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 aidthe 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 magnifiion.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 microscopea 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 hyoxide, or KOH, prep. When the vaginal sample was collected,the swab was placeda test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a op 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 op of the vaginal sample on another slide and add one op 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. Keepmind 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 cellsfoundthe vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularitythe 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 indie infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similarsize 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 itsand. Cluecells are associated with bacterial vaginosis, a conditionwhich the normal microbialflora of the vagina is disrupted. Yeast may be foundtwo 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 yeastsaline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
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 dinnermy 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 synome. Yes, and rotted fish smells means you havethe vaginosis or severe yeast infection, plus the bacteria that can cause toxic shock synome.
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.