1What are the 3 major causes of vaginal discharges/discomfort/ ordor?
Bacterial vaginosis
Candidiasis
Trichomoniasis
2These symptoms are positive for which tests?
Bacterial vaginosis
Candidiasis
Trichomoniasis
Bacterial vaginosis - WHIFF (+)
Candidiasis - KOH (+)
Trichomoniasis - WHIFF (+)
3What tests are done to differentiate between conditions?
Wet mount examination
Amine of "whiff" test
Potassium hydroxide (KOH) examination
Gram stain
4pH of vaginal secretions (normal) . and why?
3.8-4.5; acidic bc of lactobacilli
5what does lactobacilli produce?
lactic acid and hydrogen peroxide
6what does hydrogen peroxide prevent the growth of?
Gardenerella vaginalis
7Absence of lactobacilli is associated with what condition?
bacterial vaginosis
8How is a wet mount prepared ? and what should be immediately be reported?
1 stop of saline suspended specimen on slide and cover slip; trichomonas vaginalis
9How do perform the KOH test?
1 drop of 10% KOH and 1 drop of vaginal suspension; immediatly observe for "fishy" odor.
10What does KOH do?
digests cellular elements in order to visualize fungal elements (yeasts)
11What are elements reported in wet mounts?
Red blood cells
White blood cells
Predominant bacterial morphotypes Yeast, hyphae/pseudohyphae Trichomonads
Clue cells
Parabasal cells -
Basal cells
Squamous epithelial cells
12Are WBC normal is vaginal secretions and when are they high?
yes; during ovulation and menses
13Are RBCs normal in vaginal secretions?
not usually present unless during menses
14What cells line the vagina?
strratifies squamous epithelium
15What are clue cells? and what does its presence indicate?
epithelial cells with numerous bacteria adhere to membranes; indicates bacterial vaginosis
16Is KOH negative or positive for bacterial vaginosis?
negative but has a fishy smell.
17Are basal cells seen in normal swab? where are they seen? what does it indicate?
no. ; seen in wet mount with numerous WBCs ; desquamative inflammatory vaginitis.
18What condition do increased numbers of parabasal cells seen?
atrophic vaginitis and inflammatory vaginitis.
19What are the results of WHIFF AND KOH for trichomoniasis?
WHIFF - POS
KOH - NEG
20What cells are seen in bacterial vaginosis? AND WHAT IS THE PH
clue cells; absence of lactobacilli ; PH GREATER THAN 4.5
21What are the WHIFF AND KOH results for bacterial vaginosis?
WHIFF - POS
KOH - NEG
22What is bacterial vaginosis?
lactobacilli replaced by Gardenerella vaginalsis and a faculative anaerobe
23What is the second most common cause of vagintis?
candidiasis
24What is seen in the wet mount for candidiasis?
wet mount: yeasts - budding/ pseudohyphae
WHIFF: neg
KOH: pos
25What is atrophic vaginitis?
thinning of vaginal epithelium and decrease in glycogen production resulting in dryness, soreness, and spotting. prone to overgrowth of other bacteria ; PH > 4.5