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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
Vaginitis or vaginal infections with Gabrielle Lany
Vaginal infections are often associated withvaginitis, an inflammation of the vaginal wall characterized by swelling, irritation,discharge and itchiness. The main causes of vaginitis are yeast infectionor candida, bacterial vaginosis, trichomonas and allergic dermatitis. Only trichomonascan be sexually transmitted. In the case of candida vaginitis or bacterialvaginosis, the causes can vary widely, including: antibiotics, hygiene products such as perfumedsoap or bubble bath, certain diseases such as diabetes, as well as sexual intercourse.Basically, these infections result from variationsthe vaginal flora.The symptoms of vaginitis include irritation
of external areas of the genitals, itchy ortingling sensations, redness and sometimes broken skin on the vulva, and especially adense white discharge resembling cottage cheese. The symptoms of bacterial vaginosis includea greyish or yellowish discharge, but it's mainly the fishy smell that characterizesthis infection. You might also experience crampsyour pelvic region, along with rednessand itching of the vulva and the vagina. The symptoms of trichomonas also include avaginal discharge, often greenish or yellowish, a changethe odour of the vaginal discharge,as well as itching, sometimes intense, of the genitals. To diagnose vaginitis, a al examination
is required, along with the patient's detailedmedical history. A number of treatments exist for vaginitisresulting from a yeast infection. Some of them are available without a prescriptionat ugstores. These remedies range from vaginal cream to a single dosepill form. However,if symptoms persist or the overthecounter treatment is not effective, we recommend thatyou see a to obtain a precise diagnosis and determine whether the infection is anSTI. Your partner does not necessarily need a treatment,exceptthe case of trichomonas, or if the infection is persistent, or if he experiencesan irritation on his penis known as balanitis.
Vaginitis is not dangerous on its own, althoughthe irritation that it causes can make you more vulnerable to STIs.Vaginitis does not pose a risk for pregnancy, but as a precaution, we recommend that yousee a to ensure that you receive the appropriate treatment for pregnant women.A few tips on preventing vaginitis: rinse your genitals each day with water, orwash with a gentle pH neutral soap; avoid perfumes and strong soaps;make sure to y your genitals each time after urinating;wash your genitals each time after sexual relations;avoid vaginal douches.
In the case of trichomonas, the rules forpreventing STIs are applicable, that is, use a condom each time you have sex with a newpartner. Treatments are available for recurrent vaginitis,which means, when the infection occurs four or more timesa year. Your can choosethe treatment that's right for you.