Bacterial Vaginosis Flashcards Preview

B - Gynaecology > Bacterial Vaginosis > Flashcards

Flashcards in Bacterial Vaginosis Deck (36)
1

What is bacterial vaginosis?

A non-sexually transmitted infection of the lower genital tract in females

2

How common is bacterial vaginosis?

The most common cause of abnormal vaginal discharge in women of childbearing age

3

What happens to the normal vagina to lead to bacterial vaginosis?

There is a disturbance in the normal vaginal flora leading to a reduction in the number of lactobacilli bacteria

4

What type of bacteria are lactobacilli?

Large rod-shaped organisms that produce hydrogen peroxide to help maintain the acidic pH of the vagina

5

What is the normal pH of the vagina?

< 4.5

6

What is the result of the acidic nature of the vagina?

Prevents overgrowth of other microorganisms

7

What happens to the pH of the vagina when lactobacilli numbers are reduced?

pH increases

8

What does the increase in pH in bacterial vaginosis allow?

Overgrowth of other microorganisms

9

What are the most common organisms found in bacterial vaginosis?

- Gardnerella vaginalis
- Anaerobes
- Mycoplasmas

10

What are the risk factors for bacterial vaginosis?

- New or multiple sexual partners
- Use of IUD
- Receptive oral sex
- Presence of STI
- Vaginal douching
- Use of scented soaps/vaginal deodorants
- Recent antibiotic use
- Black ethnicity
- Smoking

11

What % of bacterial vaginosis cases are asymptomatic?

Up to 50%

12

What is the most common symptom of bacterial vaginosis?

Offensive, fishy smelling discharge

13

What symptoms are NOT usually associated with bacterial vaginosis?

- Soreness
- Itching
- Irritation

14

What are the examination findings in bacterial vaginosis?

Thin, white/grey homogenous vaginal discharge

15

What are the differentials for bacterial vaginosis?

- Other vaginal infections
- Other benign causes of vaginal discharge
- Tumours of the vulva, vagina, cervix or endometrium
- Atrophic vaginitis

16

What other vaginal infections can be differentials for bacterial vaginosis?

- Candida
- Trichomoniasis
- Chlamydia
- Gonorrhoea
- Herpes simplex

17

What benign causes of vaginal discharge are differentials for bacterial vaginosis?

- Physiological discharge
- Chemical irritants
- Foreign body
- Pregnancy
- Cervical ectropion

18

How is bacterial vaginosis diagnosed?

- History
- Vaginal examination
- Microscopy

19

How is a sample obtained for microscopic testing for bacterial vaginosis?

High vaginal swab

20

What will be seen on gram stained microscopy of bacterial vaginosis?

- Clue cells
- Reduced number of lactobacilli
- Absence of pus cells

21

What are the clue cells seen in bacterial vaginosis?

Vaginal epithelial cells studded with gram variable coccobacilli

22

Isolation of what is not sufficient to diagnose bacterial vaginosis?

Gardnerella vaginalis

23

Why is isolation of Gardnerella vaginalis not diagnostic of bacterial vaginosis?

It can be cultured from 50% of uninfected women

24

What are some other diagnostic investigations for bacterial vaginosis?

- pH >4.5
- KOH Whiff test

25

What is the KOH Whiff test for bacterial vaginosis?

Addition of potassium hydroxide (KOH) causes vaginal discharge to release a strong fishy odour

26

Do asymptomatic bacterial vaginosis patients require treatment?

Only if they are pregnant

27

What is the most common treatment for bacterial vaginosis?

Metronidazole

28

What regimes of metronidazole are available for bacterial vaginosis?

- 400mg BD for 5-7 days
- OR single dose of 2g
- OR gel applied to vagina

29

What are the alternative antibiotics for bacterial vaginosis?

- Clindamycin
- Tinidazole

30

How should breastfeeding women be treated for bacterial vaginosis?

Vaginal metronidazole

31

What should patients avoid after diagnosis of bacterial vaginosis?

- Vaginal douching
- Scented shower gels
- Anti-septic agents
- Shampoos in bath

32

What should be considered if bacterial vaginosis is present with an IUD?

Removal of IUD

33

What % of people with bacterial vaginosis have return of symptoms within 3 months of treatment?

>50%

34

What are the complications of bacterial vaginosis following TOP?

- Endometriosis
- PID

35

What are the potential complications of bacterial vaginosis in pregnancy?

- Late miscarriage
- Preterm delivery
- Premature rupture of membranes
- Low birth weight
- Post partum endometriosis

36

What is a potential complication of bacterial vaginosis in all women?

Can increase the risk of acquiring HIV and other STIs