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 Menopause
I need your input on vaginal discharge duringmenopause. When you're going through menopause, you'llhave your period less often or less intensely before it finally shuts off. I know menopause isn't an off switch butmore a slow fade. When you're going through menopause, you'llsee similar shiftsvaginal discharge like white and sticky to y right before yourperiod, but you may not see the clear and slippery phase for ovulation. Because I might not ovulate.
However, when you're going through menopause,there's still a chance you'll get pregnant. And have a kid with a higher risk of healthproblems. Or multiples. As your eggs hit their expirationdate, the body offsets it by releasing multiple eggs. What other vaginal discharge should I expectduring menopauseé If it starts to smell sweet down there, you'reprobably developing diabetes â€“ especially so if the urine smells sweet and looks likesyrup too. A rash of repeated yeast infections can bea symptom of diabetes too.
And your odds of adult onset diabetes go upwith age. What else should I knowé With age, the vaginal discharge goes down,which is why older women tend to need lubriion, since the body doesn't make as much. And while a lack of lubriion and make youmore sensitive to yeast and bacterial infections, using too much lubriion can alter pH levelsand do the same. You'll know you have one of those infectionsby the foul smelling discharge if it is bacterial and the fish smell with yellow and solid massesif yeast based.
Fortunately, I haven't had to do a smelltest to see what is wrong. If you get red or brown vaginal discharge,you'll probably want to talk to a . We already discussed how your period fadesaway at this age. Yes, but red blood that's constant indieslesions or a serious infection, while brown blood can be a period that's not completeor internal bleeding. Okay, that's a reason to talk to the . And just because you don't have to use birthcontrol anymore doesn't mean you don't have to use birth control.
Menopause is all natural birth control. Just because you can't get pregnant anymoredoesn't mean you can't get a sexually transmitted disease anymore. And green, yellowand red vaginal discharge, especially with redness, itching or sores are strong signsof an STD. What a pain. Any discharge with pain means talking to a, too. Whether an STD or fibroids or worse, only the doc could say.