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 tutorialmy 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 thata later tutorialthe GYN section. Gonorrheaand Chlamydia present primarily with cervicitis, but it can also cause vulvovaginitis. GCwill be covered laterits 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 op of saline added to it while the other halfof the slide has a op of 1020% KOH (Potassium hyoxide) 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 increasethe 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;4.5reproductive 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 bacteriathis 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 coveredmany adherentcoccoid bacteria (Gardenerella Vaginalis). Here is a picture comparing normal squamousepithelial cells with a few stered lactobacill to squamous cells that are coveredthousandsof 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
What is bacterial vaginosis
Bacterialvaginosis is a disease that's caused by the overgrowth of a type of bacteria that's called Gardnerella vaginalis, Gardnerella vaginalis. And as the name might suggest, this is the most common vaginal infection. Now I wanna put these really big quotes
around the term infection because the thing that's interesting about Gardnerella vaginalis is that it's a bacteriathat's naturally foundthe vagina. Now some may consider this to be a sexually transmitted infection, which is interestingbecause it doesn't cause
any problems until there'stoo much of it there. So when we look to the causes of bacterial vaginosis, they are all things that change the vaginal environment. That can include acts like douching, so douching, or rinsing of the vagina. The other is having newor multiple sex partners.
And finally, another known cause is the use of antibiotics. This could bethe case of somebody that has a throat infection or a pneumonia that's on antibiotics which will then attackthe bacteria that exists within the vagina andallow Gardnerella vaginalis to overgrow and cause bacterial vaginosis.
So we've touched a little bit on it here, but I wanna aw it out. So when we talk about the pathophysiology of a disease, we'retalking about the mechanism by which that disease occurs. Soorder to understandthe pathophysiology of bacterial vaginosis, we need to take a look at a sample of bacteria
that existsthe vagina. So I'll aw out someGardnerella vaginalis bacteria, and so I'll put this upour key. This is the symbol forGardnerella vaginalis. And I'll aw a few of them around here, but I also wanna show that there are a lot of other bacteriathat existthis sample. So if you really look at it here,
Vagina Warning Signs that Your Vagina is Unhealthy
Warning Signs that Your Vagina is Unhealthy1. Itching Burning A constant itching and burning sensation indiesthe onset of a number of vaginal infections. When the harmful bacteria outnumber the goodbacteriathe vagina, the imbalance manifests itself through the physical symptom of itchingand burning. A certain amount of yeast is essential toward off harmful bacteriathe vaginal area. However, an overproduction of yeast can resultin a yeast infection, causing symptoms that include itching and burning.
An inflammatory sensation and itching withoutany foul odor emanating from the vagina are signs of a yeast infection, according to a2004 study publishedThe Journal of the American Medical Association. Itching can also be a reaction to chemicalsor ingredientssoaps, creams, contraceptive foams and prepackaged douching mixtures. These mixtures can alter the bacterial balanceand acidity of the vagina that protect it against infections. 2.
Smelly Discharge Itï¿½s unlikely for your vagina to smell likea bed of roses, but if you notice a recurrent strong odor, one that even transfers to yourundergarments, it might be a sign of an infection. An excess of harmful bacteria causes bacterialvaginosis. A foulsmelling vaginal discharge is oftenthe first and most common symptom of this infection. A ï¿½fishy odorï¿½ is one of the major symptomsof bacterial vaginosis, according to a 2011 study publishedthe International Journalof Womenï¿½s Health.
This discharge may especially occur afterintercourse. Pregnant women who contract bacterial vaginosisrun a risk of delivering their baby prematurely, according to the Centers for Disease Controland Prevention. It also increases the risk of contractingsexually transmitted diseases (STDs), including HIV, and may sometimes lead to pelvic inflammatorydisease. Therefore, seek medical attention right awayif you notice a vaginal odor. 3. Discoloration Excessive Discharge
Vaginal discharge is the bodyï¿½s naturalmechanism to keep the vagina lubried and flush out harmful bacteria. Normal vaginal discharge ï¿½ clear or whiteand does not give off a bad odor. A brown or red discharge that occurs rightafter a menstrual cycle is usually not a matter of concern. However, if you experience brown or red dischargeon normal days between periods, seek medical attention as it could be indiive of cervicalcancer. If it occurs during early pregnancy, it couldsignify a miscarriage.
A green or yellow, smelly and frothlike dischargeis not normal and may be a sign of trichomoniasis, an STD. A watery white, gray or yellow discharge mightbe a symptom of bacterial vaginosis. While the amount of discharge differs fromwoman to woman, recurrent and excessive discharge may also indie bacterial vaginosis. Seek medical attention right away if you noticea discolorationyour vaginal discharge. 4. Abnormal Bleeding