Professional Documents
Culture Documents
ACID (VIA)
VISUAL INSPECTION WITH ACETIC ACID (VIA)
• Cervical cancer screening test
• Rationale: application of 3%- 5% dilute acetic acid turns abnormal tissue
(areas of nuclear density) to temporarily become white
• Methods:
• (1) Direct Visual Inspection (DVI)
• (2) Visual Inspection with Magnification (VIAM)
Colposcope
• Low power binocular
microscope placed just
outside the vagina after
speculum has been inserted
• Brings to view the cervix
STEPS
• Apply speculum
• Remove obscuring mucus with swab
• Visualize for presence of any cervical lesions
• Apply 3% - 5% dilute acetic acid to cervix
• After 30 secs, visualize and examine again
• Visualize transformation zone in its entirety
Source: http://screening.iarc.fr/doc/RH_via_evidence.pdf
TRICHOMONAS
TRICHOMONIASIS
Etiologic agent: Trichomonas vaginalis
ALTERNATIVE REGIMEN
• Metronidazole 500 mg orally twice a day for 7 days
OTHER MANAGEMENT CONSIDERATIONS
In some women, infection is likely to recur and require repeated treatment during
pregnancy
If azithromycin allergic, Doxycyline 100 mg PO BID for 7 days can be used in place
of azithromycin in combination with a cephalosporin
CHLAMYDIA
CHLAMYDIA
• Chlamydia is a bacterial infection caused by Chlamydia trachomatis. Genital
tract infections are usually caused by Serovars D-K.
-Dysuria
-Vaginal discharge
-Abnormal vaginal bleeding
-Dyspareunia
-Proctitis, rectal discharge, or both
-Fever
DIAGNOSIS
Whom to test
Symptomatic and at-risk patients
Patients with persistent symptoms
Recurrence of symtpoms
Detection methods
NAAT, culture, antigen detection, serology
Choice of specimen
Cervical and vaginal swabs
Urine
TREATMENT
Uncomplicated chlamydial infection
7-day course of tetracycline (500mg 4x a day), doxycycline (100mg BID),
erythromycin (500mg 4x daily)
7-day course of fluoroquinolone (ofloxacin 300mg BID or levofloxacin
500mg)
Single dose of azithromycin 1g
TREATMENT
Pregnant women
Amoxicillin 500mg TID for 7 days
Single dose of azithromycin 1g (not FDA approved)