Vaginal Discharge Solution
A 30-year-old woman presents to your office with the chief complaint of a yeast infection that I can't seem to shake. She also has noticed that she has been urinating more frequently, but thinks that it is related to her yeast infection. Over the last several years she has noticed that she has gained more than 40 lb. She has tried numerous diets, most recently a low-carbohydrate, high-fat diet. The patient's only other pertinent history is that she was told to watch her diet during pregnancy because of excessive weight gain. Her baby had to be delivered by cesarean because he weighed more than 9 lb. Her family history is not known, as she was adopted. On physical examination, her blood pressure is 138 88 mm Hg. her pulse is 72 beats min, and her respiratory rate is 16 breaths min. Her height is 65 inches and her weight is 190 lb (body mass index BMI 31.6). Her physical examination reveals darkened skin that appears to be thickened on the back of her neck and moist, reddened skin...
The main symptoms of preterm labor are uterine contractions and abdominal tightening. Sometimes, pelvic pressure or increased vaginal discharge also is present. The diagnosis is established by confirming cervical change over time by the same examiner, if possible, or finding the cervix to be 2 cm dilated and 80 effaced in a nulliparous woman. Once the diagnosis has been made, then an
Chorioamnionitis affects approximately 1 of all pregnancies and 7 to 10 of those with PPROM with prolonged rupture of membranes. Maternal fever, maternal tachycardia, uterine tenderness, and malodorous vaginal discharge are some clinical indicators. An early sign is fetal tachycardia, a baseline heart rate greater than 160 bpm.
Often more prominent at the outset and largely due to oestrogen, these include nausea and, rarely, vomiting breast discomfort, fluid retention, headache (including increase in migraine), lethargy, abdominal discomfort, vaginal discharge or dryness. Depression may occur but most depression in pill users is not due to the contraceptive.
Next, visualize the structures by separating the labia with your fingers as A vaginal discharge in early child-shown at the left on the following page. You can also apply gentle traction hood can be due to perineal irrita-by grasping the labia between your thumb and index finger of each hand, tion (e.g., bubble baths or soaps),
58.1 A 22-year-old woman is seen for vaginal discharge. The presumptive diagnosis is bacterial vaginosis. Which of the following most likely is present B. Heterogenous vaginal discharge 58.2 A 26-year-old woman taking antibiotics for cystitis complains of itching, burning, and a yellowish vaginal discharge. Which of the following is the best therapy 58.4 A 27-year-old woman complains of a fishy odor and a vaginal discharge. Speculum examination reveals an erythematous vagina and punctations of the cervix. Which of the following is the most likely diagnosis
Trichomonas vaginalis is a single-cell anaerobic flagellated protozoan that induces an intense inflammatory reaction. It is a common sexually transmitted disease. Trichomonas vaginalis can survive for up to 6 hr on a wet surface. In addition to causing infection of the vagina, this organism can inhabit the urethra or Skene's glands. The most common symptom associated with trichomoniasis is a profuse frothy yellow-green to gray vaginal discharge or vaginal irritation. Intense inflammation of the vagina or cervix may be noted, with the classic punctate lesions of the cervix (strawberry cervix). A fishy odor is common with this disorder, which is somewhat exacerbated with KOH. Microscopy in saline often displays mobile, flagellated organisms. If the wet mount is cold or excess leukocytes are present, movement of the trichomonads may be inhibited. Optimal treatment consists of a fairly high dose of metronidazole (2 g orally) as a one-time dose, with the partner treated as well. Resistant...
In pelvic inflammatory disease, the patient has symptoms of nausea, vomiting, and fever, lower abdominal pain, and dysuria however, she most likely will also have an abnormal vaginal discharge and or abnormal uterine bleeding, dyspareunia. On physical examination, the patient will have cervical motion tenderness and may have adnexal tenderness or even an adnexal mass. In this scenario, the patient has a normal pelvic exam without cervical motion tenderness, which makes the diagnosis of pelvic inflammatory disease less likely.
A 16-year-old female presents to your office with the complaint of greenish vaginal discharge for the past 2 months and the recent onset of lower abdominal pain. She reports that her last period was about 2.5 months ago. She is sexually active with two partners and has never used a condom or any other contraception with either. On physical examination she is not febrile with normal blood pressure and pulse. She has greenish discharge from the cervix with friability and cervicitis. There is no cervical motion tenderness. Her urine pregnancy test is positive. A cervical sample is positive for Chlamydia and negative for gonorrhea. Her rapid plasma reagin (RPR) is nonreactive and an HIV test is negative. The patient is treated with appropriate antibiotics and counseled concerning safer sex practices. You also inform the patient regarding her risk for HIV conversion, even though today's test was negative. The patient asks if you are going to tell her mother that she is pregnant and has...
Bacterial vaginosis is a common form of vaginal discharge in which neither Trichomonas vaginalis nor Candida albicans can be isolated and inflammatory cells are not present. There is evidence to associate the condition with overgrowth of several normal commensals of the vagina including Gardnerella vaginalis, Gram-negative curved bacilli, and anaerobic organisms, especially of the Bacteroides genus, the latter being responsible for the characteristic fishy odour of the vaginal discharge. The condition responds well to a single 2 g oral dose of metro-
18.1 A 14-year-old female is here to see you for complaints of greenish vaginal discharge. She is sexually active with one partner and does not use condoms. You do a culture and find that she has Trichomonas vaginitis. She asks you not to tell her mom about this diagnosis or that she is sexually active. Can you keep this information from her parents
She has noticed increased tiredness and was nauseated for a few weeks, but it went away a couple of weeks ago. She denies any fever or chills. She denies abdominal pain or vaginal discharge. She has noticed some intermittent low back pain. She has not used any over-the-counter medications to treat the pain.