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.
Does Urine Smell Different During Pregnancy
Does urine smell different during pregnancyé How on Earth do you know that it smells differenté Given all the trips to the bathroom, it ishard not to notice. There are a couple of causes of such a change.It could have a sweet smell because you are letting out too much sugar. What would cause thaté Unfortunately, it is too often prenatal diabetes.If you even think you have diabetes, you need to see the .
I've heard prenatal diabetes can hurt bothyou and the baby. But what else could it beé Pregnant women are at risk for urinary tractinfections. They generate more pee while having a hard time getting it all out, making a UTImore likely. And pregnancy makes all infections more likely. And then there is the possibility you arejust really dehyated. I don't see how that would cause the urineto smell worse. If you are dehyated, you'll still peebut there is more ureait. Then the urine smells much worse.
I'm inking a lot of water. But how much are you throwing upé If you aresuffering from bad morning sickness, how much you ink matters a lot less than how muchstaysyour system. And what is the solution for thaté Ginger, avoiding foods that make you sick,antinausea medicine. If you are that badly dehyated, you may need to see a . I need to know that is the cause before Irun off to the . If you are badly dehyated, the urine willbe really dark, even brown. That is a visual
sign that you could measure. So any time it smells, it is a sign of a problem. Well, stinking more than usual.
Cervical MucusEarly Pregnancy
What happens to cervical mucusearly pregnancyé I would consider a pregnancy test a way moreaccurate indior of pregnancy. I've been monitoring my cervical mucus totrack fertility; I want to know how it changes if I get pregnant. When you ovulate, the cervical mucus getsthinner, clearer, more watery. Yes, and it does that when you ovulate andthe egg is prime, versus the body temperature spike that happens a day after you ovulate. After that 24 hour expiration date, the cervicalmucus goes back to being thick, white and
gooey. What does it do if I'm pregnanté In the first days, it will be the normal thick,white and gooey. The biggest change will be that the cervical mucus won't be wiped outby your period. A lack of a period can be a sign of pregnancy,but it can also mean you're so stressed out that your period skipped. If you were tracking your fertility via cervicalmucus, you probably wouldn't see a shift due to ovulation if a health condition hasshut that down.
So if I don't have a period because of anout of whack thyroid or too strict diet, the cervical mucus will remain unchanged. Unless you are not having a period becausesomething else is wrong. That would make the cervical mucus ultrathickand usually other colors like green tinged or yellow. A yeast infection can make it thicker too,and smell fishy. If only that could be a sign of pregnancy. It could be a sign of diabetes too, if youkeep getting infections.
What happens if I got pregnanté It will be the same thick, white or creamcolor, sticky stuff throughout the pregnancy. The difference is that during pregnancy, thecervix usually makes more. I've heard of women having so much cervicalmucus that they need to wear a pad to contain it. They sometimes do, but that is usually inthe second or third trimester, notthe first week or two. I heard there were changes.
You might see a few spots of bloodthecervical mucus when the embryo implants. That could be mistaken for the start of aperiod. Except your period should not start. The morecertain changes are the cervix going back up after conception but not as high as normal,and hardening a little but not as hard as normal. You're right, a pregnancy test is way moreobvious.