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 Have a Healthy Vagina by Keeping Your Vagina Clean
1.Wash with hot water only. It may seem counterintuitive, but washing your vagina with soap, whetherit's bar soap or liquid, isn't the best way to keep clean. The vagina actually stays quiteclean on its own without the help of outside cleansers.Like other parts of the body, thevagina has a pH level that needs to be maintained within a certain range 3.5 and 4.5, to bespecific order to prevent the growth of unhealthy bacteria and facilitate the growthof good bacteria. Using harsh cleansers can upset the balance, leading to infection, irritation,and even bad smells. People often refer to the entire area quot;downtherequot; as the vagina, but remember that the
vagina is actually the tubelike muscle loedinside your body. The vulva, the skin outside the vagina, may be cleansed with nofrillsbar soap, as long as you don't find that it irritates your skin.If you do end up washing your vagina with soap, make sure to thoroughly rinse it withwarm water so that no traces of soap are left behind. Soap left inside the vagina can causeirritation. 2.Don't use douches or feminine sprays. Douching with chemicals that are supposed to make yourvagina smell like a field of flowers actually ends up having quite the opposite effect.Theywash out all the healthy bacteria that helps
your vagina stay clean and infectionfree.The chemicals left behind by douches can cause irritation and even burning, and the samegoes for feminine sprays. If you keep your vagina healthy using other methods, therewill be no need to try to make it smell different. Scented creams marketed as a way to changethe smell of your vagina can cause the same problems, so these should also be avoided.The same goes for scented pads and tampons and scented wipes.If you feel like you absolutely have to use a scent on your vagina, go for something completelynatural and chemical free. You can make your own body spray by mixing a few ops of anessential oil like rose, lavender or lemongrass
with watera spray bottle. Use the bodyspray after showering, and make sure you're completely y before getting essed.3. Have good hygiene during your period. Manywomen experience an increased rate of vaginal infections when they're menstruating, sincehaving bloodthe vagina changes its pH and throws things out of balance. To stayhealthy during your period, practice the following habits: Change your tampon frequently. Tampons absorbmenstrual blood, and if you leave themtoo long, you're keeping the bloodyourvagina where it can change your pH. Make sure
you change your tampon every few hours tokeep this from happening. Don't use pads or panty liners for longerthan necessary. Wearing pads and panty liners all month long or after your period is overcan lead to skin irritation. Consider getting a menstrual cup. These rubbercups are insertedthe vagina to ch the blood, then rinsed out with hot water everyfew hours. Menstrual cups are a chemicalfree choice for handling your period, and theycan be really helpful if you tend to get irritated by tampons and pads.4. Wipe from front to back. It's important towipe from front to back, rather than the reverse,
to keep fecal matter from entering your vaginaand causing an infection. Use plain, unscented toilet paper to wipe. Avoid using wet wipesor any other product that contains perfumes and chemicals.