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Cervical Uterine Dz

Slides Notes

CC: vaginal discharge. next step? bimanual pelvic; speculum (pH, wet prep, STD testing), external genitalia; Q and A about discharge; Sexual history.
cyclic discharge: midcycle (Estrogen), pos-ovulatory (progesterone) physiologic discharge
LMP, sexual history; contraception; exposure type; STD exposure, assciated (pruritis, dyspareunia, odor, dysuria, fever, chills, pelvic, flank pain) detailed sexual history
bacterial vaginosis, trichomonas vaginalis, GC, Chl, candidiasis, HSV (vesicles, external, internal), syphilis (chancre painless) cervical/vaginal discharge
douching increases bacterial vaginosis
do not sample in posterior fornix bc elevated falsely by cervical mucus, semen, blood do no sample PH in posterior fornix
NAAT test for? STD (oral, cervical, rectal, UA)
bimanual pelvic exam, rectovaginal, CMT, adnexal tenderness (endometriosis, PID, TOA) female exam
watery, white/gray discharge, no pruritis, fishy odor, esp after sex or menses bacterial vaginosis (lactobacillus = acid)
risk factors for bacterial vaginosis? HIV, GC, sex, douching, multi-partners
test of cure if sx, pregnancy (TOC with NAAT 3 wk after Rx), (educate, partner tx, aggressive detection, use condoms)
Created by: jamieseals
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