Infections of the Vagina and Vulva Flashcards
(29 cards)
which type of organism predominates infections of the vagina and vulva?
anaerobes
what is the vaginal pH range?
3.5-4.5
what is the patho of bacterial vaginosis?
decreased hydrogen peroxide-producing lactobacilli
increased anaerobic gram - rods
what is the gold standard diagnostic for bacterial vaginosis?
gram stain
what is the criteria for bacterial vaginosis?
amsel’s diagnostic criteria
2/4:
clear, creamy, thin discharge
odor
pH > 4.5
clue cells
patient presents with clear, creamy, thin discharge with an odor and pH > 4.5. Dx? treatment?
bacterial vaginosis
metronidazole
patient presents for the 3rd time with clear, creamy, thin discharge with an odor and pH > 4.5. Dx? treatment? (3)
bacterial vaginosis
intravaginal boric acid + metronidazole
condom use 3-6 mo
what is the most prevalent nonviral STD worldwide?
trichomoniasis
a patient presents with foul, thin, yellow/green discharge. On PE, there are strawberry spots on the cervix, and an elevated vaginal pH. Dx? treatment?
trichomoniasis
metronidazole
what diagnostic is used for trichomoniasis?
NAAT
when to retest for trichomoniasis? why?
3 weeks - 3 months after treatment
check if patient has gotten reinfected by her partner
patient presents with vulvar pruritis, burning, erythema, and edema with excoriations. Vaginal discharge looks like curd/cottage cheese that is adhered to the vaginal walls. Dx? treatment (2) for first occurrence and no comorbidities?
candidiasis
1 dose of 150mg fluconazole
topical antifungal
what are 3 risk factors for candidiasis?
diabetes mellitus
immunosuppression
pregnancy
a patient presents with vulvar itching and white discharge. Vaginal pH is 3.6 and KOH prep and wet mount are negative. what is the next best step in evaluation?
culture for yeast
what is the gold standard diagnostic for candidiasis?
what are 2 other options?
culture
KOH prep
PCR
patient with a history of diabetes presents with vulvar pruritis, burning, erythema, and edema with excoriations. Vaginal discharge looks like curd/cottage cheese that is adhered to the vaginal walls. Dx? treatment?
candidiasis
150mg fluconazole q 72 hours for 2-3 doses
patient presents for the 4th time this year, with vulvar pruritis, burning, erythema, and edema with excoriations. Vaginal discharge looks like curd/cottage cheese that is adhered to the vaginal walls. Dx? treatment?
Candidiasis
topical / oral fluconazole x 10-14 days, then
weekly 150mg fluconazole x 6 months
a patient presents with burning, severe pain, dysuria, fever, headache, and myalgias. they had a vesicle that ulcerated and become crusty. Dx? treatment? (4)
herpes simplex virus
antiviral
antipyretic
pain meds
suppressive therapy for type 2
what is the preferred test to diagnose HSV?
what will be present in serologic testing of HSV?
NAAT
IgG antibody assays
patient presents with an isolated, nontender ulcer with raised rounded borders. 6 weeks later, they notice a maculopapular rash on their palms and soles of feet. Dx? treatment?
syphilis
penicillin
what is the gold standard diagnostic for syphilis?
direct detection of spirochetes with blood test
patient presents with soft, irregular margins and a friable base, tender inguinal lymphadenopathy. The buboes suppurate and form fistulas. Dx? 2 treatment options?
chancroid
PO azithromycin / IM ceftriaxone
what is the diagnostic used for chancroid?
NAAT
patient presents with small painless papule that leads to regional lymphadenopathy, and then anogenitorectal fibrosis. Dx? treatment?
lymphogranuloma venereum (LGV)
doxycycline
