Vulvitis/Vaginitis

Question 1

Vulva Anatomy

Answer 1

• BS: Pudenedal ARtery/vein
• Innervation: Pudendal nerve via sacral plexus
• Lymphatics: Superficial Inguinal

Question 2

Intertrigo

Answer 2

An inflammatory eruption in body folds brought about by opposition of moist surfaces.

Question 3

Folliculitis/Furunculosis Tx

Answer 3

• Warm compress
• Dicloxacillin
• Hibiclens (Chlorhexidine gluconate)

Question 4

Scabies Tx

Answer 4

Permethrin

Question 5

Hidradenitis Suppurativa

• Path
• Tx

Answer 5

• Path: Blockage/infx of sweat glands

- Tx: Sx “unroofing”

Question 6

Fox-Fordyce Disease

• Path
• A/S
• Tx

Answer 6

• Path: Apocrine glands plugged by keratin
• A/S: Improves w/ estrogen
• Tx: Topical glucocorticoids

Question 7

Physiologic Leukorrhea

Answer 7

• non-homogenous, odorless
• Superficial epithelial cells, lactobacilli, + few WBCs
• Addition of KOH does NOT produce odor

Question 8

Bacterial Vaginosis Diagnosis “amsel’s criteria”

Answer 8

• Milky Discharge
• Clue Cells (Epithelium w/ studded bacteria)
• • “Whiff” test
• pH > 4.5
• Mobilincuss flora (Gram - anaerobic rrod shaped bacilli)

Question 9

BV Tx

Answer 9

• Clindamycin
• Metronidazole
• Tinidazole

Question 10

Trichomoniasis

• s/s
• LabDx
• Tx

Answer 10

• s/s: acute onset itching, frothy gray-green discharge;
• LabDx: Strawberry cervix, wet prep basal cells; Oval unicellular flagellated organisms
• Tx: Metronidazole (***2G single dose); Tinidazole

Question 11

Candidias

• S/S
• Tx

Answer 11

• S/S: Acute onset, itching/burning, dysuria, thick cottage cheese discharge, adhgerent white patches
• Tx: Topical imidazoles, Oral fluconazole for recurrent

Question 12

A 43 year old female presents to the office c/o intense vulvar itching and frothy green discharge for several days. What would you predict to be found on her wet mount?
A.  Budding yeast
B. Pseudohyphae
C. Clue Cells
D. Trichomonads

Answer 12

D. Trichomonads

Question 13

A 19 year old female presents to your clinic c/o of copious amount of vaginal discharge. The wet mount has clue cells and a (+) whiff test. What is her treatment?A.Flucanazole
B.Clotrimazole
C.Metronidazole

Answer 13

C.Metronidazole