Vulva - ANSWER External female genitalia
Vaginitis - ANSWER Vaginitis is characterized by one or more of the following symptoms: increased volume of
... [Show More] discharge; abnormal color (yellow or green) of discharge; vulvar itching, irritation, or burning; dyspareunia; and malodor. Vaginitis may be caused by infectious agents (e.g., Candida, Gardnerella, and Trichomonas ) or
by atrophic changes.
Signs, Symptoms, and Diagnosis of Vulvovaginitis - ANSWER
Bacterial Vaginosis - ANSWER
Bacterial vaginosis - ANSWER This vaginal infection results from the replacement of the normal H2O2 producing Lactobacillus with high concentrations of other Anaerobe bacteria, such as Gardnerella vaginalis, Mobiluncus, Bacteroides, and Mycoplasma.
*The anaerobic bacteria produce enzymes that break down peptides to amino acids and amines, resulting in compounds associated with the discharge and odor characteristic of this infection.*
A 32-year-old G2P1001 at 32 weeks gestation presents with a 4-day history of vaginal discharge. She denies itching, burning, or pain. On physical exam, a homogenous white discharge is noted to coat the vaginal side
walls. A wet mount of the discharge shows clue cells, and a fishy odor is noted when KOH is added to the discharge. What is the most likely diagnosis? What is the best treatment? - ANSWER Answer: Symptoms and diagnosis based on Amsel's criteria is consistent with bacterial vaginosis. The treatment of choice in pregnancy is oral metronidazole
Bacterial vaginosis Clinical presentation - ANSWER Fifty percent of women with bacterial vaginosis are asymptomatic. In symptomatic patients, the most common presentation is a malodorous, gray discharge.
Bacterial vaginosis Diagnosis - ANSWER *Three of the following four criteria* must be present:
-a. The *vaginal pH is generally between 5.0 and 5.5*.
-b. *Wet mount preparations with* saline reveal a "clean" background with minimal or no leukocytes, an abundance of bacteria, and *the characteristic clue cells*. The clue cells are squamous cells in which coccobacillary bacteria have obscured the sharp borders and cytoplasm.
-c. Application of *10% KOH to the wet mount specimen produces a fishy odor*, indicating a positive "whiff" test. [Show Less]