Vaginitis Candida BV Trichomoniasis Wet Mount Whiff Test Vaginal pH Trich Albicans gardnerella
Distinguished future physicians welcome toStomp on Step 1 the only free tutorials series that helps you study more efficiently by focusingon the highest yield material. I'm Brian McDaniel and I will be your guide on thisjourney through vulvovaginal infections. This is the 3rd tutorial in my playlist covering allof microbio. Vulvovaginitis (AKA Vaginitis) is inflammationof the lower genital tract. It is usually due to infection, but there are a wide varietyof causes. During this tutorial we will focus on the 3 most important causes of vulvovaginitisfor the medical board exam (trichomonas, candida and BV). However, you should know that othertypes of vaginitis include mechanical irritation,
allergic reactions (to soaps or feminine products)and a variety of other infections. Atrophic Vaginitis is a common cause of vaginitis inpostmenopausal women and we will cover that in a later tutorial in the GYN section. Gonorrheaand Chlamydia present primarily with cervicitis, but it can also cause vulvovaginitis. GCwill be covered later in its own tutorial. We will start with a few different tests thatwe will use to differentiate between the different infections.Wet Prep (AKA Wet Mount Test) is a microscopic examination of vaginal discharge used to differentiatebetween different types of vulvovaginitis. The vaginal specimen is obtained using a speculumand a que tip similar to how one gets a pap
smear. Then the specimen is rubbed onto aglass slide. One half of the slide has a drop of saline added to it while the other halfof the slide has a drop of 1020% KOH (Potassium hydroxide) added to it.When Saline is added it makes it easier to view clue cells for BV flagellated motilecells for trichomonas. The KOH kills bacteria and vaginal cells leavingonly yeast cells. This makes it easier to view the psuedohyphae and budding yeast presentduring vulvovaginal candidiasis. KOH is also alkalotic so it can be used fora â€œWhiff Test.â€� In this scenario when the alkalotic KOH is added to a sample containingBV it will create an amine or fishy smell.
This is a similar principle behind how thesmell of BV can increase after unprotected sex since semen is alkalotic. The normal vaginal pH for a reproductive agewoman is about 4, while the normal vaginal pH before puberty and after menopause is about7. During puberty there is an estrogen guided increase in the growth lactobacilli flora.These bacteria break down glycogen into lactic acid which lowers pH from about 7 to about4. Now that you know the normal values you can apply it to diseases. Usually, BacterialVaginosis Trichomonas have alkalotic pH (gt;4.5 in reproductive age women) while candidahas normal pH (lt;4.5). pH paper can be tested
by using pH paper on vaginal discharge. You can see here at the top right corner thatI give BV a high yield rating of 3 on a scale from 1 to 10. If you want to learn more about that ratingsystem you can go to my website or click on this orange box here if you are watching thistutorial on a computer. Bacterial Vaginosis (AKA BV) is a polymicrobialinfection caused by the overgrowth of normal flora. The key bacteria in this infectionis gram negative Gardnerella Vaginalis. Clue cells are visible on the saline portionof a wet prep. A Clue Cell is a sloughed mucosal
squamous epithelial cell covered in many adherentcoccoid bacteria (Gardenerella Vaginalis). Here is a picture comparing normal squamousepithelial cells with a few scattered lactobacill to squamous cells that are covered in thousandsof adherent garenerella bacteria. Here is one more pic. You can see on the leftwe have a normal squamos epithelial cell with a few WBCs. On the right we have the darkerClue cells. Finally I have a photomicrograph to look atin case you see that on your test. A thinwatery graywhite discharge is presentA fouls smell is present and often described as an Amine Odor or Fishy Smell. This smellis intensified after unprotected intercourse
My Vaginal Discharge is Bleaching My Underwear
My vaginal discharge is bleaching my underwear. That can happen when you have an ammonialikedischarge. That doesn't tell me what causes it or howto cure it. Your vagina usually maintains an acidic pH. I really don't know what it is supposed tosmell like, so I can't tell you if it smells very different. The ammonia like smell can be similar to thatlike pee. I am not peeing in my pants.
If you are dehydrated, the ammonia in theurine can get concentrated and make things smell even more strongly, even a few drops.And some women do mistake a leaky bladder for vaginal discharge. I know women often use light days menstrualpads for bladder leakage, but that would stain my underwear yellow not white, and I knowwhat pee smells like. Bacterial vaginosis is a common cause of avagina that smells like ammonia. The odds you have that are higher if you have itching,burning a fishy smell, grey or offwhite discharge. All the discharge is off white.
During your fertile time, it becomes thinnerand white, normally. I'm not paying attention to what normallyhappens except that my underwear sometimes turns white after I wash it, right where thevaginal discharge was in contact with it. If you have a bacterial vaginal infection,you can try over the counter treatments, or you need to talk to the . I don't have symptoms that seem like an infection. It can cause bleaching, though, when the badbacteria turn nitrogen into ammonia, creating the smell and discoloration.
What else can do thisé Next I'd have to ask about your diet. It's healthy, so don't blame this on junkfood or too much sugar. And if I had diabetes, I'd get more yeast infections and sugarysmellingurine. If you eat a lot of nitrogen rich vegetableslike broccoli and asparagus, you can get that ammonia smell in the vagina. I don't need yet another reason to not eatasparagus, and you can have a healthy diet without that.
If you're doing a high protein diet for weightloss, eating a lot of foods like eggs, meat and dairy with high nitrogen levels can causethe ammonia in the urea to build up. That would be ammonia smelling pee, not vaginaldischarge. The ammonia smell can get into your skin andexcreted as sweat, and depending on how you work out, the chemicals can build up therewhile it evaporates off your arms and legs. And I thought a rich sweat odor was the worstI could worry about. I've heard of vaginal discharge turning bleachywhen someone had polycystic ovaries or another hormonal disorder. Getting that under controlor eliminating gluten and high sugar foods
helps. For all the reasons one might say a glutenfree diet helped their wardrobe, this was never on the list. Everyone can brag about dresses fitting betterand old jeans actually fitting without a muffin top, but few people admit anything about lacyunderwear except maybe that they are wearing it. Just having some ways I could wear the blackones without them going gray in odd places would be progress.
My Vaginal Discharge Smells Like Fish
My vaginal discharge smells like fish. I'm assuming this couldn't possibly bedue to a messy fish and chips dinner. No, way more intimate than someone constantlyspilling dinner in my lap. Then the most likely cause is due to an infection. I don't think I have a social disease. Well,I hope I don't have a sexual disease. If you have bacterial vaginosis caused bythe overgrowth of bacteria naturally down there, you can end up with a fishy odor. How could I have developed thaté
So much douching to remove any odor that youstripped away healthy bacteria, leaving the bad ones a fertile playground. If you said that about my digestive tract,the solution would be probiotics. If you have that type of discharge, you cantreat it by eating yogurt and hoping that circulates through your system to the vagina.Or you can take the direct route and put yogurt up there. That's as embarrassing to admit as a coloncleanse. You know that it is bacterial overgrowth ifit is worse after you have sex or if you're
suffering a UTI too. I don't see how a UTI could cause this. If you're wiping back to front, the poopbacteria that get into the urinary tract and cause a UTI will cause vaginosis too. What's a reason that doesn't have to dowith a playground being between two sewersé A fishy odor accompanied by a green dischargemeans you have trichomoniasis. It is sometimes called just trich, pronounced trick. *That I've heard of, but I don't knowanything about it.
Trichomoniasis is a protozoan infection, andit causes a sour or fishy smell. Then trich is a sexual disease. Yes, and they can cure it with antibiotics. What else could it beé If it smells like rotted meat down there,you may have forgotten a tampon. That's what can cause toxic shock syndrome. Yes, and rotted fish smells means you havethe vaginosis or severe yeast infection, plus the bacteria that can cause toxic shock syndrome.
Anything on that list necessitates gettingto a , and after which, only using ultrathick maxi pads. If the vaginal discharge smells bad and lookslike curds, you have a yeast infection. It is also more likely if the itching is bad,skin is red and it hurts when you pee or have sex. At least that I can treat with stuff fromthe store. And any other cause requires talking to a, yogurt or not.