Vaginitis Candida BV Trichomoniasis Wet Mount Whiff Test Vaginal pH Trich Albicans gardnerella
Distinguished future physicians welcome toStomp on Step 1 the only free tutorials series that helps you study more efficiently by focusingon the highest yield material. I'm Brian McDaniel and I will be your guide on thisjourney through vulvovaginal infections. This is the 3rd tutorialmy playlist covering allof microbio. Vulvovaginitis (AKA Vaginitis) is inflammationof the lower genital tract. It is usually due to infection, but there are a wide varietyof causes. During this tutorial we will focus on the 3 most important causes of vulvovaginitisfor the medical board exam (trichomonas, candida and BV). However, you should know that othertypes of vaginitis include mechanical irritation,
allergic reactions (to soaps or feminine products)and a variety of other infections. Atrophic Vaginitis is a common cause of vaginitis inpostmenopausal women and we will cover thata later tutorialthe GYN section. Gonorrheaand Chlamydia present primarily with cervicitis, but it can also cause vulvovaginitis. GCwill be covered laterits own tutorial. We will start with a few different tests thatwe will use to differentiate between the different infections.Wet Prep (AKA Wet Mount Test) is a microscopic examination of vaginal discharge used to differentiatebetween different types of vulvovaginitis. The vaginal specimen is obtained using a speculumand a que tip similar to how one gets a pap
smear. Then the specimen is rubbed onto aglass slide. One half of the slide has a op of saline added to it while the other halfof the slide has a op of 1020% KOH (Potassium hyoxide) added to it.When Saline is added it makes it easier to view clue cells for BV flagellated motilecells for trichomonas. The KOH kills bacteria and vaginal cells leavingonly yeast cells. This makes it easier to view the psuedohyphae and budding yeast presentduring vulvovaginal candidiasis. KOH is also alkalotic so it can be used fora â€œWhiff Test.â€� In this scenario when the alkalotic KOH is added to a sample containingBV it will create an amine or fishy smell.
This is a similar principle behind how thesmell of BV can increase after unprotected sex since semen is alkalotic. The normal vaginal pH for a reproductive agewoman is about 4, while the normal vaginal pH before puberty and after menopause is about7. During puberty there is an estrogen guided increasethe growth lactobacilli flora.These bacteria break down glycogen into lactic acid which lowers pH from about 7 to about4. Now that you know the normal values you can apply it to diseases. Usually, BacterialVaginosis Trichomonas have alkalotic pH (gt;4.5reproductive age women) while candidahas normal pH (lt;4.5). pH paper can be tested
by using pH paper on vaginal discharge. You can see here at the top right corner thatI give BV a high yield rating of 3 on a scale from 1 to 10. If you want to learn more about that ratingsystem you can go to my website or click on this orange box here if you are watching thistutorial on a computer. Bacterial Vaginosis (AKA BV) is a polymicrobialinfection caused by the overgrowth of normal flora. The key bacteriathis infectionis gram negative Gardnerella Vaginalis. Clue cells are visible on the saline portionof a wet prep. A Clue Cell is a sloughed mucosal
squamous epithelial cell coveredmany adherentcoccoid bacteria (Gardenerella Vaginalis). Here is a picture comparing normal squamousepithelial cells with a few stered lactobacill to squamous cells that are coveredthousandsof adherent garenerella bacteria. Here is one more pic. You can see on the leftwe have a normal squamos epithelial cell with a few WBCs. On the right we have the darkerClue cells. Finally I have a photomicrograph to look atin case you see that on your test. A thinwatery graywhite discharge is presentA fouls smell is present and often described as an Amine Odor or Fishy Smell. This smellis intensified after unprotected intercourse
How to Wash Your Vagina by Daily Washing Routine
1.Lather up a washcloth or sponge with some mild natural soap and warm water. Avoid usingsoaps with heavy perfumes, or gels or antiseptics, which may throw off the balance of healthybacteria and irritate the sensitive skin around your vagina. The actual vagina (the inner canal) is quot;selfcleaningquot;and doesn't require washing; soap is likely to irritate the vagina if you try to use iton the vagina itself. You don't need to wash the vagina, just the area around the vagina(the vulva), using a plain, unperfumed soap, using the steps that follow.2.
Clean the folds around your clitoris. Useyour fingers to pull your labia away from your clitoris. Gently wipe the skin on bothsides of your clitoris with the washcloth. 3.Wash your vulva and your vaginal opening. Also, clean around your bikini line.4. Wash your perineum. The perineum is the areabetween your vagina and your anus. 5.Wash your anal area last. Keep your washcloth from touching your vaginal area after you'vewashed your anus. Doing this will ensure that you don't ag rectal germs toward your vaginalarea. These germs can cause you to get urinary
tract infections.6. Wash your vagina at least once per day. Ifyou have sex, you may want to wash it a second time to feel fresh and clean, although washingafter sex will not prevent pregnancy on its own.
Laci There was a pointmy life where I had majorinsecurity about my labia. The two lips that are outside your vagina. The only times I was reallyseeing labia wasporn. And I was like, quot;Aw, thatmust be what I look like. quot;Is that, what's going onquot; Eventually, I just decidedto check things out and I was like, quot;What theé
quot;Jay, what does your vagina look likeéquot; Then I remembered Jaydoesn't have a vagina. And I was, like, all alone with my mirror and my porn and my freaky labia. My insecurity with my labiacontinued to grow until at one point I was incollege and then some people that I knew said, quot;Hey, guess whaté quot;Labia comealldifferent shapes and sizes.
quot;No, they don't all looklike they doporn. quot;Not all labia are, like, this big.quot; (simulates explosion) Mind blown. (gentle music) So, like I said the labia are the lips that are outside the vagina. There's two sets of them.
There's the inner set that'scalled the labia minora and there's the outer set,it's called the labia majora. These lips are verysensitive and have lots of nerve endings, and theyact like a doorway to the vag. The lips can be lightly colored. They can be darkly colored. The inner can be dark,the outer can be light, the outer can be dark,the inner could be light.
It might be straight, itmight be kind of wavy, it might have lots of wrinkles,it might be really smooth. The inner lips can longer than the outer and the outer lips canbe longer than the inner. Or they can be about the same. They can this long, thislong, this long, this long. It's actually kind of amazing how many types of labia there are.
Which is why the real reaction to looking at my labia shoulda been, quot;That's pretty rad.quot; Not, quot;Oh my god.quot; (gentle music) Labia distortion is aproblem all over the world. Depending on where yougo, you're gonna find people changing itdifferent ways.