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Discharges and Infections in Gynecology ppt
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Discharges and Infections in Gynecology ppt

Created by
@BrighterDahlia

Questions and Answers

Which diagnostic test is commonly used for detecting sexually transmitted infections?

  • Nucleic Acid Amplification Test (NAAT) (correct)
  • Urinalysis
  • Cervical biopsy
  • Complete blood count

    • What is the key reason to perform endocervical swab for GC/CHL testing before a bimanual exam?

  • To ensure no external lesions are present
  • To avoid bleeding during the examination
  • To prevent contamination from lubricant (correct)
  • To assess the pH before treatment

    • Which condition is characterized by a painless chancre?

  • Bartholin’s cyst
  • Syphilis (correct)
  • Cervicitis
  • HSV infection

    • What is a Nabothian cyst best described as?

    <p>A mucous-filled gland with a blocked exit</p> Signup and view all the answers

    Which vaginal infection type is treated with antifungal medications?

    <p>Candida infection</p> Signup and view all the answers

    What factor may lead to the formation of ectropion in the cervix?

    <p>Enlargement of the uterus during pregnancy</p> Signup and view all the answers

    Which STI testing may include oral and rectal swabs based on exposure?

    <p>Gonorrhea and Chlamydia</p> Signup and view all the answers

    What type of vaginal discharge is typically associated with viral infections like HSV?

    <p>Discharge with vesicles present</p> Signup and view all the answers

    What is the primary mode of transmission for the Herpes Simplex Virus?

    <p>Skin-to-skin or mucous membrane contact</p> Signup and view all the answers

    Which of the following symptoms is most commonly associated with a primary Herpes Simplex outbreak?

    <p>Genital vesicular shallow ulcerations</p> Signup and view all the answers

    What is the recommended management for symptomatic relief during a primary HSV infection?

    <p>Oral acyclovir or pain relief methods</p> Signup and view all the answers

    What is a characteristic feature of Bartholin's Gland Cyst?

    <p>Mucus accumulates when the duct is blocked</p> Signup and view all the answers

    Which treatment is specifically recommended for syphilis infection?

    <p>Benzathine penicillin</p> Signup and view all the answers

    What condition is often suggested by the presence of unilateral chanchre?

    <p>Primary syphilis</p> Signup and view all the answers

    What test is recommended for diagnosing Treponema pallidum in primary syphilis cases?

    <p>Darkfield microscopy or PCR</p> Signup and view all the answers

    What viral shedding characteristic is true of recurrent herpes infections?

    <p>Can occur asymptomatically</p> Signup and view all the answers

    Which term refers to the accumulation of mucus due to a blocked Bartholin duct?

    <p>Bartholin's Gland Cyst</p> Signup and view all the answers

    Which option is essential for managing recurrent Herpes Simplex infections?

    <p>Daily suppressive therapy after frequent recurrences</p> Signup and view all the answers

    What is the significant risk associated with Bartholin's Gland Abscess?

    <p>Higher risk in women at risk for STIs</p> Signup and view all the answers

    How long does the incubation period for primary syphilis generally last?

    <p>10 days to 3 months</p> Signup and view all the answers

    What consequence can occur from Herpes Simplex Virus during pregnancy?

    <p>Potential transmission to the newborn</p> Signup and view all the answers

    Which is a common systemic symptom of primary HSV infection?

    <p>Fever</p> Signup and view all the answers

    What should be tested for in individuals with a diagnosis of gonorrhea or chlamydia?

    <p>Other STIs</p> Signup and view all the answers

    Which of the following is considered an upper genital tract infection?

    <p>Pelvic inflammatory disease (PID)</p> Signup and view all the answers

    What is a common symptom observed in individuals with gonorrhea or chlamydia who have a penis?

    <p>Purulent urethral discharge</p> Signup and view all the answers

    What is the primary method of diagnosing gonorrhea and chlamydia?

    <p>Nucleic acid amplification test (NAAT)</p> Signup and view all the answers

    Which of the following should be included in the treatment regimen for PID?

    <p>Broad spectrum antibiotics</p> Signup and view all the answers

    Which population is considered at high risk for gonorrhea and chlamydia infections?

    <p>Sexually active women under 25</p> Signup and view all the answers

    What finding is associated with mucopurulent cervicitis on examination?

    <p>Presence of WBCs</p> Signup and view all the answers

    What is a recommended follow-up procedure for women diagnosed with gonorrhea or chlamydia after treatment?

    <p>Retesting after 3 months</p> Signup and view all the answers

    Which symptom could indicate the presence of Fitz-Hugh-Curtis Syndrome?

    <p>Right upper quadrant pain</p> Signup and view all the answers

    Why might hospitalization be warranted for a patient with PID?

    <p>Inability to tolerate outpatient therapy</p> Signup and view all the answers

    What does the CDC recommend regarding annual screening for sexually active females?

    <p>All sexually active females under 25</p> Signup and view all the answers

    Which finding is NOT associated with a diagnosis of PID?

    <p>Negative wet prep for WBCs</p> Signup and view all the answers

    What is the appropriate management for non-responsive PID patients after initial outpatient treatment?

    <p>Hospitalization for further diagnostics</p> Signup and view all the answers

    What is a common symptom associated with a Bartholin Gland Abscess?

    <p>Acute pain with inability to walk</p> Signup and view all the answers

    Which organism is most commonly responsible for vulvovaginal candidiasis?

    <p>Candida albicans</p> Signup and view all the answers

    What is the primary treatment goal for bacterial vaginosis (BV)?

    <p>Reestablishing normal lactobacillus flora</p> Signup and view all the answers

    What type of discharge is typically associated with trichomonas vaginalis infection?

    <p>Copious yellow/green discharge</p> Signup and view all the answers

    Which examination finding is most indicative of bacterial vaginosis?

    <p>Clue cells on saline wet mount</p> Signup and view all the answers

    In managing a Bartholin Gland Cyst that is asymptomatic, what is the recommended approach?

    <p>Regular monitoring without treatment</p> Signup and view all the answers

    What pH value is indicative of bacterial vaginosis when measured?

    <p>4.5 or greater</p> Signup and view all the answers

    What is the standard first-line treatment for a Trichomonas vaginalis infection?

    <p>Single dose of Metronidazole 2 gm</p> Signup and view all the answers

    What symptom is typically NOT associated with vulvovaginal candidiasis?

    <p>Foul fishy odor</p> Signup and view all the answers

    What is the most common diagnostic test for Trichomonas vaginalis?

    <p>Wet prep with observed motile organisms</p> Signup and view all the answers

    Which condition is primarily associated with vulvitis but may also involve vaginitis?

    <p>Vulvovaginal candidiasis</p> Signup and view all the answers

    Which of the following statements accurately describes the role of estrogen in normal vaginal physiology?

    <p>Promotes the growth of lactobacilli</p> Signup and view all the answers

    What is the purpose of the ‘whiff test’ in diagnosing bacterial vaginosis?

    <p>To detect amines in the discharge</p> Signup and view all the answers

    Study Notes

    Discharges and Infections in Gynecology

    • Instructional objectives include differentiating, diagnosing, and treating various STIs, recognizing history and physical exam needs, and comparing diagnostic tests (pap smear, KOH prep, wet mount).
    • Key conditions include Vaginitis, Cervicitis, Bartholin’s Cyst/Abscess, Endometritis, and Pelvic Inflammatory Disease.
    • Infection pathways are particularly relevant in gynecology due to the short tract from external to internal sites.
    • Assess cervical/vaginal discharge through external inspection, speculum examination, pH testing, wet prep, STD testing, and considering HPV testing.

    Cervical Disease and STD Testing

    • Nucleic Acid Amplification Test (NAAT) is crucial for identifying STDs.
    • Endocervical swabs for GC/Chl and Trich should be performed before bimanual exams to avoid contamination.
    • The cervix shows variations; Nabothian cysts and ectropion occur often due to hormonal changes.

    Herpes Simplex Virus (HSV)

    • HSV is transmitted through skin/mucous contact; genital HSV-1 is rising due to increased oral-genital contact.
    • Symptoms include fever, chills, and painful vesicular lesions.
    • Primary infections are most symptomatic; future episodes are usually less severe but can still result in shedding.
    • Diagnosis often involves culture (PCR for specific types), and management includes oral antivirals like acyclovir.

    Syphilis

    • Syphilis is caused by Treponema pallidum, with increasing rates reported in the U.S.; primary lesions are typically painless ulcers.
    • Diagnosis relies on serology or darkfield examination of chancres.
    • Treatment is mainly via Benzathine Penicillin; partners should also be treated.

    Bartholin’s Gland Cyst/Abscess

    • The Bartholin's glands, located at the 4 and 8 o'clock positions of the vulva, secrete lubricating fluid and can develop cysts or abscesses.
    • Cysts are often asymptomatic, while abscesses cause severe pain and require incision and drainage.
    • Management includes monitoring asymptomatic cysts, draining symptomatic abscesses, and culture if necessary.

    Vaginitis and Vulvovaginitis

    • Vulvitis often accompanies vaginitis; both conditions can stem from similar irritants.
    • Normal vaginal physiology involves a pH of 4.0-4.5, promoting beneficial flora and defensive against infections.
    • Trauma, pH shifts, and decreased immunity can lead to infections like yeast or BV.

    Vulvovaginal Candidiasis

    • Often caused by Candida albicans; symptoms include pruritis and thick, white discharge.
    • Diagnosis involves examination and wet prep showing hyphae.
    • Treatments include OTC antifungals and prescription therapies like fluconazole.

    Bacterial Vaginosis (BV)

    • Represents a shift in normal flora with increased anaerobic bacterial growth; often asymptomatic but may produce a fishy odor.
    • Diagnosed based on Amsel Criteria: thin discharge, high vaginal pH, and presence of clue cells.
    • First-line treatment includes Metronidazole and Clindamycin.

    Trichomonas Vaginalis

    • A protozoal infection, presenting with yellow/green discharge and causing vulvar discomfort.
    • Diagnosis via wet prep showing motile organisms; treatment involves Metronidazole for both patient and partner.

    Cervicitis and PID

    • Cervicitis can result from several infections, including Trichomonas and STIs leading to potential upper genital tract infections.
    • Gonorrhea and Chlamydia are common causes; both can often present asymptomatically, especially in women.
    • Diagnosis usually involves NAAT and clinical examination; high-risk populations should be screened regularly.

    Pelvic Inflammatory Disease (PID)

    • Diagnosed through specific criteria, including imaging and biopsy.
    • Treat with broad-spectrum antibiotics to cover multiple pathogens.
    • Hospitalization criteria include severe illness or non-responsiveness to treatment; follow-up is critical to ensure recovery.

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    Description

    This quiz assesses your understanding of the diagnosis, treatment, and laboratory tests related to sexually transmitted infections in gynecology. It covers the differentiation of various vaginal infections as well as the use of diagnostic methods such as pap smears and KOH prep. Test your knowledge on recognizing clinical signs and appropriate treatments.

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