2 - Vaginal Infections Flashcards Preview

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Flashcards in 2 - Vaginal Infections Deck (29)
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1
Q

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

A

Bacterial Vaginosis, Candidiasis, Trichamonas

2
Q

For Candidiasis infections, what is the most common organism?

A

Albicans

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

3
Q

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

A

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

4
Q

What is the normal range for vaginal pH?

A

3.8-4.2

5
Q

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

A

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

6
Q

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

A

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

7
Q

What are the topical OTC recommendations for yeast infection?

A

Miconazole, Clotrimazole

8
Q

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?

A

Candidiasis

9
Q

What is the prescription strength topical recommendation for yeast infection?

A

Terconazole

10
Q

What is the oral script for yeast infection?

A

Fluconazole

11
Q

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

A

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

12
Q

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

A

trichomoniasis

13
Q

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

A

superficial vaginal pain

14
Q

What does trich discharge look like?

A

yellow-green, frothy

15
Q

What is the pH for trich dx?

A

> 4.5

16
Q

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

A

strawberry vagina

17
Q

What is the tx for trich?

A

Metronidazole 2grams, single dose

18
Q

Do you need to get a culture to confirm trich?

A

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

19
Q

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

A

Lactobacilli

20
Q

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

A

menses, douching, lubes, intercourse, abx

21
Q

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

A

Clue cells

22
Q

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

A

Bacterial Vaginosis

23
Q

What is the vaginal discharge like for BV?

A

thin, gray, fishy

24
Q

What is the pH for BV?

A

> 4.5

25
Q

What are some complications from BV?

A

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

26
Q

What is the tx for BV?

A

ORAL metronidazole 500mg one po BID x 7 days

better than topical b/c it will handle systemic complications

27
Q

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

A

cyst, abscess, tumor

28
Q

How do you tx problem with Bartholin’s Gland?

A

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

29
Q

What abx course is best for Bartholin’s abscess?

A

Doxy + Metronidazole

or Augmentin