repeated alkalization as in many sexual encounters, bleeding, using alkaline soaps and washed down there.
there is no wbcs because its not an infection. just alteration in the normal flora
the clue cells is created because the gram negative rods stick onto the surface of thenvaginal epithelurm cells.
pregnancy isnt an immunocomprmised state but an immunomodulate state.
Bacterial vaginosis isnt an inefcetion or disease because its not an infection but alteration in bacterial flora so there isnt neutrophils ..and its not an stds.
prally fluconozole but if vaginal tablets or pessaries can have many formularions like the above.
Contrast between these three vaginatis ** final mbbs essay question.
they usually coexists together so thats why when treating for gonnorreha will treat for chlamydia as well.
the above two can have urinary tract infection as well
Syndromic approach for treatment
syndromic approach is utilised when health care facilities are limited. Investigations are limited. And when treatments are cheap and no side effects and can treat empirically.
We use syndromic approaches in other places and for other diseases too, but this is on recognised used for it. !!!!
acid ph test can be done
wet smear can be done (normal saline)
no need actual investigations and stuff, rather just can diagnose clinically (by clinically means HISTORY and examintion).
By diagnosing clinically, also means history too!!!
uusally will just suspect vaginitis and treat for everything as in the syndromic appporach for treatment.
But some centers do the wetsmears,
the reddish part is the endocervix and the pinkish is the ecto cervix. but when the red can be seen as coming out here its called as cervical erosions.
cervical erosions is when the cervix gets eroded and the endocervix protrudes out like the above. vs cervical ectropian
and use condoms for a while atleast
IF diagnose individual diseases then can only give the individual particular treatment
For cervicitis do need to do the IOC. and some centers wont even do a gram stain. so just blanket treatment with cetfriazone (if injections not available then can go for cefixime).
for cervicitis need partner treatment as well. but for vaginitis if identified as bv then dont need partner treatment as not std just ateration of flora. But if blanket or idenfiied as the otger, need partner treatment.
sometimes they come over and over again becaude have not treated the partner and have not told to abtain or use condoms so they keep infecting each other and incubation period means it will come again.
so in pregnant women the class of drug is the same..but vaginal route is preferred instead of orally.
Go trhough the PID page as well!
Lap findings in PID:
will be able to see a swollen tube with water or pus inside. Inflammed. Sometimes as abcess and even pus coming off the tubes
And adhesions all over
if no adnexal mass then no need to do ultra sound
plus abstinence or condom use
check the PID page as well !!
Genetic ulcer disease
haemophylis ducreyi isolation and testing is difficult and not always available so in that case can go for a syndromic appraoch to treatment
also give pain relieving medications as well
