questions 2

Vaginitis

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Topic updated on 04/11/16 7:03pm

Snap Shot
  • A 40-year-old woman with diabetes mellitus comes to the office complaining of pruritic, grayish vaginal discharge. On KOH prep you notice a fishy smell.
Introduction
  • The normal vagina contains
    • mixed bacterial flora
    • acidic environment maintained by lactic acid producing lactobacilli
    • any change in the pH can lead to an overgrowth of other bacterial species
  • Caused by 
    • Gardnerella vaginalis
      • most common cause
      • gram negative rod
    • Trichomonas vaginalis
      • protozoa with "jerky" motility
    • Candida
      • pseudohyphic yeast
      • risk factors
        • diabetes, antibiotics, and pregnancy
Presentation
  • Symptoms
    • vulvovaginal pruritus
    • burning sensation
    • odor
      • fishy = G. vaginosis
    • increased vaginal discharge
      • cottage cheese = Candida
      • yellow/green = T. vaginalis
      • watery/grayish = G. vaginosis
Evaluation
  • Vaginal discharge slide smear
    • KOH prep
      • clue cells = G. vaginosis 
        • organism adherent to squamous cells
    • Gram stain
Treatment
  • G. vaginosis
    • metronidazole
  • T. vaginalis
    • metronidazole
  • Candida
    • fluconazole 


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Qbank (1 Questions)

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(M1.RP.75) A 24-year-old woman presents complaining of a new onset vaginal odor. She reports that she is sexually active in a monogamous relationship with the same partner for two years. You perform a KOH prep, and notice an abnormal smell. On microscopy in your office, you observe the findings in figure A.

What is the most likely causative organism? Topic Review Topic
FIGURES: A          

1. Trichomonas vaginalis
2. Candida albicans
3. Escherichia coli
4. Gardnerella vaginalis
5. Neisseria gonorrhoeae

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