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25 Cards in this Set
- Front
- Back
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Your patient is a 23-year-old female who presents to your clinic with a:
profuse vaginal discharge, with burning, itching, and chafing. The exudate is slightly green and bubbly. The vaginal mucosa is mildly hyperemic with multiple punctuate lesions on the cervix. A drop of the exudates was examined microscopically which revealed parasites with jerky motility . . . |
Dx:
Trichomonas vaginalis |
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What do Trichomonas vaginalis look like on micro?
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Trichomonads are globular-like parasites,
slightly larger than a leukocyte, 3 - 5 flagella on the anterior side, an undulating membrane, and a single oval nucleus. |
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In what form are trichomonas found?
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appear ONLY IN THE
TROPHOZOITE FORM. (i.e., no cysts) ****EXAM |
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the most common curable STD in young, sexually active women
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Trichomonas vaginalis
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Is co-infection with other STDs and trichomonas common?
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Co-infection with other STDs is common so infection with Trichomonas may indicate high-risk sexual behavior
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Do young women usually show signs or symptoms if they are infected with trichomonas?
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Perhaps 50% of infected females are asymptomatic at the time of diagnosis, but go on to develop vaginitis within 6 months
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When will symptoms usually show when a women contracts trichomonas?
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appear in women within 5 – 28 days of exposure.
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How long will symptoms last once infected with trichomonas?
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Symptoms may persist for weeks or months
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How are men affected by Trichomonas?
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Males are usually asymptomatic,
but infections may affect the prostate and urethra, displaying a thin discharge |
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What are clinical manifestations seen in a women who contracted trichomonas?
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• frothy yellow/green vaginal discharge (occasionally a bad odor)
• vulvar itching or burning • dyspareunia (pain during the sexual act) and dysuria • Colpitis macularis (strawberry cervix)****EXAM is the finding of punctate hemorrhages and occasionally vesicles or papules on the cervix • elevated vaginal pH (> 4.5) with increased neutrophils |
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What are some complications of trichomonas?
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increased risk of HIV infection, preterm delivery and other pregnancy problems
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How do you Dx Trichomonas?
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*identification of the motile organisms in the genital tract:
*usually done with a wet mount preparation examined under the microscope. *****WET MOUNT More sensitive detection tests include: culture, rapid antigen detection kits, and use of nucleic acid probes |
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What is the DOC for Trichomonas vaginalis?
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Oral metronidazole (Flagyl)
is a highly effective treatment, with simultaneous treatment of sexual partners. |
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Who should you give Metronidazole to?
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Oral metronidazole (Flagyl) is a highly effective treatment,
******with simultaneous treatment of sexual partners. EXAM |
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Why do you give Metronidazole?
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This is necessary to prevent re-infection
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What is an alternative DOC for trichomonas?
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Tinidazole
may be an alternative drug |
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How are trichomonas and HIV related?
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Trichomoniasis may increase susceptibility to HIV infection
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A young adult female presented with a profuse white vaginal discharge, associated with burning, itching and chafing. She admitted to recently having unprotected sexual intercourse.
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A what.....
oh no she didn't |
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The inflammatory exudate was slightly yellow/green and bubbly.
There may be a strong odor associated in some cases. |
Vaginal Mucosa:
1. Strawberry” appearance – from punctate hemorrhages 2. Postcoital bleeding can occur. |
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The inflammatory exudate was slightly yellow/green and bubbly.
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There may be a strong odor associated in some cases
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next you look at the vaginal mucosa and find....
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“Strawberry” appearance – from punctate hemorrhages
& Postcoital bleeding can occur. |
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A drop of exudate was examined microscopically and it showed parasites with jerky movements, undulating membrane and flagella.
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How should you manage this pt?
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Treat patient with metronidazole
Little or no immunity develops, so re-infection is common Notify and treat sexual partner(s) to prevent re-infection Patients should avoid sexual intercourse until asymptomatic |
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How is this disease transmitted?
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Sexual intercourse. ****EXAM
There is little evidence for other modes of transmission. |
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What counseling would you give a female patient with trichomoniasis
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Protected sex.
Also have sexual partners tested and treated*****EXAM |
