Vaginal discharge / vulvar pruritus

Rationale

Vaginal discharge, with or without pruritus, is a common problem

Causal Conditions

(list not exhaustive)

1. Physiologic discharge and cervical mucus production
2. Non-physiologic
3. Genital tract infections
4. Genital tract inflammations (e.g., irritants)

Key Objectives

Given a patient who presents with vaginal discharge or vulvar pruritus, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan. In particular, the candidate will distinguish sexually transmitted infection (STI) from other causes of vaginal discharge or vulvar pruritus.

Enabling Objectives

Given a patient who presents with vaginal discharge or vulvar pruritus, the candidate will

1. list and interpret critical clinical investigations, including
   1. the precipitating or aggravating factors;
   2. the diagnosis of the likely cause of vaginal discharge and/or vulvar pruritus;
   3. the results of an appropriate abdominal and pelvic examination, including a speculum examination;
2. list and interpret critical investigations, including
   1. pH and wet or KOH smear;
   2. appropriate tests if the patient presents with purulent discharge;
3. construct an effective initial management plan, including
   1. recognize vulvovaginitis associated with sexual activity and counsel on risk reduction;
   2. initiate appropriate management plan (e.g., STI, non-STI causes);
   3. recognize the obligation to report to appropriate authority;
   4. refer the patient for specialized care, if indicated.