any one pl clarify - swanganz

[ArchivalUser]

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



* Re:imp step3 q pl answ
#1424262
desire - 08/18/08 15:30

d..
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swanganz - 08/19/08 01:27

that is the answer by Kaplan but MKSAP gives as follows

Approximately 5% of women experience recurrent vaginal infections (three or more episodes per year), and weekly oral fluconazole for 6 months reduces the recurrence of candidal vaginitis. which is correct? Any inputs pl.....
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* similar q in MKSAP
#1424814
swanganz - 08/19/08 01:33

A 30-year-old woman is evaluated for a 3-day history of vaginal discharge, itching, and irritation. During the past 12 months, she has had five similar episodes and has treated her symptoms successfully with an over-the-counter vaginal yeast cream. Three months ago, a fasting plasma glucose measurement was normal. She is monogamous and has had one male partner for the past 6 months. Vaginal examination during an office visit reveals inflammation of the external genitalia and a nonodorous vaginal discharge adherent to the vaginal walls. Upon microscopic examination of the vaginal discharge with potassium hydroxide slide preparation, pseudohyphae and budding filaments are noted. A pregnancy test is negative. She would like to discuss what she can do to prevent recurrences.

Which of the following is the most appropriate next step in management?

A Ingest lactobacillus cultures daily
B Begin weekly douching
C Avoid simple sugars
D Treat partner with antifungal cream
E Begin weekly oral fluconazole


answ is E which is correct? Any one pl give ur inputs

[ArchivalUser]

frist case:Torolopsis candida (C glabrata ) infection, ttt caspofungin

second case:
intermittent prophylactic treatment with a single dose or multiple doses of topical or oral antifungals given to prevent symptomatic episodes. Local treatment with clotrimazole or miconazole at every two to four weeks suppresses symptoms even if mycological cure is not achieved.

Intermittent single doses of oral fluconazole 150 mg are also effective for three to six months