08-18-2008, 11:08 AM
a 44 yrold woman comes to clinic complaining of vaginal ittch for the last month.she is fairly certian that she has yeast infection,as she had similar complaints in the past successfully treated with over the counter topical antifungal medications.this time howver topical flucanozole is not effective.although she suffers from dm for 4yrs she reports compliance and good control.review of system reveals recent sinusitis for which a friend prescribed 2 week course of amoxillin /clavul.vital signs are normal,physical examination reveals redness of the vaginal introitus,swollen,reddenedlabia,and a thick milky white vaginal discharge. awet mount is prepared which reveals oval yeast like organisms.the most appropriate managment in this pt is
a)offer topical estrogen cream
b)prescribe oral metronidazole
c)recommend vaginal douching and warm compressing
d)send vaginal discharge for fungal culture
e)prescribe oral flucanozole weekly
a)offer topical estrogen cream
b)prescribe oral metronidazole
c)recommend vaginal douching and warm compressing
d)send vaginal discharge for fungal culture
e)prescribe oral flucanozole weekly