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
Vaginal Discharge During Pregnancy
I want your opinion of vaginal discharge duringpregnancy. If you have a sudden white mucus plug comeout, you're about to end the pregnancy and go into labor. I'm not that far along. The vaginal discharge will go back to whiteand thick after you ovulate. If you conceive, there may be ops of blood mixed in, or justbrown or orange streaksthe discharge. I'm a little farther along than that. The vaginal discharge usually increases involume during pregnancy, starting after implantation.
However, it remains white and thick throughoutunless something is wrong. I know any red bloodvaginal dischargeis dangerous, whether a sign of a miscarriage or uterine tear or something else only the will know. When you are pregnant, any bleeding is a reasonto go to the ER. Fortunately, I'm not seeing that type ofvaginal discharge. You'll normally see more white and thickvaginal discharge. Some women wear menstrual pads when pregnant to contain it. That sounds fishy to me. I didn't thinkI'd need diapers until after I had the kid.
If the vaginal discharge smells fishy or likevinegar, you have a yeast infection. I can't even take a pain reliever rightnow. What do I do about a yeast infectioné It is safe to use over the counter yeast infectiontreatment when pregnant, and you may need several. Pregnancy throws off your pH balanceand makes yeast infections much more likely. Glad I don't have that fishy smell downthere, then. It is thick and offcolor though. If it is green or yellow, you may have a bacterialovergrowth. That's dangerous during pregnancy. It could make things smell, and you do wantto talk to a about it. However, if
there are any lesions, itching and other signsof a social disease, you have to talk to a . Technically, life is sexually transmitted. A sexually transmitted disease contractedbefore or during pregnancy puts the kid at risk, and it may be flaring up worse whilepregnant because pregnancy compromises the immune system. Yes, I'd talk to the if I was worriedabout it, but I am not. Then you'll just see more white and thickdischarge. It would have increasedvolume
as the cervix thickened and rose up from thelow point after ovulation. But not as high as it would be if I wasn'tpregnant. That's where a lot of the mucus is comingfrom, but know that it will become y if you're dehyated just as when you'renot pregnant.