GYN Infections

Question 1

Where are the Bartholin ducts?

Answer 1

Posterior lateral vaginal opening

Question 2

What will result if a Bartholin duct is occluded and causes occasional pain, but may be asymptomatic?

Answer 2

Bartholin Cyst

Question 3

What will result if a Batholin duct cyst then gets infected and becomes an abscess?

Answer 3

Painful, warm and fluctuant mass at the posterior lateral edge of vaginal opening with possible cellulitis

Question 4

Treatment for Bartholin cysts? Abscess?

Answer 4

Cysts – Supportive
Abscess – I&D

Question 5

What is Condyloma Acuminata?

Answer 5

Genital warts

Question 6

What causes Condyloma Acuminata?

Answer 6

HPV 6 or 11

Question 7

How will Condyloma Acuminata present?

Answer 7

Clusters of skin colored verrucous/flat lesions
+/- bleeding with manipulation

Question 8

What are 3 possible treatments for Condyloma Acuminata?

Answer 8

• Topical podophyllin resin/acetic acid
• Imiquimod

Question 9

How does Bacterial Vaginosis occur?

Answer 9

Normal organisms are replaced with Gardnerella Vaginalis

Question 10

How will Bacterial Vaginosis present?

Answer 10

Thin grey-white vaginal discharge with a fishy odor

Question 11

Thin grey-white vaginal discharge with a fishy odor

Answer 11

Bacterial Vaginosis

Question 12

What will the pH of the vagina be with Bacterial Vaginosis? What test will be (+)?

Answer 12

pH > 4.5
(+) Whiff test

Question 13

What cells will be present with Bacterial Vaginosis?

Answer 13

Clue cells = epithelial cells coated with bacteria

Question 14

What is the treatment for Bacterial Vaginosis?

Answer 14

Metronidazole

Question 15

What things can increase your chances of getting Candida Vaginitis?

Answer 15

Obesity/Diabetes
Recent antibotic/OCP use
Immunosuppression
Tight fitting clothing

Question 16

How will Candida Vaginitis present?

Answer 16

Thick white cottage cheese discharge with possible itching and burning

Question 17

Thick white cottage cheese discharge with possible itching and burning

Answer 17

Candida Albicans Vaginitis

Question 18

What may you see with Candida Vaginitis?

Answer 18

Loosely adherent pseudomembrane

Question 19

What will be seen on KOH prep with Candida Vaginitis?

Answer 19

Pseudohyphae

Question 20

Treatments for Candida Vaginitis? (2)

Answer 20

Oral Fluconazole
Topical Miconazole

Question 21

Trichomonas Vaginalis infection is a STI. How will it present?

Answer 21

Green frothy vaginal discharge with possible itching and burning

Question 22

Green froth vaginal discharge with possible itching and burning

Answer 22

Trichomonas Vaginalis infection

Question 23

What may be seen at the cervix with Trichomonas Vaginalis?

Answer 23

Strawberry cervix

Question 24

What will be seen on Saline prep with Trichomonas Vaginalis?

Answer 24

Motile flagellated protozoa

Question 25

What is the treatment for Trichomonas Vaginalis?

Answer 25

Metronidazole to patient AND PARTNER

Question 26

What 2 infections commonly cause Cervicitis?

Answer 26

Gonorrhea or Chlamdyia

Question 27

Cervicitis may be asymptomatic, although how may it present?

Answer 27

Purulent cervical discharge + cervical motion tenderness

Question 28

Purulent cervical discharge + cervical motion tenderness is likely?

Answer 28

Cervicitis

Question 29

What causes PID?

Answer 29

Repeated bouts of cervicitis that allow organisms to ascend

Question 30

Signs of PID?

Answer 30

Pelvic pain + tenderness to palpation @ cervix/adnexa/uterus + systemic signs of infection

Question 31

Signs of PID?

Answer 31

Pelvic pain + tenderness to palpation @ cervix/adnexa/uterus + systemic signs of infection

Question 32

What is the outpatient treatment for PID?

Answer 32

Ceftriaxone + Doxycycline +/- Metronidazole

Question 33

What is the outpatient treatment for PID?

Answer 33

Ceftriaxone + Doxycycline +/- Metronidazole

Question 34

What may result from PID, especially if the patient has extreme 1 sided tenderness?

Answer 34

Tubo-ovarian abscess

Question 35

What is a possible syndrome that can result from PID?

Answer 35

Fitz-Hugh-Curtis Syndrome

Question 36

Fitz-High-Curtis Syndrome

Answer 36

Perihepatitis = RUQ pain + HIGH LFTs

Question 37

What causes Toxic Shock Syndrome?

Answer 37

Preformed Staph. Aureus Toxin often after tampon use

Question 38

What are the signs of Toxic Shock Syndrome?

Answer 38

- Fever and hypotension - Vomiting/diarrhea - Red rash that desquamates on the palms/soles

Question 39

What are the signs of Toxic Shock Syndrome?

Answer 39

- Fever and hypotension - Vomiting/diarrhea - Red rash that desquamates on the palms/soles

Question 40

What is the treatment for Toxic Shock Syndrome?

Answer 40

Rehydration + Antibiotics = Vancomycin + Clindamycin