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Vaginal Odor Dx

Examination of Vaginal Wet Preps

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.

Why Does My Pee Stink Really Bad

Why does my pee stink really badé I really hope you aren't going to ask meto second that opinion. No, I know that for myself. What could causeit to smell badé You mean smell worse than usual. Have youbeen eating asparagusé What does that have to do with anythingé Andno, because it tastes awful. The same chemicals responsible for the badtaste end upyour urine, making it smell bad. Another reason to hate asparagus.

There are prescription mediions like someantibiotics that have the same effect. I'm not on any meds. You might need to be. Urinary tract infectionsand kidney infections can make your pee smell bad. It's worstthe morning. When the chemicals have had hours to concentratein your body before evacuation. And then everyone wants to evacuate the bathroom. inking at least three liters a day shouleduce the smell via dilution. But if there's

any possibility there is an infection, youneed to see the . I don't want a 's hand up my butt.It reminds me too much of a TSA screening. You'd only have to pee on a test strip foran initial diagnosis. Urinary tract infections are relatively common. What can I do until I getto see the é ink lots of water. ink cranberry juice,since that also treats UTIs. I thought the serving of cranberry jelly wasbad. You can get grapecranberry juice blends orcranberry juice sweetened with splenda to

make it palatable. Will it make peeing not stingé OK, if you have that problem, you may havean STD. Get to a ASAP. How would an STD cause thisé You use the same pipe for both sets of plumbing.And the germs go up the pipe, and often into the bladder. What do you think can get methefastesté.

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