Vaginitis and Vaginosis: Ryan Flashcards

1
Q

Since many of the infectious agents causing bacterial/fungal vaginosis are normal flora of the vagina, how is it that they cause pathology?

A

Disturbance of the normal flora, esp. the gram + lactobacilli, that help maintain a low pH and produce hydrogen peroxide that hold infectious bacteria at bay.

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2
Q

What are the etiologic agents of bacterial vaginosis (BV)>

A

Gardnerella vaginalis, Mobilunicus, anaerobes

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3
Q

Yellow discharge from vagina. What is the etiological agent?

A

Trichomonas vaginalis. Should smell like fish. Do wet mount to confirm. Should see protozoa swimming around. Also look for strawberry cervix on speculum exam.

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4
Q

White or grey discharge from the vagina, what is causing this?

A

Possibly bacterial vaginosis. Look for clue cells (epithelial cells covered w/ bacteria). Should smell like fish.

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5
Q

How do you distinguish cystitis from pyelonephritis?

A

Cystitis: suprapubic pain, insignificant fever, dysuria, significant bacturia.
Pyelonephritis: back pain, significant fever, WBC/RBC casts in urine.

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6
Q

Which of the etiological organisms of BV is sexually transmitted?

A

Trich (the protozoan)

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7
Q

How do we diagnose BV, clinically? (no extensive labs)

A

Foul odor
ALWAYS see Discharge (dirty white/gray)
pH of discharge >4.5
Presence of clue cells (epithelial cells covered w/ bacteria)

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8
Q

How do we dx candidiasis, clinically? (no ext. labs)

A

Vaginal itching
Cottage cheese exudate (discharge)
Pungent (not foul smelling) odor
pH

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9
Q

How do we treat candidaisis?

A

Azoles (topical and oral) or nystatin

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10
Q

How do we treat trich?

A

Oral metronidazole

Metronidazole is of the nitroimidazole class. It inhibits nucleic acid synthesis by disrupting the DNA of microbial cells. (NOT AN AZOLE)

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11
Q

How do we treat BV?

A

Oral metronidazole

Metronidazole is of the nitroimidazole class. It inhibits nucleic acid synthesis by disrupting the DNA of microbial cells. (NOT AN AZOLE)

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