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.
Why Is My Vagina So Itchy
Hi, Erik Bakker with Candida Crusher frequentlyasked questions. Here is a question I received from a ladyAuckland, New Zealand. Why is my vagina so itchyé What can I do torelieve the itchiness of vaginal itchingé There are many reasons why vaginal itchingmay occur. Here are some of the best solutions, which I'm going to read out to you from mybook, eleven different solutions, which I think are some of the best you can try. It'simportant if you get recurring itching certainly to get checked out by your or gynecologistto make sure that there are no underlying problems there.
The first thing to do is to avoid sexual relationswith a person, you know, particularly if you have a genital infection or itch justcaseyou're passing a condition on to somebody else and they're going to pass it back toyou. So that's one of the first things you do until you resolve the issue is refrainfrom intimate relations. If you've got repeated issues with vaginalitching, be careful of tight clothingthe area and wear more loose clothing; that makessense. Third issue is avoiding nylon underclothing,so wear cotton that can breathe. This is very important to do. It's going to allow moreair to the area. So wear cotton garments and
loose garments. Use nonperfume soap and becareful of any hygiene products you use which may aggravate or irritate the area. Avoid douches. In chapter fiveCandidaCrusher is a whole chapter on chronic vaginal candidiasis, which will give you some verygood approaches to vaginal yeast infections. There's my twostep approach which is excellentwhich worksclearing up a chronic vaginal infectiona few months. If you follow itcarefully, you'll get outstanding results particularly if you've been diagnosed witha vaginal yeast infection. When at home when you can, leave undergarmentsoff as often as you can to allow air to circulate
through the region; that makes sense, too.Be particularly careful if you're using any toys during sexual relations. Don't laughhere, but I once worked with a and I saw quite a lot of gay and lesbian patientswho were involvedthese sorts of things that I found sometimes that using vibratorsand sex toys can create a huge problem with people, so be sure that these things are cleanwhen you use them. Watch out for scratching or rubbing irritatedtissue around the vagina. This can cause a lot of problems, too. You can also be moreprone to infections if you do those sorts of things. So keep your fingernails shortand watch for scratching or rubbing.
As I mentioned previous, if you can't resolvethe condition very soon, you need to get an expert opinion. Go to your or gynecologist;have a smear test done, get checked out to make sure that you find the cause of thischronic itching. Are you menopausal or postmenopausalé This is an interesting question. Itching canoccur there due to a thinning of the vaginal tissue due to low estrogen. So again, youmay need to get a blood test or salivary hormone test to determine what your estrogen and progesteronelevels are like and maybe have them balanced if need be.
But please do have a look at my book, CandidaCrusher. There are many solutions for vaginal itchingthis book. Chapter five has particularlygood information for the femaleit. So I hope that answers your question. Thank you.