Vaginal Discharge

Question 1

What STI could be responsible for a watery grey/white discharge that has a foul fishy smell (worse after sex or menstruation)

Answer 1

BV

Question 2

Mandatory tests

Answer 2

Culture / NAAT for N. gonorrhoea
NAAT for chlamydia

Endocervical swab
Vulvo-vaginal swab
High vaginal swab

Question 3

What would the pH of the vaginal fluid be in BV?

Answer 3

> 4.5

Question 4

Microscopy of BV?

Answer 4

Loss of lactobacilli
Replaced by small cocco-bacilli
Clue cells - studded epithelial cells

Question 5

Treatment of TV and BV?

Answer 5

Metronidazole
Usually tablets for 5-7 days BD
Gel if breast feeding

Question 6

White curdy discharge with pruritis and vulval rash. Superficial dyspanuria

Answer 6

Candidiasis (white patches, leukorrhea (curd dischage) and pruritis

Microscopy = spores +/- pseudohyphae
Culture - high vaginal swab

Question 7

Treatment of candidiasis?

Answer 7

Fluconazole

Question 8

Swab for TV, BV and candidiasis?

Answer 8

High vaginal

Question 9

Cervix appearance in TV?

Answer 9

Strwaberry cervix (5%)

Question 10

Dischage in TV?

Answer 10

Purulent frothy discharge - malodorous, green/yellow

Question 11

Microscopy of TV?

Answer 11

flagellated protozoa

Question 12

Risk factors for candidiasis?

Answer 12

DM
Pregnancy
Immunosuppressed - chemo, HIV, steroids
Recent Abx
OCP

Question 13

Purulent discharge with cervicitis, dysuria and PCB?

Answer 13

Gonorrhoea or chlamydia