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
Discharge before period White discharge before period
Discharge before period When you are about to start your period, sometimesthere is a lot of white discharge that builds up very unpleasantly. The white dischargebefore your period is actually a form of mucus that is naturally produced from the neck ofthe wombâ€”scientifically called the cervix. The amount of white discharge will vary throughoutyour menstrual cycle and most pregnant women will get something that is known as a quot;pregnancydischargequot;. A healthy white discharge does not have astrong smell or color. There is the uncomfortable wetness, but you should not have any itchingor soreness around your vagina. If you are
experiencing those symptoms, then seek medicalhelp from your . Do I Have Normal or Abnormal Dischargeé Normal white discharge before period The white discharge before your period isactually completely normal and natural. The white discharge before your period is mainlyfrom the uterus and cervix, but is not a beginning of an infection. The white discharge thatyou are experiencing is only caused from congestion of your pelvis, which is why the white dischargeis really just mucus. A couple of days before your period, the process that leads to menstruationmay cause an initial leak of clear fluid;
this is not an infection, either. An excessivewhite or clear dischargethe middle of your period is quite common. Abnormal white discharge before period Typically, the vaginal discharge is normal,but there are some cases where the discharge can indie an infection. If your dischargeis not clear or white and it is really yellow or green, then you may have one of the followinginfections, or abnormal discharge: Yeast Infection A common infection that most women get aftersex, and sometimes randomly, is a yeast infection.
This is when the white discharge appears morelike cottage cheese. There are over the counter mediions that work just fine on this infectionand usually it is gonea week or less with proper treatment. Trichomoniasis: If the discharge has a smell like rotten eggsand is kind of frothy, then you more than likely have some kind of sexually transmitteddisease and need to get it taken care of immediately.
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.