[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-402147-105":3,"detail-sidebar-cat-0-en-105":85,"doc-detail-402147-en":135},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","vaginitis-milestone-based-focused-questions","VAGINITIS - Milestone Based Focused Questions","","Clinical teaching material on vaginitis management organized by milestone levels. Presents common etiologies and risk factors, then guides evaluation of vaginal irritation and discharge through history, physical exam, wet mount (including pH and amine “whiff” testing), and targeted diagnostic testing for bacterial vaginosis, candidiasis, and trichomoniasis. Includes diagnostic criteria such as Amsel criteria and discusses initial empiric treatment considerations. Further addresses partner management for trichomoniasis and recommended additional STI testing. Also begins guidance on recurrent vaginitis treatment.",{"@graph":14,"@context":77},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/vaginitis-milestone-based-focused-questions/402147/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/vaginitis-milestone-based-focused-questions/402147.png","ImageObject",300,407,{"name":42,"@type":43},"OmBimo","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-07","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What are the most common etiologies of vaginitis?","Question",{"text":63,"@type":64},"The most common causes are bacterial vaginosis (BV), vaginal candidiasis, and trichomoniasis. Less common causes listed include atrophic vaginitis, vulvar dermatoses, and desquamative inflammatory vaginitis.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How should a patient with vaginal irritation and discharge be evaluated?",{"text":68,"@type":64},"Evaluation includes a focused history, focused external and speculum examination, wet mount with pH and amine “whiff” testing, and diagnostic testing targeted to BV, candidiasis, and trichomoniasis. Consider testing for gonorrhea, chlamydia, and other STIs when assessing vaginitis.",{"name":70,"@type":61,"acceptedAnswer":71},"How is bacterial vaginosis diagnosed using Amsel criteria?",{"text":72,"@type":64},"BV is diagnosed if 3 of 4 criteria are present: homogenous thin gray-white discharge, >20% clue cells on wet prep, vaginal fluid pH >4.5, and positive KOH whiff test.",{"name":74,"@type":61,"acceptedAnswer":75},"What partner treatment and additional testing are recommended for trichomoniasis?",{"text":76,"@type":64},"Partner treatment is recommended because trichomoniasis is a sexually transmitted infection, with options including partner referral or expedited partner treatment (EPT). Patients should also be offered testing for other STIs including gonorrhea, chlamydia, syphilis, HIV, hepatitis B, and hepatitis C.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},402147,1791097352,{"code":4,"msg":86,"data":87},"success",[88,92,96,100,105,110,114,119,124,127,131],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},"Exam",70,"exam",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},5,"Comic",60,"comic",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},6,"Technology",50,"technology",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},7,40,"healthcare",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},8,"Research & Report",30,"research-report",{"id":120,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":122,"slug":123},9,"Religion & Spirituality",20,"religion-spirituality",{"id":122,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":122,"slug":126},"World Cup","world-cup",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":128,"slug":130},10,"Lifestyle","lifestyle",{"id":132,"doc_module":4,"doc_module_name":25,"category_name":133,"show_sort_weight":101,"slug":134},19,"General","general",{"code":4,"msg":86,"data":136},{"doc_id":83,"user_id":137,"nickname":42,"user_avatar":138,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":144,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":12,"update_tm":148,"read_time":149,"preview_page_count":4},962090893581,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","VAGINITIS  \nAuthors: Lauren Meiss, MD and Sarah Baxley, MD  \nIntroductory Case  \nA 28-year-old G2P2 presents to the office with concerns of vaginal irritation and discharge for the past two days. She reports clear vaginal discharge associated with itching and burning. She has no other significant past medical history.  \nMilestone Based Focused Questions  \n\n| LEVEL 1: DEMONSTRATES BASIC KNOWLEDGE ABOUT COMMON AMBULATORY GYNECOLOGIC PROBLEMS |\n| --- |\n| WHAT ARE THE MOST COMMON ETIOLOGIES OF VAGINITIS? |\n| Vaginitis is defined as inflammation of the vagina\u003Cbr>The most common causes of vaginitis are:\u003Cbr>• Bacterial Vaginosis (BV)– a change in the normal microbiome of the vagina with an overgrowth of facultative anaerobic organisms such as Gardnerella vaginalis, Bacteroides and Peptostreptococcus\u003Cbr>• Vaginal Candidiasis – vaginal overgrowth of Candida species\u003Cbr>• Trichomoniasis – presence of a pathologic organism, the protozoan Trichomonas vaginalis\u003Cbr>Less common causes of vaginitis include:\u003Cbr>• Atrophic Vaginitis\u003Cbr>• Vulvar Dermatoses\u003Cbr>• Desquamative Inflammatory Vaginitis |\n| WHAT ARE SOME RISK FACTORS FOR VAGINITIS? |\n| Risk factors for vaginitis include anything that alters the microbial balance of the vagina.\u003Cbr>These includes:\u003Cbr>• Diabetes/insulin resistance\u003Cbr>• Antibiotic use\u003Cbr>• Douching\u003Cbr>• Changes in hormonal balance in vagina (menstrual changes, menopause) |\n| LEVEL 2: PERFORMS THE INITIAL ASSESSMENT, FORMULATES A DIFFERENTIAL DIAGNOSIS, AND INITIATES TREATMENT FOR COMMON AMBULATORY GYNECOLOGIC PROBLEMS |\n| HOW DO YOU EVALUATE A PATIENT WITH VAGINAL IRRITATION AND DISCHARGE? |\n\nEvaluation of vaginitis in women should include:  \n• Focused history of vaginal symptoms including nature of vaginal discharge, odor, associated symptoms (itching, burning, irritation, dyspareunia, dysuria)  \no Associated factors: onset and duration of discharge, relationship of symptoms to menses, use of over-the-counter treatment options and other medication use, douching, sexual history  \n• Focused examination including: external genital exam, speculum exam assessing for discharge, location of discharge, lesions, or rashes  \n• Wet mount: pH, amine “whiff” test (see below)  \n• Diagnostic Testing:  \no BV – Amsel criteria (see below) can be used and BV diagnosed if 3 of the 4 criteria are present. Diagnostic tests using polymerase chain reaction (PCR) test for Gardnerella vaginalis and other organisms associated with BV are currently being evaluated.  \no Candidiasis – When microscopy is negative, culture is recommended for symptomatic patients and patient with persistent symptoms despite treatment.  \no Trichomoniasis – Nucleic acid amplification testing (NAAT) is the preferred diagnostic test.  \no Consider testing for gonorrhea, chlamydia and other sexually transmitted infections when evaluating symptoms of vaginitis.  \no There are some commercial tests that have been approved by the US Food and Drug Administration for the diagnosis of vaginitis.  \nClue cell demonstrated on wet prep  \nBudding yeast with pseudohyphae on wet prep  \nTrichomonad demonstrated on wet prep  \n(All images licensed for public use through Creative Commons)  \nAssessment of Vaginal Discharge  \n\n| Normal BV Candida Trichomonas |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| Vaginal pH | 3.8-4.2 | >4.5 | \u003C4.5 | >4.5 |\n| “Whiff” test | Negative | Positive | Negative | Positive |\n| Microscopic findings | Lactobacilli, epithelial cells | Clue cells | Pseudohyphae/hyphae/ spores | Motile flagellated\u003Cbr>protozoans (trichomonads) |\n\nAmsels Criteria (3 of 4 present to diagnose BV)  \n1. Homogenous, thin, grey-white discharge on the vaginal walls  \n2. More than 20% clue cells on wet prep with saline  \n3. pH of vaginal fluid > 4.5  \n4. Positive KOH whiff test (detection of a fishy odor before or after sample of vaginal discharge is missed with 10% KOH)  \nInitial Treatment of Vaginitis  \nSource: ACOG Practice Bulletin 215 Vaginitis in Nonpregnant Patients  \n\n| \u003Cbr>SHOULD PATIEN","cbCaigT16Ly21koE","https://ap.wps.com/l/cbCaigT16Ly21koE","pdf",563593,"English","# Milestone Based Focused Questions\n## Most common etiologies of vaginitis\n## Risk factors for vaginitis\n## Evaluation of a patient with vaginal irritation and discharge\n## Initial treatment of vaginitis\n## Should patients be offered empiric treatment without an exam?\n## Partner treatment for patients with vaginitis\n## Additional testing recommended for patients with vaginitis\n## Recurrent vaginitis treatment","[{\"question\":\"What are the most common etiologies of vaginitis?\",\"answer\":\"The most common causes are bacterial vaginosis (BV), vaginal candidiasis, and trichomoniasis. Less common causes listed include atrophic vaginitis, vulvar dermatoses, and desquamative inflammatory vaginitis.\"},{\"question\":\"How should a patient with vaginal irritation and discharge be evaluated?\",\"answer\":\"Evaluation includes a focused history, focused external and speculum examination, wet mount with pH and amine “whiff” testing, and diagnostic testing targeted to BV, candidiasis, and trichomoniasis. Consider testing for gonorrhea, chlamydia, and other STIs when assessing vaginitis.\"},{\"question\":\"How is bacterial vaginosis diagnosed using Amsel criteria?\",\"answer\":\"BV is diagnosed if 3 of 4 criteria are present: homogenous thin gray-white discharge, \\u003e20% clue cells on wet prep, vaginal fluid pH \\u003e4.5, and positive KOH whiff test.\"},{\"question\":\"What partner treatment and additional testing are recommended for trichomoniasis?\",\"answer\":\"Partner treatment is recommended because trichomoniasis is a sexually transmitted infection, with options including partner referral or expedited partner treatment (EPT). Patients should also be offered testing for other STIs including gonorrhea, chlamydia, syphilis, HIV, hepatitis B, and hepatitis C.\"}]","VAGINITIS - Milestone Based Focused Questions | PDF",1790527589,18]