Week 2: Vaginosis

Question 1

Vaginal ecosystem

Answer 1

• Mix of protective and pathogenic bacteria
• Dominant physiologic/protective bacteria: H2O2+ Lactobacilli
• Many external factors affect this ecosystem
• A ‘healthy’ vagina reduces STI risk

Question 2

Vulvovaginal Candidiasis findings

Answer 2

• patient complains of itching/burning, discharge
• vaginal pH 3.8-4.5 (nl 4-4.5)
• White, curdy, cottage cheese like discharge
• absent amine odor
• budding yeast, pseudohyphae seen microscopically
• WBCs may be seen

Question 3

Trichomonas vaginalis findings

Answer 3

• patient complains of frothy discharge, bad odor, vulvar pruritus, dysuria
• vaginal pH greater than 4.5
• grey, yellow-green, frothy flocculent, and adherent discharge
• amine odor frequently present
• WBCs usually seen microscopically. +trichomonads
• sexually transmitted

Question 4

Bacterial vaginosis findings

Answer 4

• patient complaints: discharge, malodor, itching
• vaginal pH greater than 4.5
• thin homogenous, white, gray, adherent discharge
• amine odor present
• microscopic: clue cells-furry looking epithelial cells
• if WBC+, consider upper tract or co infection