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
