Vaginal Discharge :: PLAB 2 Symptomatic Differential Stations

• Bacterial Vaginosis

  • Other presenting symptoms: 

    • Fishy smelly vaginal discharge

    • Greenish copious discharge

    • History of bubble baths, vaginal douching or IUCD 

  • Past history and PMAFTOSA: 

    • Sexual history

    • P questions

  • Social:

    • Life effects

    • Mood, relationships

  • Exam and Invs:

    • GPE, vitals

    • Abdominal examination

    • PV

    • Vaginal swab

    • Cervical smear

    • Urine dipstick, Urine pregnancy test

  • Referral:

    • None

  • Treatment: 

    • Metronidazole if confirmed

    • General advice:

      • Avoid douching

      • Avoid bubble baths

  • Warning signs:

    • High fever

    • Severe pelvic pain

• Candidiasis

  • Other presenting symptoms: 

    • Itchy, white vaginal discharge

  • Past history and PMAFTOSA: 

    • Sexual history

    • P questions

  • Social:

    • Life effects

    • Mood, relationships

  • Exam and Invs:

    • GPE, vitals

    • Abdominal examination

    • PV

    • Vaginal swab

    • Cervical smear

    • Urine dipstick, Urine pregnancy test

  • Referral:

    • None

  • Treatment: 

    • Antifungal (Clotrimazole vaginal single dose)

    • General advice:

      • Avoid douching 

      • Avoid bubble baths

      • Safe sex

      • Avoid sex till treatment complete

  • Warning signs:

    • High fever

    • Severe pelvic pain