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.
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