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Chapter 83. Superficial Fungal Infections

JT is a 25-year-old asthmatic woman who presents with vaginal itching accompanied by curd-like discharge. According to her chart, she was in the clinic 2 weeks ago for uncontrolled asthma for which she was prescribed a course of oral prednisone. She was also, according to her chart, diagnosed with vulvovaginal candidiasis last year. Her reports that her symptoms are similar to those she experienced with that infection. What would you recommend for treating her infection?

A. An over-the-counter topical azole or a single dose of oral fluconazole 150mg

B. Long-term suppressive therapy

C. Candida cultures

Referring to the previous question, although JT may have other risk factors that we cannot yet identify, what known risk factor does she have?

A. Broad-spectrum antibiotic use

B. Diabetes

C. Sexual activity

D. Systemic corticosteroid

E. Altered vaginal pH

CS, a 42-year-old woman, presents with her fifth episode of vulvovaginal candidiasis in a year. To achieve remission, CS should be treated with:

A. Oral itraconazole

B. 14 days of boric acid capsules intravaginally

C. Two doses of oral fluconazole 150 mg dosed 3 days apart

D. One dose of oral fluconazole 150 mg

After achieving remission, CS (from previous question) is initiated on long-term suppressive therapy. To improve adherence, the preferred treatment is:

A. Miconazole cream

B. Oral fluconazole

C. Boric acid in gelatin capsules

D. Oral itraconazole

RG, a 22-year-old pregnant woman, comes to the clinic complaining of vaginal itching. This is her first pregnancy so she was unsure if this was just a “normal part of pregnancy.” Since she is 7 months pregnant, she is having difficult seeing past her abdomen so she is seeking help determining the cause of her itching. to eat and cries more than usual. Upon examination, the practitioner notes a non-odorous discharge. Which of the following should be considered as part of her care plan:

A. Amphotericin B

B. Oral fluconazole

C. Miconazole cream ...

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