Vulvovaginal Disorders

Question 1

Increased risks for a yeast infection: medications

Answer 1

ABX, immunosuppressants, estrogen-containing contraceptives, estrogen replacement systemic steroids, sodium-glucose cotransporter inhibitor class of DM meds

Question 2

Other increased risks for a yeast infection

Answer 2

Pregnancy, onset of sexual activity, DM, high intake of refined sugar products, vaginal sponge use

Question 3

Yeast infection presentation

Answer 3

White, curd-like discharge with no odor

Complaints of itching, burning, swelling, redness, external dysuria, excoriations

Normal pH of 4-4.5

Microscopy may show C. albicans

Question 4

Nonpharm treatment for yeast infection

Answer 4

Decreased consumption of sucrose and refined carbs

D/C meds that may increase risk

Question 5

Pharm treatment for yeast infection

Answer 5

Topical imidazole (Monistat)
Rx treatment: Fluconazole, Ibrexafungerp

Question 6

Yeast infection treatment side effects

Answer 6

Minor burning, itching, irritation

Question 7

Yeast infection counseling

Answer 7

Apply med, avoid, symptom improvement will occur 203 days after and will resolve in a week

Question 8

Increased risks for bacterial vaginosis

Answer 8

Smoking, multiple partners/new partners, douching, African American race, IUD use, reception of oral sex

Question 9

BV presentation

Answer 9

Thin, off-white or discolored foamy discharge with a fishy odor
Clue cells
pH >4.5

Question 10

BV nonpharm treatment

Answer 10

Yogurt

Question 11

BV pharm treatment

Answer 11

RX ONLY!

Metronidazole, clindamycin

Question 12

Is partner treatment necessary for a yeast infection?

Answer 12

No

Question 13

Is partner treatment necessary for BV?

Answer 13

No

Question 14

Increased risks for trichomoniasis

Answer 14

Multiple sex partners, non-barrier contraceptive use, presence of other STIs

Question 15

Presentation of trich

Answer 15

Strawberry spots, copious yellow-green, malodorous discharge, vulvar irritation

Trichomonas vaginalis on microscopy, WBCs in vaginal culture

Elevated pH (5-7.5)

Question 16

Trich pharm treatment

Answer 16

RX ONLY!
Aim for a single-dose regimen

Metronidazole 2g PO, tinidazole 2g PO

Question 17

Pregnant women trich treatment

Answer 17

Metronidazole 2g PO

Question 18

Is partner treatment necessary for trich?

Answer 18

YES! Avoid intercourse until both partners have completed treatment

Question 19

Increased risks for atrophic vaginitis

Answer 19

Post-menopausal, postpartum, currently breastfeeding, antiestrogenic medications

Question 20

Atrophic vaginitis presentation

Answer 20

Decrease in vaginal lubrication, vaginal irritation, dryness, itching, leukorrhea, dyspareunia

Thin watery, sometimes bloody, or yellow malodorous vaginal discharge

Question 21

Atrophic vaginitis treatment

Answer 21

OTC: water-soluble products
RX: topical estrogen products