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SGD

45 years old, female, single, newly-hired secretary in coop store, from Ajoy Iloilo
Cc: vaginal itching
HPI:
o 5mo PTA
vaginal itching noted with no aggravating factors, worse at night
Consulted a doctor from health center and was advised to use povidone iodine
as vaginal wash daily
Given topical cream offered relief
No secretions
o 4mo PTA
Increased appetite
o 3mo PTA
(+) whitish, curdlike vaginal secretion
Consulted private doctor and was prescribed with Clotrimazole and vaginal
suppository relief
(+) weakness and fatigue, wt loss
Frequent urination at night (3x/night)
Excessive thirst
(+) wt loss even with increased appetite
o 3d PTA
Vaginal itch and secretion recurred
Vaginal suppository no relief consult
PMI:
o 3yrs ago hospitalized due to diarrhea
o No other hospitalizations
o No history of food and drugs allergy
Family History:
o Diabetes (father)
o HPN (paternal grandmom and maternal granddad)
Personal and Social:
o NBSB
o Not sexually active
o Non-smoker, not alcoholic, sedentary lifestyle
o Diet: fish and vegetable, rarely meat
OB:
o Menarche: 12yo
o Initially irregular: 2-3mo interval/yr
o Regular up to now (45yo)
o No dysmenorrhea
o 2-3 pads/day; moderately soaked

Differential Diagnosis:

DM
Infection bacteria and fungal (candidiasis)
Malignancy (I think were considering HPV)

ILOs:

Hyperglycemia (Type 1 or 2)
Perimenopausal vaginal pruritus (role of estrogen)
Differentials
Pathophysiology of itch
Vaginitis
Normal pH and microflora of vagina
clotrimazole

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