DRCOG MCQs for Circuit B Answers
Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Trichomonas vaginalis is a sexually transmitted disease and is readily diagnosed under the microscope in a drop of saline. T. vaginalis is a flagellated protozoon and may infect the vagina, cervix, urethra and Bartholin's glands. It causes a frothy yellow-green purulent vaginal discharge. It is amenable to a 5-day course of metronidazole therapy.
Trichomonas Vaginalis Vaginitis
William J. Ledger, Steven S. Witkin in Vulvovaginal Infections, 2017
Too many practicing physicians have a knowledge deficit regarding Trichomonas vaginalis vaginal infections. Their vision of this infection as they evaluate patients in their private offices is focused upon the rare troubled woman with a bothersome persistent discharge hurriedly seeking relief. In this imagined scenario, the physician will provide care by first confirming the diagnosis, viewing a saline wet mount through the office microscope, or by sending vaginal samples to the laboratory for testing. Unfortunately, this view does not match the reality of clinical practice. As many as one-third of women with this vaginal infection are asymptomatic, and there are wide ranges of test positivity to this organism depending upon the ethnicity of the female population and the geographic setting of the health-care unit. , This is not a rare and uncommon infection, so well captured by the title of Reference 1, “Trichomonas vaginalis infection: the most prevalent nonviral sexually transmitted infection receives the least public health attention.”The overall prevalence of trichomoniasis in young adults in the United States was 2.3%, in a gene amplification–based survey of the urine of men and women for T. vaginalis. The prevalence was higher among women, 2.8%, than among men, 1.7%. The frequency of infection in women varied among racial groups from a low of 1.1% among whites to 6.9% in blacks and was most often found in patients over the age of 25 (see Table 6.1). There was also variation by region, highest in the south (2.8%) and lowest in the west (1.4%). In this survey of a population not seeking care, the majority of the patients with infections were asymptomatic. Also, contrary to commonly held physician assumptions, an office microscopic examination will miss many women with this infection. In one survey of a sexually transmitted disease clinic in which the practitioners regularly used microscopes as part of their evaluations of these often symptomatic women, only 69.6% of infected women, confirmed by laboratory testing, had a positive microscopic screen.
Sexually transmitted infections
Sarah Bekaert in Women's Health, 2018
Often women infected with Trichomonas vaginalis do not have any symptoms, but discharge can occur, together with genital soreness, pain when passing urine and pain during sex.
Point of care diagnostics for sexually transmitted infections: perspectives and advances
Published in Expert Review of Anti-infective Therapy, 2014
Charlotte Gaydos, Justin Hardick
Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexually transmitted infection epidemics, so that patients can receive immediate diagnoses and treatment. Current POC assays for Chlamydia trachomatis and Neisseria gonorrhoeae perform inadequately and require better assays. Diagnostics for Trichomonas vaginalis rely on wet preparation, with some notable advances. Serological POC assays for syphilis can impact resource-poor settings, with many assays available, but only one available in the U.S. HIV POC diagnostics demonstrate the best performance, with excellent assays available. There is a rapid assay for HSV lesion detection; but no POC serological assays are available. Despite the inadequacy of POC assays for treatable bacterial infections, application of technological advances offers the promise of advancing POC diagnostics for all sexually transmitted infections.
Sexually transmitted infections in women
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2014
Sexually transmitted infections (STIs) are highly prevalent and cause a wide spectrum of disease. However, the majority of these infections may be unrecognized due to lack of overt signs or symptoms of infection. Asymptomatic infections remain significant as a result of the potential for long-term sequelae, predominately in women, and the risks of complications during pregnancy as well as mother-to-child transmission. Laboratory diagnostics play an important role in identifying infection and in public health efforts to reduce the prevalence of these diseases. Serologic diagnosis is appropriate for syphilis and, in some settings, for herpes infections. However, the organisms that cause discharge such as Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium are best diagnosed using molecular assays. Currently available molecular assays are suitable for use with non-invasively collected sample types, most notably vaginal swabs for women thus expanding the potential reach of STI control programs to include non-clinic based screening.
Controlled delivery of the antiprotozoal agent (tinidazole) from intravaginal polymer matrices for treatment of the sexually transmitted infection, trichomoniasis
Published in Pharmaceutical Development and Technology, 2019
Hevanshi Vidhushika Fernando, Li Li Chan, Nhung Dang, Diviya Santhanes, Hasini Banneheke, Sivalingam Nalliah, Allan G. A. Coombes
Microporous polymeric matrices prepared from poly(ɛ-caprolactone) [PCL] were evaluated for controlled vaginal delivery of the antiprotozoal agent (tinidazole) in the treatment of the sexually transmitted infection, trichomoniasis. The matrices were produced by rapidly cooling co-solutions of PCL and tinidazole in acetone to −80 °C to induce crystallisation and hardening of the polymer. Tinidazole incorporation in the matrices increased from 1.4 to 3.9% (w/w), when the drug concentration in the starting PCL solution was raised from 10 to 20% (w/w), giving rise to drug loading efficiencies up to 20%. Rapid ‘burst release’ of 30% of the tinidazole content was recorded over 24 h when the PCL matrices were immersed in simulated vaginal fluid. Gradual drug release occurred over the next 6 days resulting in delivery of around 50% of the tinidazole load by day 7 with the released drug retaining antiprotozoal activity at levels almost 50% that of the ‘non-formulated’ drug in solution form. Basic modelling predicted that the concentration of tinidazole released into vaginal fluid in vivo from a PCL matrix in the form of an intravaginal ring would exceed the minimum inhibitory concentration against Trichomonas vaginalis. These findings recommend further investigation of PCL matrices as intravaginal devices for controlled delivery of antiprotozoal agents in the treatment and prevention of sexually transmitted infections.