USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

GYN TRIAD

Candida (Yeast) Vaginitis

Risk factors include diabetes mellitus, systemic antibiotics, pregnancy, obesity,
and decreased immunity.

The most common patient complaint is itching, burning, and pain with
intercourse. Candida vaginitis is seen in non-sexually active patients as well.

Speculum Examination: Vaginal discharge is typically curdy and white. The
vaginal epithelium is frequently edematous and inflamed. Vaginal pH is normal
<4.5.

Wet Mount: Microscopic examination reveals pseudohyphae on a KOH prep.
WBCs are frequently seen.

Management: Either a single oral dose of fluconazole or a vaginal “azole”
cream. An asymptomatic sexual partner does not need to be treated.

Vaginal discharge   pH  <4.5

Itching and burning

Pseudohyphae