Candidal Vaginitis

Candidal Vaginitis

Q. 1 True about vaginal candidiasis :

 A Risk is not increased in pregnancy

 B

Associated with intense pruritus

 C

Typical “Cottage — cheese” discharge occurs

 D

b and c both

Q. 1

True about vaginal candidiasis :

 A

Risk is not increased in pregnancy

 B

Associated with intense pruritus

 C

Typical “Cottage — cheese” discharge occurs

 D

b and c both

Ans. D

Explanation:

Ans. is D. i.e. b and c both

  • Candida albicans is the common cause of vaginitis.
  • Candida albicans >Candida glabrata > Candida tropicalis
  • M/C vaginitis in Pregnancy, diabetes, immunocompromised people, OCP users, steroid users, antibiotic users.
  • Usually not an STD

Signs & Symptoms

  • pH < 4.5 (so it is the M/C vaginitis in acidic media) or during Pregnancy.
  • Intense pruritis.
  • Curdy white discharge (or cottage cheese-like discharge).
  • Splash dysuria.
  • Sign-Examination reveals erythema and edema of labia and vulvar skin.

Q. 2 Regarding vaginal candidiasis which is false:

 A

Cottage cheese like secretions are seen

 B

Intense pruritus

 C

Most common in non-pregnant women

 D

Buds and hyphae seen in KOH preparation

Ans. C

Explanation:

Ans. is C. i.e. Most common in non-pregnant women

  • Candidiasis is caused by Candida albinism which thrives in an acidic medium with an abundant supply of carbohydrates.
  • It is found commonly in pregnancy, and in patients on oral contraceptives, antibiotics, and corticosteroids.
  • It is also seen in patients with diabetes.
  • It causes a profuse discharge and intense pruritus with soreness of vagina and dysuria.
  • Vagina and vulva are edematous and excoriated and the white patches of cheesy material on the vagina and vulva can be easily identified.
  • A 10% KOH smear shows the buds and hyphae of the Candida organism.
  • Nystatin or ketoconazole vaginal tablets used for one week are curative when used along with the cream of the same medication for External use.

Q. 3 All are risk factors for vaginal candidiasis except:

 A

Diabetes mellitus

 B

HIV

 C

Hypertension

 D

Pregnancy

Ans. C

Explanation:

Ans. C. Hypertension

  • Vaginal candidiasis is the. fungal infection of the vagina with Candida Albicans.
  • Vaginal candidiasis can be sexually transmitted or associated with sexual activity but commonly occurs in women who are not sexually active.

Characteristics symptoms of vaginal candidiasis are:-

  • Itching, discomfort in the vagina or vulva.
  • Curd like vaginal discharge
  • Bright red rashes affecting inner and outer parts of the vulva.

Risk factors

  • Pregnancy
  • Medications—Oral contraceptives( Monilial vaginitis), antibiotics, corticosteroids, cancer chemotherapy.
  • HIV and other STDs.
  • Diabetes mellitus(Vulval candidiasis )
  • Poor personal hygiene.
  • Rundown condition of health in general.

Q. 4 Oral contraceptives cause all side effects, except:

 A Monilial vaginitis

 B

Pituitary adenoma

 C

Ca uterus

 D

B and C

Ans. D

Explanation:

Ans. is D i.e. B and C.

Adverse Effects of Oral Contraceptive:

Minor:

• Intermenstrual spotting- first 3 months
• Nausea, vomiting, lack of appetite,
• Breakthrough bleeding
• Breast tenderness, vaginal discharge
• Headache, migraine Chloasma
• Weight gain Acne, Oily skin

Major:

• Cardiovascular disease, Stroke, Venous Thromboembolism
• Vaginal moniliasis
• Ca. Endocervix: if used for> 5years, dysplasia more common
• Cancer – Breast Ca(controversial), Ca cervix, Liver Ca
• Diabetes & Gall stones
• Affects lactation

 

 


Q. 5

A patient presented with intense vulvar pruritus, a white curd-like, cheesy vaginal discharge, and vulvar erythema. Candidiasis was diagnosed. Which among the following is NOT a risk factor for vaginal candidiasis?

 A

Diabetes mellitus

 B

Hypertension

 C

Human Immunodeficiency Virus (HIV) infection

 D

Pregnancy

Ans. B

Explanation:

Ans. is B. i.e. Hypertension

Risk factors of a candida infection include:

  • Diabetes mellitus
  • Human immunodeficiency virus [HIV]
  • Obesity
  • Pregnancy
  • Medication (antibiotics, corticosteroids, oral contraceptives)
  • Chronic debilitation

Q. 6 One of the following is the MOST common vaginal infection during pregnancy:

 A

Gonorrhea

 B

Trichomoniasis

 C

Bacterial vaginosis

 D

Candidiasis

Ans. D

Explanation:

Ans. is D. Candidiasis.

  • The most common vaginal infections during pregnancy are candidiasis.
  • The growth of candida is favored by the high acid pH of vaginal secretions and frequent passage of sugar in the urine during pregnancy.
  • It is more prevalent in diabetic pregnancy.

Q. 7 Candidiasis is associated with all except-

 A

OCP user

 B

IUCD user

 C

Diabetes

 D

Pregnancy

Ans. B

Explanation:

Ans. is B. i.e. IUCD user

  • Candida albicans is the common cause of vaginitis.
  • Candida albicans >Candida glabrata > Candida tropicalis
  • M/C vaginitis in Pregnancy, diabetes, immunocompromised people, OCP users, steroid users, antibiotic users.

Risk factors

  • Pregnancy
  • Medications—Oral contraceptives (Monilial vaginitis), antibiotics, corticosteroids, cancer chemotherapy.
  • HIV and other STDs.
  • Diabetes mellitus(Vulval candidiasis )
  • Poor personal hygiene.
  • Rundown condition of health in general.

Q. 8 Commonest fungal infection of the female genitalia in diabetes is:

 A

Cryptococcal

 B

Madura mycosis

 C

Candidal

 D

Aspergillosis

Ans. C

Explanation:

Ans. is C. i.e. Candidal

  • Candida albicans is the common cause of vaginitis.
  • Candida albicans >Candida glabrata > Candida tropicalis
  • M/C vaginitis in Pregnancy, diabetes, immunocompromised people, OCP users, steroid users, antibiotic users.
  • Usually not an STD

Signs & Symptoms

  • pH < 4.5 (so it is the M/C vaginitis in acidic media) or during Pregnancy.
  • Intense pruritis.
  • Curdy white discharge (or cottage cheese-like discharge).
  • Splash dysuria.
  • Sign-Examination reveals erythema and edema of labia and vulvar skin.

Risk factors

  • Pregnancy
  • Medications—Oral contraceptives( Monilial vaginitis), antibiotics, corticosteroids, cancer chemotherapy.
  • HIV and other STDs.
  • Diabetes mellitus(Vulval candidiasis )
  • Poor personal hygiene.
  • Rundown condition of health in general.

Q. 9 Vulval candidiasis is associated with:         

 A

Addison’s disease

 B

Cushing’s disease

 C

Diabetes mellitus

 D

Acromegaly

Ans. C

Explanation:

Ans. C i.e. Diabetes mellitus

  • Candida albicans is the common cause of vaginitis.
  • M/C cause is Candida albicans >Candida glabrata > Candida tropicalis.
  • M/C vaginitis in Pregnancy, diabetes, immunocompromised people, OCP users, steroid users, antibiotic users.

Risk factors

  • Pregnancy
  • Medications—Oral contraceptives( Monilial vaginitis), antibiotics, corticosteroids, cancer chemotherapy.
  • HIV and other STDs.
  • Diabetes mellitus(Vulval candidiasis )
  • Poor personal hygiene.
  • Rundown condition of health in general.

Q. 10 Genital infection in females presenting with thick curdy or flaky discharge may be:      

 A

Candidiasis

 B

Trichomoniasis

 C

Syphilis

 D

Gonorrhea

Ans. A

Explanation:

Ans. A i.e. Candidiasis

  • Candida albicans is the common cause of vaginitis.
  • Candida albicans >Candida glabrata > Candida tropicalis.
  • M/C vaginitis in Pregnancy, diabetes, immunocompromised people, OCP users, steroid users, antibiotic users.
  • Usually not an STD.

Signs & Symptoms

  • pH < 4.5 (so it is the M/C vaginitis in acidic media) or during Pregnancy.
  • Intense pruritus.
  • Curdy white discharge (or cottage cheese-like discharge).
  • Splash dysuria.
  • Sign-Examination reveals erythema and edema of labia and vulvar skin.

Q. 11 Pruritis of vulva may be a symptom of:      

 A

Candidiasis

 B

Trichmoniasis vaginitis

 C

Early carcinoma of the vulva

 D

All of the above

Ans. D

Explanation:

Ans. is D. i.e. All of the above.

Pruritus vulvae is itchiness of the vulva.

Causes: Itch due to infections

  • Candida albicans infection (vulvovaginal thrush) is the most important microorganism to consider in a postpubertal woman with vulval itch.
  • Bacterial vaginosis causes a frothy, malodorous discharge, and uncommonly causes vulval itch, possibly as a result of contact dermatitis.
  • Genital viral warts are often itchy.
  • Pinworms can reside in the vagina or anus and cause itch when they exit at night.
  • Infections that rarely cause vulval itch include cytolytic vaginosis (associated with vaginal lactobacilli) and trichomoniasis.

Itch due to an inflammatory skin condition

Irritant contact dermatitis is the most common cause of an itchy vulva at all ages. It may be due to diverse causes, including:

  • Age-related prepubertal or postmenopausal lack of estrogen
  • Underlying tendency to atopic dermatitis
  • Scratching for another reason
  • Friction from skin folds, clothing, activity, or sexual intercourse
  • Moisture due to occlusive underwear
  • Urine and/or feces
  • Soap or harsh cleanser
  • Frequent washing
  • Inappropriate or unnecessary chemical applications, including over-the-counter or prescribed medications
  • Fissuring of the posterior fourchette
  • Normal, excessive or infected vaginal secretions

The severe vulval itch may be due to:

  • Lichen simplex
  • Lichen sclerosis
  • Lichen planus

Other common skin disorders that may cause vulval itch include:

  • Psoriasis
  • Seborrhoeic dermatitis
  • Allergic contact dermatitis*
  • Irritant or allergic contact urticaria
  • Dermographism
  • Folliculitis

Potential vulval allergens include:

  • Methylisothiazolinone, a preservative in moist wipes
  • Various textile dyes in underwear
  • Fragrance in a douche or antiperspirant
  • Rubber accelerants in condom, menstrual cup or underwear
  • Latex rubber and semen are potential causes of contact urticaria.

Itch due to neoplasia

Benign and malignant neoplastic disorders of the vulva are often asymptomatic in their early stages, but they can cause itch. The most common cancerous lesions are:

  • Squamous intraepithelial lesions (SIL, also known as vulval intraepithelial neoplasia or VIN)
  • Extramammary Paget disease
  • Invasive vulval cancer (squamous cell carcinoma)

Itch due to neuropathy


Q. 12

Which of the following condition is most likely to be associated with vaginal pH of 4 :   

 A

Atrophic vaginitis

 B

Trichomonas vaginitis

 C

Candidal vaginitis

 D

Gardenella vaginitis

Ans. C

Explanation:

Ans. is C i.e.  Candidal Vaginitis

  • Candida albicans is a gram-positive yeast-like microorganism and grows well in acidic medium.
  • Vaginal pH remains normal (4.0-4.5) in candida infection whereas pH above 4.5 should suggest the possibility of Other bacterial vaginosis (BV), trichomoniasis or mixed infections.

Q. 13 Identify the infection in Vagina as shown in the photograph below? 

 A

Candidiasis.

 B

HIV.

 C

Bacterial vaginosis.

 D

Syphilis.

Ans. A

Explanation:

Ans. is A. Candidiasis

  • The infection in the vagina as shown in the photograph above represents candidiasis as it shows the presence of white, thick, curd-like discharge.
  • Candidiasis is caused by Candida albinism which thrives in an acidic medium with an abundant supply of carbohydrates.
  • It is found commonly in pregnancy, and in patients on oral contraceptives, antibiotics, and corticosteroids.
  • It is also seen in patients with diabetes. It causes a profuse discharge and intense pruritus with soreness of vagina and dysuria.
  • Vagina and vulva are edematous and excoriated and the white patches of cheesy material on the vagina and vulva can be easily identified.
  • A 10% KOH smear shows the buds and hyphae of the Candida organism.
  • Nystatin or ketoconazole vaginal tablets used for one week are curative when used along with the cream of the same medication for external use.


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