CC May 2016 Vulvovaginal Candidiasis of Pregnancy

echoecho's version from 2016-07-27 03:21


Question Answer
What is the treatment of VVC (vulvovaginal candiasis) in pregnancy?a topical azole for 7 days
In 2011, the FDA reported that high-dose oral fluconazole 400 to 800 mg used in the first trimester was associated with birth defects involving what part of the fetus?1) cranium 2) face 3) heart
Because of this, the FDA changed high-dose fluconazole in the first trimester to category ____?D
A 2013 study found no association of 150 mg fluconazole with birth defects noted with higher-dose therapy, but did note that lower-dose therapy may be associated with a higher risk of what?Tetralogy of Fallot
Single dose fluconazole 150 mg is still category ____?C
The American College of Obstetricians and Gynecologists (ACOG) guidelines states what?although low-dose, short-term fluconazole is not associated with known birth defects, higher doses of 400 to 800 mg per day have been linked to birth defects. Thus, treatment of vulvovaginal candidiasis in pregnancy should consist of one of the topical imidazole therapies for 7 days
Does the CDC recommend the ACOG guidelines?yes
Is there any limitation of use of topical therapies in the first trimester?no
A 2016 Danish study showed as an association of single-dose fluconazole 150 mg in early pregnancy with ____ ______, but not still birth.spontaneous abortion
No link with still birth was found but the recommendations remains that women avoid fluconazole throughout _____?pregnancy
As patients incorrectly self-dx of VVC, the CDC recommends against _____ treatment of VVC and recommends further testing to make the dx?empiric
What further testing should be done instead of empiric treatment?1) wet prep 2) KOH testing 3) nucelic acid probe-based test (Affirm VPIII) 4) yeast culture
Unlike a pregnant woman, where a 7 day course of standard dose topical azole is recommended, nonpregnant women have more options, name these?1) Topical azoles (7, 3-and 1-day courses) - the efficacy decreases with shorter courses
The success of oral and topical azole treatment regimens are similar and costs are comparable with _____ therapies?generic
Women prefer ___ therapy?oral
Fluconazole has a slightly delayed (___ day) onset of symptom relief; in severe cases topical therapy provides faster relief?one
*** SUMMARY = Treatment of VVC in pregnancy consists of one of the topical imidazole therapies for ___ days?7
*** SUMMARY = Pregnant women should avoid ____ fluconazole for candiasis vulvovaginitis in pregnancy due to an increased risk for ____ _____ and possible increased risk of birth defects? oral; spontaneous abortion