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40 Cards in this Set

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what is the definition of complicated vulvovaginal candidosis?
recurrent (at least 4 times a year)

predisposing host factors

severe extent
what are the six predisposing host factors for vulvovaginal candidiasis?
ovulation inhibitors
pregnancy

antibiotic treatment

diabetes mellitus
immunosuppression/ cellular immune defects
what is a microcopic finding diagnostic of a infection in vulvovaginal candidiasis?
presence of hyphae
what regions of the female genital tract are affected by candidiasis?
most commonly vulvitis and colpitis, cervicitis in advanced cases
what are symptoms of vulvovaginal candidiasis?
pruritus and friable fluor
what does the local therapy of vulvovaginitis consist of?
vulvitis with topical clotrimazole for 7-10 days

colpitis with intravaginal clotrimazol tablets for 3 days
what does the therapy of complicated candididiasis consist of?
local therapy

plus

diflucan 150mg once

or

itraconazol for two days
what regions of the female genital tract are affected by trichomoniasis?
primarily colpitis
what is the differential diagnosis for trichomoniasis?
bacterial vaginosis
what is the diagnostic approach to trichomoniasis?
fluor under microscope --> mobile flagellata = trichomonades
what is the therapy for trichomoniasis?
protozoa -->

flagyl 1x2g p.o.
what regions of the female genital tract are affected by chlamydia?
preferably

cervizitis

and/or

urethritis
what percentage of women infected with chlamydia are asymptomatic?
4 out of 5!
what is particular about the clinical manifestations of chlamydia?
no vulvovaginitis!!!
what are the groups of complications caused by chlamydia?
early

late

and

perinatal infection
what are early complications of chlamydial infection?
adnexitis, perihepatitis
what are late complications of chlamydial infection?
tubo-ovarial abscess

sterility

extrauterine gravidity
what is the diagnostic approach to chlamydial infection?
swab of cervix, urethra or tube or urine sample

then

PCR/LCR
what are complications of chlamydial infection?
complications of adnexitis or salpingitis

sterility
increased incidence of EUG
chronic pain/ PID
what are perinatal complications of chlamydial infection?
conjunctivtis

and

pneumonia
what is the therapy for asymptomatic chlamydial infection?
azithromycin 1x1g

or

doxycyclin 2x100 mg for seven days
what is the therapy for asymptomatic chlamydial infection in pregnancy?
erythromycin
what is the therapy for ascending chlamydial infection/ PID in pregnancy?
amoxicillin/clavulanic acid 3x1g for 5 days

plus

doxycyclin 2x100 mg for 14 days
what are the two principal forms of gonorrhea?
lower and upper gonorrhea
what is lower gonorrhea?
affection of vulva/vagina and cervix
what is upper gonorrhea?
ascension through cervical canal to tubes and possibly to peritoneal cavity
in what percentage does ascending infection of gonorrhea occur?
10%
what are the symptoms of lower gonorrhea?
asymptomatic cervicitis!!!
what are the symptoms of upper gonorrhea?
often fierce up to acute abdomen
what are manifestation of upper gonorrhea?
endometritis, salpingitis, tubo-ovarian abscess, PID or peritonitis
what are possible extragenital manifestations of gonorrhea?
conjunctivitis, pharyngitis, proktitis

arthritis
what is the diagnostic approach to gonorrhea?
swab with PCR
what is the therapy for lower gonorrhea?
ceftriaxon 1x250 mg i.m.
what is the therapy for upper gonorrhea?
1x1g ceftriaxon i.v.
what are indications for eradication of bacterial vaginosis?
pregnancy

impending surgery
what is the therapy for bacterial vaginosis without pregnancy?
1x2g metronidazol p.o.
what is the therapy for bacterial vaginosis in pregnancy?
clindamycin 2x300mg/d p.o. for 7 days
what are the diagnostic criteria for bacterial vaginosis?
proven when 3 out of 4

thin fluor

pH of fluor >4.7

positive amine test = odor increased

microscopic clue cells
what is the therapy for genital herpes?
primoinfection or reactivation

valaciclovir 2x500mg/d p.o. for 5-10 days
what is the suppression therapy for genital herpes?
valaciclovir 2x250mg/d p.o.