thrush

Question 1

bacterial cause

Answer 1

candida albicans

Question 2

RF for thrush

Answer 2

broad spec ABX
cushing’s disease
uncontrolled diabetes (SGLT2i)
meds - SGLT2i, corticosteroids
immunosuppression (HIV, chemo)
inc oestrogen (pregnancy, COC, HRT)
local factors - heat, moisture, topical cs
female

Question 3

symptoms

Answer 3

• vulval/vaginal itching
• vulval/vaginal or penile soreness, redness, burning, irritation
• discharge -> white, cheese like, NO SMELL
• superficial dyspareunia (pain on intercourse, not internal, discomfort)
• dysuria

Question 4

1st line Tx

Answer 4

oral fluconazole 150mg capsule stat dose

Question 5

c/i for fluconazole

Answer 5

pregnant

breastfeeding

Question 6

fluconazole interactions

Answer 6

erythromycin

Question 7

2nd line Tx

Answer 7

clotrimazole 2% external cream
16-60yrs
apply BD-TDS until Sx improve

if >7 days, see GP

Question 8

counselling

Answer 8

• avoid tight fitting clothes especially synthetic underwear
• wear loose fitting, natural fibre underwear
• avoid using perfumed products/soaps around genital area
• clotrimazole can damage condoms/diaphragms
• should clear up in 7-14 days of starting Tx
• don’t need to treat partners unless they have Sx

Question 9

referral

Answer 9

• FIRST PRESENTATION (licencing)
• U16, O60
• diabetic
• pregnant/bf
• 2 episodes in 6 months
• patient/partner with Hx STI
• abnormal menstrual bleeding/lower abdominal pain
• systemic Sx: fever, chills, lower back pain
• foul smelling discharge (BV)
• no improvement in 7 days
• vulval/vaginal sores, ulcers, blisters
• male and partner doesn’t have trush -> refer