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 Vinegar
My vaginal discharge smells like vinegar. Discharge is normally a little acidic andsmells a little like vinegar. We'll just say the smell is bad enough tobe more than normal. Fortunately, the cause of that isn't asfishy as it sounds, I mean smells. It is a little fishy, yes, but I'm not usedto it smelling like this. If you were used to yeast infections, youeither have a depressed immune system or diabetes. I know out of control diabetes means highblood sugar. I didn't think it could cause too much yeastmy own body.
It could also be because you're pregnant.The immune system decreasessome regards while pregnant to not harm the baby, raisingthe odds of a yeast infection. I don't think I'm pregnant. 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. If I had that many symptoms, I wouldn'tbe having sex. You could also have bacterial vaginosis.
Just what I need, a social disease. You could have thick discharge that smellsmore than usual due to bacterial overgrowth of the bacteria normally there and it isn'tclassified as a social disease. So how could I treat ité Don't douche like you might do, since thosecleansings actually worsen the normal bacterial balance. And you need yogurt That sounds like a fancy new age treatment,up there with herbs and lotionsmy underwear. You eat the yogurt to help restore your body'sbacterial balance. There are some people who
do put yogurt up there, but it isn't recommended,though tea tree oil is. inking herbal teas is supposed to treateverything. What else can I doé Make sure you wipe front to back when youpoop so there isn't any bacteria making it from back to front. Any other ideas of what could be causing thisé It could be something sexually transmitted,especially if the cervical mucus is yellow or green or streaked with blood. I suppose the blood would be from lesionsor sores.
Yes, and you'll want to see a forany social disease. And it can be mistaken for a yeast infection, since the itching,burning and so forth are similar unless someone actually looks at it. Which is pretty much impossible for me unlessI reach the next levelyoga. You can try over the counter yeast infectiontreatments and diet changes, but if you have more than foura year or it resists treatment,you need to see a .