Flashcards in Vaginitis and Vaginosis: Ryan Deck (11)
Since many of the infectious agents causing bacterial/fungal vaginosis are normal flora of the vagina, how is it that they cause pathology?
Disturbance of the normal flora, esp. the gram + lactobacilli, that help maintain a low pH and produce hydrogen peroxide that hold infectious bacteria at bay.
What are the etiologic agents of bacterial vaginosis (BV)>
Gardnerella vaginalis, Mobilunicus, anaerobes
Yellow discharge from vagina. What is the etiological agent?
Trichomonas vaginalis. Should smell like fish. Do wet mount to confirm. Should see protozoa swimming around. Also look for *strawberry cervix* on speculum exam.
White or grey discharge from the vagina, what is causing this?
Possibly bacterial vaginosis. Look for clue cells (epithelial cells covered w/ bacteria). Should smell like fish.
How do you distinguish cystitis from pyelonephritis?
Cystitis: suprapubic pain, insignificant fever, dysuria, significant bacturia.
Pyelonephritis: back pain, significant fever, WBC/RBC casts in urine.
Which of the etiological organisms of BV is sexually transmitted?
Trich (the protozoan)
How do we diagnose BV, clinically? (no extensive labs)
ALWAYS see Discharge (dirty white/gray)
pH of discharge >4.5
Presence of clue cells (epithelial cells covered w/ bacteria)
How do we dx candidiasis, clinically? (no ext. labs)
Cottage cheese exudate (discharge)
Pungent (not foul smelling) odor
How do we treat candidaisis?
Azoles (topical and oral) or nystatin
How do we treat trich?
Metronidazole is of the nitroimidazole class. It inhibits nucleic acid synthesis by disrupting the DNA of microbial cells. (NOT AN AZOLE)