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OB/GYN: Infections

Terms in this set (70)

etiology of vulvovaginal atrophy?
decrease estrogen states- postmenopausal
Most common cause of vaginitis?
bacterial vaginosis
Vaginitis: pathophysiology of bacterial vaginosis?
decreased lactobacilli acidophilus, overgrowth of normal flora- Gardnerella vaginalis
Vaginitis: bacterial vaginosis clinical manifestation?
odor worst after sex, =/- pruritus
Vaginitis: bacterial vaginosis vaginal discharge?
copious, thin, homogenous, watery, GREY-WHITE "fish rotten" smell
Vaginitis: bacterial vaginosis pH?
>5
Vaginitis: bacterial vaginosis whiff test?
positive- fishy odor with 10% KOH prep
Vaginitis: bacterial vaginosis microscopic?
clue cells, few WBCs
Vaginitis: bacterial vaginosis treatment?
Metronidazole or clindamycin
Vaginitis:BV prevention?
avoid douching, DON't have to treat partner
Vaginitis: trichomoniasis patho?
trichomonas vaginalis- pear shaped flagellated protozoa- sexually transmitted
Vaginitis: trichomoniasis s/s?
vulvar pruritus, erythema, dysuria, dyspareunia
Vaginitis: trichomoniasis vaginal discharge
copious, malodorous, frothy yellow green, strawberry cervix
Vaginitis: trichomoniasis pH
>5
Vaginitis: trichomoniasis whiff test?
may be present
Vaginitis: trichomoniasis microscopic?
mobile protoza, WBCs
Vaginitis: trichomoniasis tx
metronidazole (PO) or tinidazole
Vaginitis: trichomoniasis prevention?
spermicidial agents, MUST treat partner
Vaginitis: candida patho?
candida albicans overgrowth (use of abx)
Vaginitis: candida s/s?
vaginal/ vulvar erythema, swelling, burning, pruritus
what increases the likelihood of candida albicans?
DM, steroid use, and pregnancy
Vaginitis: candida vaginal discharge?
thick curd like/ cottage cheese
Vaginitis: candida pH?
normal- 3.8-4.2
Vaginitis: candida whiff test?
Negative
Vaginitis: candida microscopic?
hyphae, yeast, spores on KOH prep
Vaginitis: candida tx?
fluconazole, intravaginal antifungals
Vaginitis: candida prevention?
keep vagina dry, no tight fitting clothes
Cytolytic vaginitis patho?
overgrowth of lactobacilli
Cytolytic vaginitis s/s?
vaginal/ vulvar pruritus, burning and dysuria
Cytolytic vaginitis vaginal discharge?
nonodorus white to opaque
Cytolytic vaginitis pH?
normal 3.8-4.2
Cytolytic vaginitis whiff test?
copious lactobacilli, large # of epithelial cells
Cytolytic vaginitis tx?
d/c tampon use, sodium bicarbonate(sitz bath)
Most common cause of cervicitis?
chlamydia
Cervicitis: chlamydia etiology?
chlamydia trachomatis
Cervicitis: chlamydia s/s?
asymp, mucopurulent, increased dysuria, ab pain, PID
Cervicitis: chlamydia dx?
nucleic acid amplification (PCR)
Cervicitis: chlamydia tx?
azithromycin OR doxy PLUS ceftriaxone for gonorrhea. Erythromycin for pregnant women.
Cervicitis: chlamydia prevention?
avoid intercourse x 7 days after tx
Cervicitis: chlamydia complications?
PID, infertility, ectopic pregnancy, premature, reactive arthritis
Cervicitis: Gonorrhea etiology?
N. gonorrhoeae
Cervicitis: Gonorrhea s/s?
aspm or vaginal discharge, increase dysuria
Cervicitis: Gonorrhea dx?
nucleic acid amplification (PCR)
Cervicitis: Gonorrhea tx?
ceftriaxone PLUS azithromycin OR doxy for chlaymdia
Cervicitis: Gonorrhea complications?
PID, infertility, ectopic pregnancy, reactive arthritis
Cervicitis: HSV etiology?
herpes simplex virus 1/2
Cervicitis: HSV s/s?
prodromal, 24 hrs, burning, paresthesias, tingling, painful grouped vesicles
Cervicitis: HSV dx?
PCR, clinical, and tzanck smear
Cervicitis: HSV tx?
acyclovir
Cervicitis: HPV etiology?
increase oncogenic 16 & 18, 31, 33, 35, also causes genital warts 6, 11 low oncogenic potential
Cervicitis: HPV s/s?
asymp, flat pedunculated or papular flesh colored, "cauliflower like" lesions
Cervicitis: HPV dx?
whitening with acetic acid, clinical dx
Cervicitis: HPV tx?
office: tricholoracetic acid, cyrotherapy, surgical
OP: podofilox, aldara
Cervicitis: HPV complications?
cervical dysplasia, CERVICAL CANCER
Lymphogranuloma venereum patho?
chlamydia in developing countries
Lymphogranuloma venereum s/s?
PAINLESS genital ulcers- painful inguinal LAD
Lymphogranuloma venereum tx??
...
Chancroid patho?
Haemophilus ducreyi (gram - bacillus) UNCOMMON in US
Chancroid s/s?
genital ulcers, soft shallow, PAINFUL and painful inguinal LAD
Chancroid dx?
clinical diagnosis
Chancroid tx?
azithromycin or ceftriaxone, erythromycin, cipro
Chancroid complications?
2nd infection, scarring
Ascending infection of upper reproductive tract
PID
MC of PID?
N. gonorrhoeae & Chlamydia
PID s/s?
lower ab pain, fever, purulent discharge, N, V +Chandeilier sign, CMT
PID dx?
clinical dx, r/o pregnancy
1: abdominal tenderness
2: CMT
3: adnexal tenderes plus >1
gram stain, temp, WBC
PID tx?
OP: doxy + ceftriaxone
IP: IV doxy + 2nd generation cephalosporin
PID complications?
fitz-hugh curtis syndrome, infertility, tubo ovarian abscess, ectopic
Syphilis etiology?
treponema pallidum
Syphilis s/s?
primary: chancre- PAINLESS ulcer, non tender LAD
secondary: wks- 6 mths after- maculopapular rash (palms/soles), condyloma lata (wart like), systemic
tertiary: 1-20 yrs later- gumma, neurosyphilis, argyll robertson pupil, CV risk AR AA
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