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Flashcards in 2 - Vaginal Infections Deck (29)
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1

What are the 3 basic vaginal infections, in order from most common to least common?

Bacterial Vaginosis, Candidiasis, Trichamonas

2

For Candidiasis infections, what is the most common organism?

Albicans
(patients who do not respond to tx for Candida Albicans may have a different organism like tropicalis, glabrata, etc)

3

What are the 7 risk factors that predispose women for developing candidiasis?

1) antibiotics
2) corticosteroids
3) diabetes
4) oral BC
5) pregnancy
6) immunocompromised
7) lubes

4

What is the normal range for vaginal pH?

3.8-4.2

5

If your patient has a complaint of vaginal discharge, what is the first thing you should do?

Test pH.
Normal = normal secretion or candidiasis
Abnormal = BV or trich

6

If your pH is normal, what could you do to make a definitive dx?

KOH prep, look for the little buds on the squiggly mycelia. (HYPHE)

7

What are the topical OTC recommendations for yeast infection?

Miconazole, Clotrimazole

8

Your patient comes in complaining of severe vaginal itching. Upon exam, you note erythema, satellite pustules, and white curd-like discharge. What is the most likely dx?

Candidiasis

9

What is the prescription strength topical recommendation for yeast infection?

Terconazole

10

What is the oral script for yeast infection?

Fluconazole

11

What are some things your patient should avoid if they are prone to candidiasis?

bubble baths, douching, oils, synthetic underwear (use cotton), dampness (careful hygiene)

12

Which of the 3 major vaginal infections is caused by an STD?

trichomoniasis

13

Where do patients experience pain during sex (dyspareunia) if they have trich?

superficial vaginal pain

14

What does trich discharge look like?

yellow-green, frothy

15

What is the pH for trich dx?

>4.5

16

Trich is a/w punctate cervical hemorrhages, what is that?

strawberry vagina

17

What is the tx for trich?

Metronidazole 2grams, single dose

18

Do you need to get a culture to confirm trich?

Not usually, you can see trich in a saline prep under the microscope

19

What is the "police force" responsible for maintaining a normal vaginal pH?

Lactobacilli

20

What are some things that can disrupt the normal levels of lactobacilli, leading to an overgrowth of anaerobes?

menses, douching, lubes, intercourse, abx

21

Vaginal epithelial cell that is studded with hundreds of microorganisms that create an uneven cell border. They indicate BV and are seen on saline microscopy

Clue cells

22

When vaginal pH is elevated due to the overgrowth of anaerobes, what is the diagnosis?

Bacterial Vaginosis

23

What is the vaginal discharge like for BV?

thin, gray, fishy

24

What is the pH for BV?

>4.5

25

What are some complications from BV?

1) PID
2) Post op infection
3) PPROM
4) preterm delivery
5) chorioamnionitis
6) endometritis

26

What is the tx for BV?

ORAL metronidazole 500mg one po BID x 7 days
(better than topical b/c it will handle systemic complications)

27

The bartholin's gland has 3 major problems associated with it. What are they?

cyst, abscess, tumor

28

How do you tx problem with Bartholin's Gland?

I&D,
clear serous drainage = cyst,
purulent = abscess (then culture and tx).
hard tumor = excise and bx

29

What abx course is best for Bartholin's abscess?

Doxy + Metronidazole
(or Augmentin)