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 After Hysterectomy
I need your advice on vaginal discharge afterhysterectomy. It certainly shouldn't include blood, sinceyou can't have a period anymore. I know any blood after a hysterectomy meanssomething is broken, well bad. But I've heard there could be some. Brown vaginal discharge for a couple of weeksafter a hysterectomy is normal. I thought it would only last a few days. The red bloody discharge as incisions healis only a few days, while the brown ied blood can leak out over weeks.
So even without a period, I have to wear maxipads for another month or two. Don't use tampons. I know, they recommended against that, evenwith the expected discharge. If you lift anything heavythe six weeksafterward and get a rush of blood, get to the emergency room because you tore something. They gave me the same advice as when you havea kid â€“ don't lift anything heavier than a newborn. You can have bleeding because you tore thingshaving sex too soon after the hysterectomy
too. Let's just say surgery and vaginal dischargelike this are the exact opposite of the mood required for that to happen. Any spotting with a bad odor, though, is areason to see a . Even if it is a really bad yeast or bacterial infection, it needsto be treated. So the standard yeast infection with a beersmell is really bad right now. Yes. And a thick white curdish material comingout from an infection is also really bad. What other discharge should I be on the lookoutforé
Any thick yellow ainage is a possible infectionof the surgical wound, so you need to see the about that. Ditto if you can'tpee or poop. I'd certainly see a about not beingable to go to the bathroom. A warning sign is when it hurts to do so. They tell you to have laxatives and lots offiber to reduce the straining down there. If it burns when you pee, that's a urinarytract infection, but it could mean other bacteria arethe incisions. And green and yellowdischarge from the vagina means there definitely is.
So even though I can't have kids, I stillget a few more weeks of looking at the multicolored diaper pad insert. You are supposed to talk to the anytime there is bleeding heavier than light spotting and any discharge that has a badodor. Ifdoubt, ask the doc.