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Obs & Gynae > Genital discharge > Flashcards

Genital discharge Flashcards

1
Q

History of genital discharge

A 
Colour, odour, consistency, bloodstaining
Itch
IM or PC bleeding
Dyspareunia
Rash
Sexual history
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2
Q

Investigation of vaginal discharge

A

Examination
High vaginal swab for trichomonas and Candida
Vulvovaginal swab for NAAT - gonorrhoea and chlamydia
Endocervical swab for gonorrhoea

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3
Q

Tests for candida

A

High Vaginal swab for:
Gran stain
Culture

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4
Q

Treatment for candida

A

Clotrimazole pessary stat

Clotrimazole cream BD for 2 weeks

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5
Q

What is recurrent candidiasis

A

> 4 symptomatic episodes per year

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6
Q

Treatment for recurrent candidiasis

A

Induction + maintenance

Maintenance therapy:
Fluconazole once a week for 6 months

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7
Q

Precipitants of BV

A

Unprotected intercourse
Receptive oral sex
Perfumed both products
Menstruation

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8
Q

Amstel criteria for BV

A 
3 or more:
Characteristic discharge (fishy, off-white)
Clue cells
Raised vaginal pH >4.5
KOH whiff test positive
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9
Q

Treatment for BV

A

Metronidazole 400mg BD for 5 days

Can also be treated with a large stat dose (2g) or a PV gel for 5 day

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10
Q

Diagnosis of trichomonas vaginalis

A 
High vaginal swab for:
Wet mount
Culture (most sensitive)
NAAT
Examination - strawberry cervix
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11
Q

Treatment for trichomonas vaginalis

A

Metronidazole 400mg BD for 5 days
Or
Metronidazole 2g stat

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12
Q

Advice for patients taking metronidazole

A

Avoid alcohol

Will make them very nauseous

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13
Q

Differential diagnosis for penile discharge and how to generally differentiate

A

Gonorrhoea
Non-specific urethritis

Greater volume of discharge in gonorrhoea (will stain pants)

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14
Q

Investigations for penile discharge

A

Examination
Urethral swab for gram stain and gonorrhoea culture
Urine NAAT

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15
Q

How to diagnose gonorrhoea

A

Endocervical or urethral swab (gram stain and culture)

Urine NAAT

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16
Q

Treatment for gonorrhoea

A

Ceftriaxone 500mg IM
AND
Azithromycin 1g PO

17
Q

Causes of nonspecific urethritis

A 
Chlamydia trachomatis >60%
Mycoplasma 
Trichomonas vaginalis
Herpes simplex 
HPV
UTI pathogens
Trauma
18
Q

How often is chlamydia asymptomatic

A

50% men

70% women

19
Q

Treatment of chlamydia

A

Azithromycin 1g PO stat

20
Q

Causative organism for BV

A

Gardnerella vaginalis

Obs & Gynae (37 decks)

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