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
What Are The Symptoms Of Severe Vaginal Yeast Infection
I've got a question here from somebody inAustralia,Sydney, Australia. What are the symptoms of severe vaginal yeast infectioné The symptoms of severe vaginal yeast infectioncan be sometimes mistaken for bacterial vaginosis. Symptoms generally include itching and sometimessevere itching. Itching can be bad and really uncomfortable. I've had some patients thatcan't work anymore because of the itching. Itching, redness, discharge is quite common.Discharge can be clear, a white finished discharge up to a thick, almost like cottage cheesewhite discharge, but the two characteristic symptoms would be itching and discharge.
BV or bacterial vaginosis is that fishy odoror the foulsmelling vaginal area. Generally, there's not a really bad foul smell with avaginal yeast infection. It can be a musky sort of odor, but not generally a really fishystrong sort of smell. We get that more with bacterial vaginosis. Bacterial vaginosis willalso have more of a whitish or a gray waterish discharge. Itching can be there, but nowherenear as intense as the vaginal yeast infection, which can be really bad. I've also found manywomen complain about a lot of pain after intercourse with a Candida yeast infection as well. Theyalso get them with bacterial vaginosis, but even more so with the vaginal infection. Thekey symptoms are those two things. Think about
the itching. Think about the discharge. Now some women with Candida yeast infectionsalso get pelvic pain to different degrees. Many of them can even have a lowgrade endometriosiswithout even knowing about it. I discovered years ago that many cases of severe endometriosisare,fact, caused by a yeast infection. It makes sense because if you've got a vaginalinfection and you're going to treat it with appliors or creams from the andyou're going to take diflucan or fluconazole recurrently to cure this problem. You're notgoing to cure it with ugs. You're not going to cure it with creams. All you're doing isyou're iving it further up the vaginal area,
through the cervix, into the endometrium,and then eventually you get endometriosis. So you get basically an inflammationthewall of the womb. Yeast actually can get through there and start creating an immune reaction.Cysts will develop; small cysts develop around that area and that becomes endometriosis. Endometriosis has skyrocketed since tamponuse with many women. I've got a female friend who said that she found years ago amassive connection between endometriosis and chronic vaginal yeast infection, so you needto bear thatmind, too. You could have a lowgrade pelvic pain.
Ifdoubt, make sure that you get checkedout and have a swab and have that cultured for Candida to see whether you've got a bacterialproblemthe vaginal area or a yeast infection. Be sure to check out my other tutorials on howto get rid of a woman's yeast infection by doing the quot;kill and build phase.quot; This isa bulletproof way; 99 percent guaranteed to get rid of this vaginal infection. Thanks for tuning in.