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 Urine
My vaginal discharge smells like urine. Are you sure you just aren't leaking urineé I don't think so. If you just had a baby, the muscles down thereare tired if not torn from the strain. The end result is greater odds of leaking peewhen you laugh, cough or bend over. No one mentioned thatthe parenting classes. That's because they are less likely to admitit and way more likely to blame it on the diapered crittertheir lap.
What else could be making it smell like urineé A really hard labor where you strain so muchit tears microscopic holesthe vaginathe wall that separates it from the bladder.Then you get urine seeping into the vaginal area. I don't think I'm leaking from the bladder. If you have that type of set of microscopicholes, urine will leak into the vagina even if you're holding the peeanyway. How do you get that fixedé
Surgery. Then again, this is a common problemwhen they do a hysterectomy and don't puta proper floor for the bladder too, butfixing that is surgical as well. I'd like to know what other things couldbe responsible for it so I have solutions other than surgery. It is possible that you are using so muchdouche and clothing so tight that the skin can't breathe that bacteria has caused thepH to shift that badly, but it is rare. I know there are douches you can't use oftenbecause it cleanses so well the good bacteria is washed away. Then you risk a bacterialinfection.
Bacterial infections smell like onion, badfish or garlic. You also have an increased risk of yeast infections, which smell likebeer. I hate to say it, but I have seen enough offeringsto the porcelain god to know the difference between pee, beer and vomitterms of smell. There's also the possibility you are leakingpee into your underwear, and the area still smells like that even after you change clothes. Which is a different reason to talk to the. Or switch to texting to continue the conversationinstead of trying to hold itwhile you
talk. I already text mostly, and I don't waitso long to stop talking that I leak while racing to the bathroom. Then the most likely a bacterial infection,made worse by wearing tight clothes, excessive sweating, and concentrated urine. Then inking water, wear loose clothing andeating yogurt is a start to fixing this. Assuming you don't need antibiotics. I prefer probiotics.
I still think you should take the yogurt orally,rather than sticking it up there and hoping it helps.