VAGINAL DISCHARGE

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VAGINAL DISCHARGE

• DR Sathisha Nayak
• Dept. of O G
• MMMC

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IDENTIFY !!
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VAGINAL DISCHRGE

• OBJECTIVES
• 1.WHAT IS LEUCORRHOEA?
• 2.IS IT NORMAL?
• 3. NORMAL VS BNORMAL
• 4.CLASSIFICATION
• 5.COMMON CAUSES
• 6.CLINICAL FEATURES
• 7.EVALUATION
• 8.MANAGEMENT

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LEUCORRHOEA

• EXECESSIVE VAGINAL DISCHARGE
• NOT DUE TO INFECTION(EXECESSIVE
• CERVICAL MUCUS OR VAGINAL
• TRANSUDATION)
• ECTROPION, CERVICAL TEARS.

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IS VAGINAL DISCHARGE NORMAL?

• COULD BE PATHOLOGICAL
• YES SOME SITUATIONS IT CAN BE
• - PUBERTAL
• - PREGNANCY
• - PREMENSTRUAL
• - OC PILLS
• -SCANTY,NO SMELL,WHITISH,NO ITCHING
• NOT BLOOD STAINED.

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NORMAL CERVIX
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CLASSIFICATION

• PHYSIOLOGICAL
• PATHIOLOGICAL
• - INFECTIVE
• - NON INFECTIVE- NEOPLASTIC
• -
  ATROPHIC
• -
  ALLERGIC,FB

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INFECTIVE CAUSES

• VAGINAL
• - CANDIDA VAGINITIS
• - TRICHOMONIAL VAGINITIS
• - BACTERIAL VAGINOSIS
• CERVICAL
• - GONORRHOEA CERVICITIS
• - CHLAMYDIA CERVICITIS

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CANDIDA VAGINITIS

• AGE- 20-40Y
• COMMON IN PREGNANCY
• DIABETIC
• OBESE WOMEN
• FEATURES - CURDY WHITE,ITENSE ITCHING
• EXCORATION OF VULVA
• SMEAR- 10KOH-FUNGAL HYPHE SEEN
• TREATMENT-CLOTRIMAZOLE-100MG BDx7D
• 
  200MGBDx3D
• RECURRENT -FLUCONOZLOE 150 MG WX4W

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CANDIDA VAGINITIS
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CANDIDA VAGINITIS
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TRICHOMONIAL VAGINITIS

• AGENT - TRICHOMONIA VAGINALIS
• AGE -20-40YRS,SEX ACTIVITY
• FEATURES
• GREENISH,FROTHY,COPIOUS,ITCHING
• STRAWBERRY SPOTS ON VAGINA
• VAG. SMEAR-MOTILE ORGANISMS
• TREATMENT- METRONIDAZOLE
• - 200XBDX7D OR400XBDX3
• -COUPLE TREATED TOGETHER

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TRICHOMONIAL VAGINITIS
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BACTERIAL VAGINOSIS

• AGENTG.VAGINALISANAEROBIC
• AGE -20-40 YRS
• FEATURES-WHITISH GREY,COPIOUS
• NO ITCHING,FISHY SMELL
• VAG.SMEAR-CLUE CELLS
• TREATMENT-METRONIDAZOLE500XBD
• 
  X7DAYS

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BACTERIAL VAGINOSIS
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HOW TO ASSES..?

• DETAILED HISTORY
• COLOUR AMOUNT,SMELL,ITCHING
• RELATION TO COITUS /MENSES,pH
• CLINICAL EXAMINATION-EX GENITAL
• 
  P/S EXAM
• INVESTIGATIONS-VAGINAL SMEAR
• -CULTURE
  

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CERVICAL INFECTIONS

• GONORRHOEA-NEISS. GONORRHOEAE
  -85
  ASYMPTOMATIC
• - MUCOPURULANT
• - SMEAR FROM CX OURETHRA
• - INTRACELL. GM VE DIPLOCOCCI
• -SINGLE DOSE CEFETRIOXONE

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CERVICAL INFECTIONS

• CLAMYDIA-CL.TRACHOMATIS
• AGE -20-40
• MUCOPURULANT
• SEXUAL TRANSMITTED
• FLOROSCENT ANTIBODY TEST/CULT.
• DOXYCYCLINE 100XBDX7D

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CERVICAL INFECTIONS
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BEWARE !

• IN ANY VAGINAL DISCHARGE R/O-
• -CARCINOMA CERVIX,CA ENDOMET.
• (FOUL SMELL OR BLOOD STAINED)
• -POLYPS,FB,VAG DOUCH(CHEMICAL)
• -STD-PARTNER SCREENING
• -DIABETES/HIV IN CANDIDA

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DYSPLASIA
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IDENTIFY
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IDENTIFY
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IDENTIFY
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IDENTIFY
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THANK YOU