Obstetrics and Gynaecology · MU Sofia

48. Vulvovaginitis - types, characteristic features, treatment. Sexual transmitted diseases. HIV/AIDS

Compares three causes of vulvovaginitis (candidiasis, bacterial vaginosis and trichomoniasis) in a table covering cause, symptoms, signs, pH, diagnostic tests and treatment. It then lists risk factors in children and postmenopausal women, goes through the main sexually transmitted infections with their features and treatments, and summarises prevention principles. The final section covers HIV/AIDS, including its gynaecological relevance, diagnosis, treatment and prevention. It ends with a short mnemonic-style summary linking symptoms to each infection.

Inside: 3 sections · 2 tables · 16 flashcards · 2 min

Topic 48 of 61 in the MU Sofia syllabus for Obstetrics and Gynaecology (Dental Medicine, Year 4). The free AceMed note covers it in 3 sections, about 148 words (2 min of reading), with 16 flashcards.

In this note

  1. Vulvovaginitis
  2. Sexually transmitted infections
  3. HIV/AIDS

Vulvovaginitis

Risk factors for candida: pregnancy, diabetes, antibiotics, immunosuppression. Children: poor hygiene, foreign bodies, pinworms; think of abuse with STIs. Postmenopausal women: atrophic vaginitis (local oestrogen).

Sexually transmitted infections

Principles: test for other STIs (including HIV and syphilis), partner notification and treatment, abstain until treated, condoms.

HIV/AIDS

  • HIV infects CD4 lymphocytes; untreated, it leads to AIDS (CD4 < 200/µl or an AIDS-defining illness).
  • Gynaecological relevance: higher risk of persistent HPV and cervical cancer (an AIDS-defining cancer), so screening starts earlier and is repeated more often; more candida, PID, herpes.
  • Diagnosis: 4th-generation antigen/antibody test, confirmed; viral load and CD4.
  • Treatment: antiretroviral therapy for everyone; an undetectable viral load means the virus is not sexually transmitted (U = U).
  • Prevention: condoms, PrEP, post-exposure prophylaxis within 72 hours, antenatal screening and treatment to prevent vertical transmission.

Itch means candida, fishy smell means bacterial vaginosis, frothy green discharge means trichomonas, and only trichomonas needs the partner treated.

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