Question 10: Vulvovaginal disease Flashcards
(21 cards)
What causes bacterial vaginosis?
Absence of Lactobacilli, leading to reduced vaginal acidity and overgrowth of anaerobic bacteria.
Which anaerobic bacteria are commonly involved in BV?
Gardnerella vaginalis
Bacteroides spp
Mobiluncus
Mycoplasma hominis
What diagnostic criteria are used for BV?
Amsel criteria (need 3/4 for diagnosis).
What are the four Amsel criteria for diagnosing BV?
Vaginal pH > 4.5
Positive Whiff test (fishy smell with 10% KOH).
Greyish vaginal discharge.
Clue cells on microscopy.
What is the treatment for BV?
Metronidazole 400mg TDS for 7 days
OR Metronidazole 2g single dose
What pregnancy complications are associated with BV?
Increased risk of second-trimester miscarriage.
Higher chance of preterm delivery.
What is Trichomoniasis?
A sexually transmitted vulvo-vaginitis caused by Trichomonas vaginalis
What are the symptoms of Trichomoniasis?
Purulent, frothy, greenish-yellow, offensive vaginal discharge
Itching/burning
Dysuria (painful urination)
What is the classic cervical appearance in Trichomoniasis?
“Strawberry cervix” due to punctate hemorrhages.
How is Trichomoniasis diagnosed?
Microscopy of vaginal secretions in normal saline (detects ~60%)
Culture (gold standard but not usually required)
Clinical diagnosis often sufficient
What is the treatment for Trichomoniasis?
Metronidazole 2g stat (single dose)
OR Metronidazole 400mg TDS for 7 days
What is the classic symptom of vaginal Candidiasis?
Severe vaginal itching.
What does the vaginal discharge look like in Candidiasis?
White, curd-like (resembles curdled milk).
How is Candidiasis diagnosed?
Microscopy with 10% KOH wet smear (shows yeasts and hyphae).
What conditions increase the risk of vaginal Candidiasis?
Pregnancy
Diabetes mellitus
HIV/AIDS
Long-term steroid use
Recent antibiotic use (due to altered vaginal flora)
What is the treatment for uncomplicated Candidiasis?
Single dose of vaginal Clotrimazole 500mg.
What causes vulval warts (Condylomata Acuminata) ?
Human Papillomavirus (HPV) types 6 and 11.
Why are vulval warts common in South Africa?
Due to widespread HIV infection, which increases susceptibility.
What are the treatment options for small vulval warts in non-immunocompromised individuals?
Trichloroacetic acid (TCA)
Podophyllin
Imiquimod
Cryotherapy
How are larger vulval warts treated?
CO₂ laser (best cosmetic result)
Electrocautery
Surgical excision
What psychological impact do vulval warts have?
Severe psychosexual morbidity
Emotional distress due to repeated treatments
