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
DermTV The Difference Between Canker Sores and Herpes DermTV Epi 103
Hello, I'm Neal Schultz pause and welcome to DermTV. When we get sores inside our mouth or on ourlips, usually they're very painful. And almost all of them are causedby one of two thingsâ€”either a herpes virus outbreak or canker sores, andI find that not only do most people get them confused, but can you believethis, most s get them confused also. So let's talk about it.
Canker sores are not contagious. They'revery painful, especially when you're eating and food touches the areawhere you have the canker sore. Canker sores occur almost exclusively insideyou mouth, not outside, not on your outer lip, and not on your chin. Andwhen they occur inside your mouth, which can be on this part of the skinor seen inside the cheeks, you see a gray or tan, round area with a brightred rim right around it. They go awaya couple of days and they'reeasily treated with topical antibiotics. Usually, we take tetracycline,open a capsule, put ita
little glass of water, and take just a pieceof cotton, dip itthat water, and hold it against the canker sorefor a few minutes and, after 2 of 3 days, it will go away. This is very,very different from herpes outbreaks. Herpes outbreaks usually are notthat painful although right before you get them, you feel a tingling ora burningthe skin where you're going to get the outbreak. They arevery contagious. They usually don't occur inside your mouth, they occuroutside your mouth. They can be right on the lip, on the edge of the lip,or around the mouth, or really
any place on your face. And when they happen,usually they occur with blisters, and those blisters are often clusteredtogether and with a red ear around it but not a red, sharp rim likeyou see with a canker sore. Over a period of a couple of days, they yand crust and scab. They're very easy to treat. They're treated withoral mediion, oral mediion for only a day may become not contagious bythe second or third day. If you're getting sore inside your mouth oraround your mouth or on your lips, and you're not sure what it is and you don'tknow how to treat it, see your
dermatologist who can give you some medicineto make sure that the sores go away faster and you become comfortable muchsooner.