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.
Catheterassociated Urinary Tract Infection CAUTI with Case Studies Part I
silence gt;gt; Good morning everyone and welcome to our third and final day of the 2014 NHSN Training Course. We want to acknowledge again, all of you here who have given your undivided attention and great participation. Everyone in the room as well as everyone watching the live webstream,.
We do appreciate your participation. I have multiple updates that I’ll give throughout the day but I have a couple of important things that you’ll need to know first thing. We wanted to remind you that the evaluation forms are in the back on the back table outside of this room. I was told that if you are getting CE’s, well, when you apply for that you’ll be able.
To do the evaluation on the computer so you don’t necessarily have to complete it today. But if you aren’t going to be applying for CE’s then we ask that you do complete the evaluation form today, and leave it on the table before you have to go. We really appreciate your feedback and your input and it is important to us, so we do ask that you complete that if you are able to give your input. With regards to feedback and input we wanted to let you know, we know some of the people.
In the front have a hard time with the bright lights. We can’t unfortunately dim the lights any more than we already have because of the live webstreams. So we apologize if they’re a little bright or hot on the tops of your heads. We also know that the round tables haven’t been ideal for you in the room. Again, hoping that you’ve been able to see the presentations with all.
Of the dropdown slide viewing but i know it’s difficult if you have to have your back or have to turn around to face the front. Just so you know, the reason we chose to do it this way was because we really wanted to maximize the amount of people we could get in a room and get here to this inperson training so that you’d be able to actually be in the room if you wanted to. So many people enroll and register to try to get on the random list that we felt that we should,.
You know, try to do this so that we could maximize to the 300 or over, but we will evaluate for next year to see if there’s any way we can fix that or get a bigger room. Let’s see, I wanted to remind you that the team outside the door is in the back to help you with your transport to the airport. So, they can help you with all of that but they need you to sign up on a sheet and let them know.
When your flight is so that they can group people together and make sure everybody gets to the airport on time. And if you are leaving early, which we want you to stay today as late as possible to hear all the important information being presented today, but if you do need to leave and you know that it’s going to be ahead of schedule, please let them know now or as early as possible so that they can make sure to set you up front aside to get you.
Out early for the transportation. We ask that oh, yes this is very important. So, you have met many of the individuals who answer the NHSN mailbox for you. There is a group of user support team that you were not able to meet because they were not presenters and they’ve actually been working behind the scenes to continue to answer the mailbox of questions that come in over the course of this training.