Causes of vaginal discharge: 1. Candida infection (Yeast infection): White, curd like discharge associated with intense itching.

More common in immunosupressed states such as diabetes mellitus or patients using antibiotics. 2. Cervical cancer 3. Trichomoniasis: Green colored frothy discharge associated with intense itching. 4. Leukorrhea: Colorless discharge. Dries up to leave a yellowish-brown stain. Usually pre-menstrual. 5. PID (Pelvic Inflammatory Disease): Pussy mucopurulent discharge. Possible causes: Chlamydia, Gonorrhea, Superimposed saprophytic infections, Infection because of an IUD. 6. Bacterial Vaginosis: Homogenous, fishy smelling discharge. A lot in amount. Questions to ask when taking a history from a patient with complaints of VAGINAL DISCHARGE: 1. Duration 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. Color Smell Consistency/frequency Quantity Relationship with menstrual cycle Associated symptoms: fever, itching, menorragia etc.. Contraceptive use Antibiotic use D/Ds of Something Coming out of the Vagina: Uterine prolapse Tumor

3. Chronic uterine inversion: A result of trauma due to the pull of the placents (mismanagement in the 3rd stage of labor). 4. Fibrinoid polyp Questions to ask when taking a history from a patient with complaints of SOMETHING COMING OUT OF THE VAGINA: 1. Does the mass go back in spontaneously? 2. Does it go back in with pressure? 3. Does an increase in intra-abdominal pressure (coughing, defecationg) worsen the prolapse? 4. 5. 6. Does this problem interfere with sexual activity? Ask about backache? Is the backache relieved on lying down? Ask about urination: burning micturition? Incontinence? Increased frequency?

7. Intermenstral bleeding? Post-coital bleeding? (Esp. important to ask when the patient has cervical polyps)