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
Case Study 20 Eric Bakker Chronic Candida Yeast Infection
I'm going to do another case history, andthis is going to be my case history. It's going to be quite different. This is a 25yearoldguy called Eric Bakker. In 1986, he was just turning 26. So this is my own personal story.You might like to hear my personal story on how I came to really develop a burning passionfor helping people like you out there with Candida.You may like to hear my own personal story about the yeast infection I used to have whenI wasmy 20s. I used to live by myselfa small housea place called Brisbanein Australia, and this little house wasa suburb that was prone to flooding. It wascheap rent, and I was workinga flourmill
at the time. I'd been living on my own forabout five years at that point. One week I would work the day shift. One week I'd workthe afternoon shift. And the following week, I would work the night shift.I started to feel increasingly stressed and tired and one winter developed a bad cough.It got worse to the point where I took an antibiotic. My little house was cold and damp,and I had to bail water out of my beoom after it rained heavily. I did tell you itwas cheap rent. The walls were covereda thin, moist film that I later discoveredwas mold. My diet wasn't the best at times. I was craving sweet foods, take out, and lotsof bread. Either my bowels were blocked or
I was experiencing diarrhea and lots of gas.I felt terrible, and my health was going downhill fast. My skin started to get itchy and I developeda bad case of athlete's foot and jock itch. To give you a background on all this, a fewyears prior, I had 13 amalgam fillings replaced over a period of two weeks1983. I startedto notice that my health was beginning to deteriorate and by early '85, I was feelingincreasingly anxious. I developed skin rashes, athlete's foot, and many manifestations ofa Candida yeast infection, all unbeknown to me at the time, including very strong sweetcravings. I had issues with my girlfriend who thoughtI was a hypochoniac because my health had
deteriorated to the point where I had to seekmedical help. But the was of little help because all the tests results came backnormal, and he wanted me to see a psychiatrist. I knew I wasn't going crazy. I knew that therewas something undermining my health, and I couldn't put a finger on it until I read theYeast Connection by William Crook and then later I read the Missing Diagnosis by Orion Truss. I've read about 50 books since then on Candida, but the first one byCrook was quite a good book. My girlfriend at the time started to doubtme and told me that my problems were allmy head. A view strongly supported by hermother and that I needed to wake up to myself.
See a shrink and take antidepressants. Idecided to end that unsupportive relationship and move out of their flat and had a garagesale a few weekends later to downsize. A naturopath was looking through some of my gear at a garagesale and asked me why I had dark circles under my eyes. I told her about my health and thefirst thing she told me was to get a hair analysis to determine the mercury levels becauseshe thought the mercury fillings being replaced, it could have caused a problem. And she saidthere may be a connection there with that and the Candida.I went to see her and showed her Crook's book, and what she said made a heck of a lotof sense. And I started getting treatment
for my yeast infection. Unfortunately, shedidn't walk me through a proper mercury detoxifiion, I felt very, very sick, and I had a bad Herxheimerreaction. I had a lot of vomiting and diarrhea for quite a few weeks. And this,fact,was one of the lowest pointsmy life. When at one point, I had considered taking my ownlife because I was so unsupported. No one wanted to listen to me. I felt terrible. The told me I was nuts. My mother said I was crazy. My girlfriend didn't listen.Is it any wonder people jump off bridges or do crazy thingsé If no one is there to listento you at all, all the doors get closedyour face. There's no support at all. What'sthe pointliving evené When you're at your