Term
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What are the hallmark symptoms of bacterial vaginosis (BV)?
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Definition
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A: Fishy odor (especially after sex), grayish-white discharge, and copious vaginal discharge.
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Term
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Definition
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A: Swab test showing Gardnerella vaginalis and Amsel criteria (pH >4.5, clue cells on microscopy).
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Term
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Q: Why is BV not considered an STI?
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Definition
| It results from an imbalance in vaginal flora, not direct sexual transmission (though sex can trigger it). |
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Term
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Name 4 risk factors for BV mentioned in the case.
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Definition
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A: Bubble baths, perfumed products, IUD use, recent partner change.
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Term
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Q: How does an IUD increase BV risk?
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Definition
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A: It may disrupt the vaginal microbiome or cause low-grade inflammation.
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Term
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Q: Why is smoking a risk factor for BV?
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Definition
| Smoking alters vaginal pH and reduces protective lactobacilli. |
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Term
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What is first-line treatment for symptomatic BV?
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Definition
A: Oral metronidazole (400mg BD for 5–7 days) or vaginal clindamycin cream.
Q: |
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Term
When is specialist referral needed for BV?
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Definition
If recurrent BV (>2 episodes in 6 months), IUD-related concerns, or pregnancy complications.
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Term
| What lifestyle changes should the patient adopt? |
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Definition
Do: Shower instead of bath, wash underwear with mild detergent.
Don’t: Use vaginal deodorants, douches, or antiseptics. |
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Term
| How would you address a patient’s fear that BV is an STI? |
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Definition
| “BV is caused by an imbalance of natural vaginal bacteria, not by sexual transmission. However, sex can sometimes disrupt this balance.” |
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Term
| Why does BV increase STI risk? |
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Definition
| Reduced vaginal acidity weakens natural defenses against infections like HIV or chlamydia. |
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Term
| What are the risks of BV in pregnancy? |
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Definition
| A: Preterm birth, low birth weight, or miscarriage. |
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Term
| When should a “test of cure” be done for BV? |
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Definition
| If symptoms persist after treatment or recurrence occurs (follow-up in 1 week). |
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Term
| What safety-netting advice should be given? |
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Definition
| Return if fever, pelvic pain, or worsening discharge occurs (signs of PID or complications) |
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Term
| How does BV differ from candidiasis? |
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Definition
BV: Fishy odor, gray discharge, no itching.
Candidiasis: Thick white discharge, itching, redness. |
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Term
| What questions help rule out PID? |
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Definition
| Ask about fever, pelvic pain, or irregular bleeding. |
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Term
| What diagnostic findings confirm BV? |
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Definition
| pH >4.5, clue cells on microscopy, positive Gardnerella swab. |
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Term
| What is first-line treatment for symptomatic BV? |
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Definition
| Metronidazole (oral 400mg BD for 5–7 days or vaginal gel). |
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Term
| Why should patients avoid alcohol with metronidazole? |
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Definition
| Risk of disulfiram-like reaction (nausea, vomiting, flushing). |
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Term
| When is BV treatment not required? |
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Definition
| A: If asymptomatic (unless pregnant/high-risk procedures planned). |
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Term
| Why is BV screening critical in pregnancy? |
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Definition
| Linked to preterm birth, miscarriage, and postpartum endometritis. |
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Term
| What distinguishes BV from trichomoniasis? |
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Definition
| Trichomoniasis causes frothy yellow-green discharge + itching; BV lacks these. |
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Term
| How would you address a patient’s fear that BV is an STI? |
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Definition
| “BV is caused by an imbalance of natural vaginal bacteria, not by sexual transmission. However, sex can sometimes disrupt this balance.” |
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Term
| When is specialist referral needed for BV? |
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Definition
| If recurrent BV (>2 episodes in 6 months), IUD-related concerns, or pregnancy complications. |
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