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