Distinguished future physicians welcome to stomp on step 1 the only free tutorials series that helps you study more efficiently by focusing on the highest yield material. Im Brian McDaniel and I will be your guide on this journey through vulvovaginal infections. This is the 3rd tutorial in my playlist covering all of microbio. Vulvovaginitis (AKA Vaginitis) is inflammation of the lower genital tract. It is usually due to infection, but there are a wide variety of causes. During this tutorial we will focus.
On the 3 most important causes of vulvovaginitis for the medical board exam (trichomonas, candida and BV). However, you should know that other types 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 in postmenopausal women and we will cover that in a later tutorial in the GYN section. Gonorrhea and Chlamydia present primarily with cervicitis, but it can also cause vulvovaginitis. G/C will be covered later in its own tutorial.
We will start with a few different tests that we will use to differentiate between the different infections. Wet Prep (AKA Wet Mount Test) is a microscopic examination of vaginal discharge used to differentiate between different types of vulvovaginitis. The vaginal specimen is obtained using a speculum and a que tip similar to how one gets a pap smear. Then the specimen is rubbed onto a glass slide. One half of the slide has a drop of saline added to it while the other half of the slide has a drop of 1020% KOH (Potassium.
Hydroxide) added to it. when saline is added it makes it easier to view clue cells for BV flagellated motile cells for trichomonas. The KOH kills bacteria and vaginal cells leaving only yeast cells. This makes it easier to view the psuedohyphae and budding yeast present during vulvovaginal candidiasis. KOH is also alkalotic so it can be used for a Whiff Test. In this scenario when the alkalotic KOH is added to a sample containing BV it will create an amine or fishy smell.
This is a similar principle behind how the smell of bv can increase after unprotected sex since semen is alkalotic. The normal vaginal pH for a reproductive age woman is about 4, while the normal vaginal pH before puberty and after menopause is about 7. During puberty there is an estrogen guided increase in the growth lactobacilli flora. These bacteria break down glycogen into lactic acid which lowers pH from about 7 to about 4. Now that you know the normal values you.
Can apply it to diseases. usually, bacterial vaginosis trichomonas have alkalotic ph (gt;4.5 in reproductive age women) while candida has 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 that I give BV a high yield rating of 3 on a scale from 1 to 10. If you want to learn more about that rating system you can go to my website or click on.
This orange box here if you are watching this tutorial on a computer. Bacterial Vaginosis (AKA BV) is a polymicrobial infection caused by the overgrowth of normal flora. The key bacteria in this infection is gram negative Gardnerella Vaginalis. Clue cells are visible on the saline portion of a wet prep. A Clue Cell is a sloughed mucosal squamous epithelial cell covered in many adherent coccoid bacteria (Gardenerella Vaginalis). Here is a picture comparing normal squamous epithelial cells with a few scattered lactobacill.
To squamous cells that are covered in thousands of adherent garenerella bacteria. Here is one more pic. You can see on the left we have a normal squamos epithelial cell with a few WBCs. On the right we have the darker Clue cells. Finally I have a photomicrograph to look at in case you see that on your test. A thin/watery graywhite discharge is present A fouls smell is present and often described as an Amine Odor or Fishy Smell. This smell is intensified after unprotected intercourse.
What is bacterial vaginosis Infectious diseases NCLEXRN Khan Academy
voiceover bacterial vaginosis is a disease that’s caused by the overgrowth of a type of bacteria that’s called Gardnerella vaginalis, Gardnerella vaginalis. And as the name might suggest,.
This is the most common vaginal infection. Now I wanna put these really big quotes around the term infection because the thing that’s interesting about Gardnerella vaginalis is that it’s a bacteria that’s naturally found.
In the vagina. Now some may consider this to be a sexually transmitted infection, which is interesting because it doesn’t cause any problems until there’s too much of it there. So when we look to the causes.
Of bacterial vaginosis, they are all things that change the vaginal environment. That can include acts like douching, so douching, or rinsing of the vagina. The other is having new or multiple sex partners.
And finally, another known cause is the use of antibiotics. This could be in the case of somebody that has a throat infection or a pneumonia that’s on antibiotics which will then attack the bacteria that exists.
Within the vagina and allow gardnerella vaginalis to overgrow and cause bacterial vaginosis. So we’ve touched a little bit on it here, but I wanna draw it out. So when we talk about the pathophysiology of a disease, we’re talking about the mechanism.
By which that disease occurs. So in order to understand the pathophysiology of bacterial vaginosis, we need to take a look at a sample of bacteria that exists in the vagina. So I’ll draw out some Gardnerella vaginalis bacteria,.
And so i’ll put this up in our key. This is the symbol for Gardnerella vaginalis. And I’ll draw a few of them around here, but I also wanna show that there are a lot of other bacteria that exist in this sample. So if you really look at it here,.