Vulvovaginitis Flashcards
3 causes of vulvovaginitis
yeast
BV
trichomonas
yeast sx
intense pruritus
clumping white discharge
pH 4.5
tx of yeast vulvovaginitis
po fluconazole or topical azoles
if complicated then longer tx or intravaginal boric acid
BV symptoms
fishy thin milky discharge
ph >4.5
tx of BV vulvovaginitis
po or topical metronidazole
trichomonas sx
intense pruritis
copious, frothy yellow-green discharge
labs for yeast
wet mount/KOH w/ budding hyphae
labs for BV
clue cells on wet saline
amine/fish odor on wet mount/KOH (pos. whiff test)
trich labs
wet mount w/ motile flagellates (protozoa)
+ whiff test
NAAT
other sx of trich
dysuria
urinary frequency
low abdominal pain
dyspareunia
tx for trich
PO metronidazole for 7 days
tx partners too
RF for yeast infection
DM
abx
immunosuppression
high estrogen
other sx of yeast
vulvar burning
dyspareunia
dysuria
two non-infectious causes of vulvovaginitis
atrophic vaginitis in post menopause
retained FB
5 chronic vulvovaginitis
atrophic vaginitis
lichen simplex chronicus (LSC)
lichen sclerosis
lichen planus
vulvar psoriasis
what is atrophic vaginitis
itching and irritation d/t estrogen deficiency (post menopause)
how is atrophic vaginitis tx ?
topical or po estrogen
what is lichen simplex chronicus
the big itch
itense itching r/t sensitive skin and external irritants
how is LSC tx?
ST topical steroid
avoid irritant
what is lichen sclerosis?
white, thin, atrophic tissue in “hour-glass” distribution
why is it important to recognize lichen sclerosis?
progressive condition & malignant potential
how is lichen sclerosis treated?
topical steroids, TCAs
what is lichen planus
red, erosive lesions, more distortion and scarring
half the ppl w/ it also have oral lesions
what is vulvar psoriasis?
thickened, lichenified tissue, white to silvery plaques
h/o psoriasis
which two conditions have elevated PH
BV and trich
you need 3 of 4 of these to diagnose BV
Homogeneous vaginal discharge
Positive whiff test
Clue cells > 20%
pH > 4.5
what is the most common non-viral STI in the world?
trich
which condition would have “strawberry cervix”?
trich
