Vaginal discharge

Question 1

What does the HPV vaccine protect against?

Answer 1

Gardasil - HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58

• Protection against cervical cancer and genital warts.
• Offered between 12-13 years single dose

Question 2

Causative organisms of bacterial vaginosis?

Answer 2

Anaerobic organisms - ph 4.5

Gardnerella vaginalis,
Prevotella species
Mycoplasma hominis
Mobiluncus species

Question 3

RF for bacterial vaginosis

Answer 3

• Being sexually active
• Douching
• Genital hygiene
• Menstruation
• Copper Coil

Question 4

Bacterial vaginosis presentation

Answer 4

Thin grey/white fishy odour vaginal discharge

No vulva itching or soreness
No urinary symptoms
No abdominal pain
No systemic symptoms
No abnormal bleeding

Examination and swabs not needed

Question 5

Bacterial vaginosis treatment

Answer 5

Metronidazole 400mg BD for 5-7 day (preferred)
Or
Metronidazole 1 applicatorful OD for 5 days, dose to be administered
at night

• Self management: avoid vaginal douching, bubble baths, water-based
  lubricants, harsh soaps

Question 6

Causative organisms of candida

Answer 6

Candida Albicans
Candida Glabrata

Question 7

RF of candida

Answer 7

• Recent antibiotic use
• Scented soaps/washes
• Immunosuppression
• Uncontrolled diabetes
• Pregnancy

Question 8

Candida presentation

Answer 8

Non offensive, white, cottage cheese like vaginal discharge
Vulva/Vaginal itching and soreness
Dysuria
Dyspareunia (superficial)

No abdominal pain
No systemic features
No abnormal bleeding

Question 9

Candida management

Answer 9

• Fluconazole 150mg oral single dose
  or
• Clotrimazole 500mg intravaginal pessary single dose

Vulva symptoms - Clotrimazole 1% or 2% cream applied TDS

Self management: avoid irritant soap/bubble baths/douching/tight fitting clothing