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Flashcards in Vaginal disorders Deck (27)
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1

VulvoVaginal Candidiasis (VVC) causative organism

Candida albicans

2

VulvoVaginal Candidiasis Clinical presentation

1. Vulvar pruritis, external dysuria, burning
2. Thick, curd-like vaginal discharge
3. Normal vaginal pH <4.5

3

VulvoVaginal Candidiasis Risk Factors

1. Abx
2. Immunocompromised

4

VulvoVaginal Candidiasis testing

Wet prep: Saline & 10% KOH- Budding yeast and Hyphae

5

VulvoVaginal Candidiasis treatment

1. Short course (1-3 days) Topical Vaginal Azole: Clotrimazole
2. Fluconazole (Diflucan)-1x

6

VulvoVaginal Candidiasis treatment in pregnancy

Topical azole x 7 days or single dose fluconazole

7

When would you treat the male partner in a yeast infection?

Balanitis: inflammation of the skin covering the glans of the penis

8

Bacterial Vaginosis causative organism

Polymicrobial: Gardnerella vaginalis & Mobiluncus

9

BV clinical presentation

1. Vaginal irritation
2. Thin white or gray discharge
3. Strong fishy odor

10

BV Risk Factors

1. New or multiple sex partners
2. Douche
3. Rarely affects women who have never been sexually active

11

BV clinical criteria

Amsel's Criteria: 3 of 4
1. Thin white homogenous discharge
2. Clue cells on microscopy
3. Vaginal fluid pH > 4.5
4. Release of fishy odor when adding KOH solution (+ whiff test)

12

What is the Gold standard test in BV?

Gram stain: Positive Gram anaerobes

13

BV Treatment

Treat ALL pt's with sx's
Metronidazole (Flagyl)

14

What does BV increase the risk of ?

1. Acquiring & transmitting HIV
2. Acquiring herpes, gonorrhea (GC) & chlamydia
3. Associated with PID

15

Atrophic Vaginitis pathophysiology

1. Loss of estrogen causes:
Epithelial thinning of vulva/vagina/bladder
2. Loss of elasticity in connective tissue

16

Atrophic Vaginitis Clinical presentation

1. Dyspareunia
2. Post-coital bleeding
3. Leukorrhea
4. Burning, raw, dry sensation: “feels like a yeast infection”

17

Atrophic Vaginitis Physical exam findings

1. Loss of rug in vagina
2. Pale: Red coloring, petechiae

18

Wet mount findings in Atrophic Vaginitis

Parabasal cells
Decreased/absent lactobacilli

19

Atrophic Vaginitis Treatment

1. OTC vaginal moisturizer
2. Vaginal Estrogens: Premarin or Estrace
3. Vaginal prasterone (DHEA)
4. Ospemifene (Osphena

20

What has to be present in order to develop Vaginal Intraepithelial Neoplasia (VAIN)?

HPV

21

VAIN Risk Factors

Same as CIN:
1. Smoking
2. Multiple sexual partners
3. Early onset of sexual activity

22

VAIN 1 classification

Benign Viral Proliferation

23

VAIN 2 classification

Intermediate risk

24

VAIN 3 classification

True precursor to vaginal cancer

25

VAIN labs/studies

1. Cytology: Pap smear
2. Colposcopy

26

VAIN 1 treatment

1. Observation is justified in younger women
2. Cytology/HPV/Colposcopy Q 6 months

27

VAIN 2/3 treatment

1. Surgical intervention: Vaginectomy, Laser Vaporization
2. Topical chemotherapy