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Medicine II: OBGYN > Vaginal Infections > Flashcards

Vaginal Infections Flashcards

0
Q

What is the main type of candida vaginitis infection?

A

Albicans

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1
Q

What is the main classification of vaginal infections?

A

Bacterial vaginosis

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2
Q

What are predisposing factors to candidiasis?

A 
Antibiotic therapy
Corticosteroid therapy
Diabetes
Oral contraceptives
Pregnancy
Immunodeficiency disorder
Use of vaginal oils
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3
Q

Clinical manifestations of candidiasis:

A 
Pruritus
Erythema
Edema
Satellite pustules
White, curd-like discharge
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5
Q

Candidiasis diagnosis:

A

Normal vaginal ph
Koh prep. (Standard office procedure)
Culture- only for patients who have been refractory to treatment (in reproduction of yeast look for budding and mycelia formation)

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6
Q

What are preventative measures for candidiasis?

A 
Avoid bubble baths
Avoid douching
Avoid use of vaginal oils
Wear cotton undergarments (better aeration)
Careful hygiene (corn starch to avoid moisture)
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7
Q

What is the treatment for candidiasis?

A

Topical antifuncal agents

  • miconazole-OTC
  • clotrimazole- OTC
  • terconazole-prescription

Oral anti-fungal agents
-fluconazole (2 tablets, 1 initially then wait)

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8
Q

What is the treatment for recurrent candidiasis infections?

A

use of topical or oral agent monthly
use oral medication weekly x 12 weeks
use oral medication daily

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9
Q

Trichomoniasis

A

STD
Incubation period is 4-28 days
highly contagious (75% chance)

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10
Q

What are the clinical manifestations of trichomoniasis?

A 
Frequency
Dysuria
Dyspareunia
Erythema
Pruritus
YELLOW-GREEN FROTHY DISCHARGE
Punctate cervical hemorrhages
Vaginal pH >4.5
Strawberry cervix
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11
Q

How do you diagnose trichomoniasis?

A

Pap smear
Saline prep- only thing moving besides sperm
Culture- rarely used in clinic

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12
Q

What is the treatment for trichomoniasis?

A

drug of choice is metronidazole
single 2 gm dose (4 tablets, 500mg)
-250 mg TID x 7 days
-500 mg BID x 7 days

Sexual partner is treated too
CONSIDER CONDOMS UNTIL PARTNER IS TREATED

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13
Q

Does trichomoniasis affect infertility?

A

no

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14
Q

What is the most common vaginal infection?

A

BV, multiple organisms

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15
Q

What is the most common bacterial vaginosis?

A

anaerobes

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16
Q

What is the pathophysiology of bacterial vaginosis?

A

results from a disruption of normal lacto bacilli dominant flora- elevation of pH and overgrowth of anaerobes

17
Q

What are causes of bacterial vaginosis?

A 
menses
douching
use of lubricants
intercourse
antibiotic exposure
18
Q

What are the clinical manifestations of bacterial vaginosis?

A

Thin gray discharge
PROMINENT VAGINAL ODOR
minimal inflammation
no pruritus

19
Q

How do we diagnose bacterial vaginosis?

A

Vaginal pH > 4.5
Positive amine test- whiff test, KOH on secretions and smell
Positive saline microscopy

20
Q

What do we look for in the saline microscopy for bacterial vaginosis?

A

the studding of the epithelial surface by multiple organisms

21
Q

What are complications of bacterial vaginosis?

A 
PID
PPROM- premature rupture of the membrane
Post operative infection
Preterm delivery
Chorioamnionitis
Endomertiosis
22
Q

Why do we have to be cautious of bacterial vaginosis?

A

It can cause serious systemic problems

23
Q

How do we treat bacterial vaginosis?

A

Topical metronidazole - once daily x 5 days at bed time

  • more expensive
  • less likely to prevent systemic complications of BV
  • **ORAL METRONIDAZOLE - 500 mg twice daily for 7 days
  • less expensive
24
Q

What can you not do while on metronidazole?

A

drink

25
Q

What are the clinical manifestations of a bartholins gland cyst?

A

pain
swelling
palpable mass

26
Q

What are the clinical manifestations of a bartholins gland abscess?

A 
fever
pain
swelling
erythema
fluctulant mass
purulent drainage
27
Q

What are the dominant oragnisms that form bartholins gland abscesses?

A

gonorrhe
chlamydia
coliforms
anaerobes

28
Q

What are the clinical manifestations of a bartholins gland tumor?

A

swelling

firm, indurated mass

29
Q

What is the most likely bartholins gland tumor?

A

adenocarcinoma, uncommon if younger than 50

30
Q

How do we diagnose a bartholins gland cyst?

A

drainage and sitz baths, marsupialization

31
Q

How do we diagnose a bartholins gland adscess?

A

drainage, abx, sitz bath

marsupialization

32
Q

How do we diagnose a bartholins gland tumor?

A

biopsy

excision

33
Q

What is the technique for drainage of a bartholins gland mass?

A

using a words catheter

34
Q

What antibiotics do we use to treat a bartholin’s gland abscess?

A

Doxycycline (100mg BID) PLUS metronidazole (500mg BID)

Amoxicillin PLUS clavulanic acid (875 mg BID)

Medicine II: OBGYN (18 decks)

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