music It's a typical day. A patient has noticedsome itching, or maybe an unpleasant vaginal odor. During her exam, the ian willcheck vaginal pH, examine any discharge that's present, and collect a sample. Then, it'son to the microscope. music This is where you'll gather more specificinformationabout what's causing those vaginal symptoms. We'll show you how to prepare andexamine vaginal wet preps and how to do a whiff test. The results, combined with the patient's vaginal pH test, will aid in the diagnosis.
Under the microscope, you'll be looking for trichomonads, yeast, and the clue cells associated with bacterial vaginosis. We'll show you how to recognize them. music First, the microscope itself: This is a compoundlight microscope. It has several objective lenses on a rotating mount. For our purpose,one of these has to be a 10x low power objective, and one has to be a 40x for greater magnification.This flat part, under the objectives, is the stage. Under the stage is the condenser. Belowthat, at the base of the microscope, is the light source. There are two knobs that controlfocus; one for coarse adjustment and one for
fine adjustment. And these are the oculars,or eyepieces. We'll come back to the microscope in a minute, but first, let's look at how to prepare wet mount slides. The complete vaginal wet mount involves botha saline prep and a potassium hydroxide, or KOH, prep. When the vaginal sample was collected,the swab was placed in a test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a drop of the suspension and place it on a slide. Add acoverslip, being careful to avoid trapping air bubbles. Your saline slide is ready.Place a second drop of the vaginal sample on another slide and add one drop of 10 percentKOH. Sniff the preparation immediately, using
your hand to waft any odor toward your nose.This is the whiff test. Note if there's a fishy or amine odor. Then add a coverslip,avoiding air bubbles. Keep in mind that you must work quickly to prepare and examine thewet mounts. That's because trichomonads may lose their characteristic motility within15 to 20 minutes. Before we move on now, though, let's lookat the cast of characters you may discover. These are normal squamous epithelial cellsfound in the vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularity in the cytoplasm.
Polymorphonuclear leukocytes are known asPolys, or PMNs. They may also be called white blood cells, or WBCs. These are small roundcells. Several lobes of the nucleus are visible within the surrounding cell cytoplasm. Findingmany PMNs may indicate infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similar in size to PMNs and are identifiedby their characteristic jerking movement. The actual flagella may be too thin and toorapidlymoving to be seen. A clue cell is a squamous epithelial cellcoated with enough small bacteria that at least 75 percent of the cell's border is obliterated.It may look as if someone has spread glue
over the cell and pressed it in sand. Cluecells are associated with bacterial vaginosis, a condition in which the normal microbialflora of the vagina is disrupted. Yeast may be found in two forms. Pseudohyphaeare the long, tubular, branching forms. Budding yeast are paired yeast cells that resemblea shoe print. The larger part is the sole and the smaller bud is the heel of the shoe. The saline prep will allow you to see epithelialcells, PMNs, trichomonads, and clue cells. You can also see yeast in saline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
5 Myths About STIsSTDs You Probably Believe
Teacher: It is important to disclose STI statusto all sexual partners. Student: â€œWell I don't have any STIs,but if I did I wouldn't have any trouble telling my partners about it.â€� Voiceover: Well maybe. But it's possibleneither of those things are true. Let's talk about STIs. intro music Hi everyone! My name is Sarah, and welcomeback to Everyday Consent. Talking about Sexually Transmitted Infectionswith your partners, also known as STIs or
STDs, is an important part of informed consent.Knowing your partner's STI status helps you to know the health risks involved in havingsex with them and make informed decisions about how you want to protect your health. But if a partner did tell you they had anSTI, how well would you really understand what that meant for you and your relationshipéThere is a lot of stigma and misinformation out there about STIs. Myths about STIs areso common that even if you did have decent sexual education, you might still believesome of them yourself. Being misinformed in this way can make having a meaningful conversationwith your partner about STI risks more difficult
and scary than it needs to be. To help makethose conversations a little easier, today I want to dispel my top Five Common MythsAbout STIs. Myth 1: STIs are really rare, or only happento irresponsible people or people who don't use condoms In truth, STIs are very common. In the US,1 in 4 teens will contract an STI each year. And fully half of all sexuallyactive peoplein the US will contract an STI by the time they turn 25. The Center for Disease Controlreports that most sexuallyactive people will get at least one type of HPV in their lives,and several strains of that virus can cause
Genital Warts or Cervical Cancer. The WorldHealth Organization estimates that twothirds of the entire world population under the ageof 50 has HSV1, which is one of two strains of the virus that causes both oral and genitalHerpes. While Safer Sex methods such as condoms canprevent or greatly reduce the chance of spreading many STIs, some STIs such as HPV and Herpesare spread through skintoskin contact. This means that condoms cannot fully protect againsttransmission of these STIs during sex. And it also means that these STIs can be spreadthrough completely nonsexual contact, such as your Great Aunt Sally giving you a kisson the cheek when she has a cold sore.
So STIs are super common and even if someoneis really â€œresponsibleâ€� and uses condoms every time they have sex, or doesn't havesex at all, they can still contract an STI. Myth 2: Everyone that has an STI knows thatthey have an STI Haha, nope! It is extremely common to havean STI and not know it. First of all someone might not be experiencing any symptoms. Accordingto the World Health Organization, the majority of STIs have no symptoms or only mild symptomsthat may not be recognized as an STI. That's why regular testing for STIs is recommendedregardless of whether you're actually showing symptoms.
But okay, at this point you're probablythinking, â€œOkay Sarah, I know, you gotta get tested. But I've been tested recentlyand they all came back negative. So I know I don't have anything.â€� Well, the thing is, even if you marched toyour 's office, head held high, and proclaimed â€œI would like a full STI panel,please! Give me everything you've got!â€� most places will actually only test you forthings that they think you are at risk for based on things like age, gender, ethnicity,location,and sexual history. So if, for example, you are in a population determined to be atvery low risk for Syphilis, many places will