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AUBF > finals - vaginal secretions > Flashcards

finals - vaginal secretions Flashcards

1
Q

one of the most common conditions diagnosed by healthcare providers for female patients particularly women of childbearing age

A

vaginitis

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2
Q

gold standard for vaginal examination

A

gram stain

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3
Q

in swabbing vaginal area, why should we not use cotton and wooden shaft for swab

A

cotton is toxic to neisseria gonorrhoeae
the wood is toxic to chlamydia trachomatis
and calcium alginate can inactivate herpes simplex virus (culture)

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4
Q

an alternative technique to analyze a sample aside from dislodging it to a saline is

A

dilute the vaginal sample with1-2 drops of saline on the other half of the slide then do the same thing on the right side with 10% KOH

remember the mycv activity? parang ganon

then cover them both with cover slip and observe under the microscope

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5
Q

if the testing is delayed, what is the temp for trichomonas vaginalis and N. gonorrhoeae

A

Room temp
`

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6
Q

if the testing is delayed, what is the temp for C. trachomatis and herpes simplex virus

A

refrigerated to prevent the overgrowth of normal flora `

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7
Q

T. Vaginalis must be examined within how many hrs

A

2 hrs -

palatandaan:
diba pwede tong makita sa urine? 2 hrs lang max ng urine so 2 hrs lang din to hehe

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8
Q

normal appearance of a normal vagigi secretions

A

white flocculent discharge

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9
Q

normal ph of a normal vagigi secretions

A

3.8 to 4.2

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10
Q

normal anine (whiff test)of a normal vagigi secretions

A

negative

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11
Q

normal wbcs of a normal vagigi secretions

A

2+

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12
Q

normal lactobacilli of a normal vagigi secretions

A

predominant

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13
Q

normal clue of a normal vagigi secretions

A

absent

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14
Q

normal other cells of a normal vagigi secretions

A

absent (except rbc during mens)

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15
Q

normal organism of a normal vagigi secretions

A

other lactobacilli subgroups, occasionally yeast

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16
Q

this parameter is conducted before submerging the sample in KOH or saline

A

pH

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17
Q

the pH test helps to differentiate the cause of vaginitis

for vulvovaginal candidiasis, the pH must be

A

3.8-4.5

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18
Q

for vulvovaginal candidiasis, the pH must be 3.8 -4.5

what will be the pH for bacterial vaginosis, trichomoniasis, desquamative inflammatory vaginitis, and athrophic vaginitis

A

above 4.5

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19
Q

normal vaginal flora has predominant lactobacilli, this bacteria produces an end product of ___ from __ metabolism

A

lactic acid from glycogen metabolism

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20
Q

what is the role of lactic acid for vaginal health

A

provides an acidic environment and maintains the balance of normal flora

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21
Q

aside from lactic acid, other subgroups of lactobacilli can produce ____ which is toxic to pathogen and provides protection from infection

A

hydrogen peroxide

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22
Q

it’s been associated with the lack of hydrogen peroxide-producing lactobacilli

A

bacterial vaginosis

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23
Q

what hormone is necessary to preserve an acidic vaginal environment

A

estrogen

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24
Q

for vaginal infection microscopic exam, what are the screening test we can conduct

A

KOH and saline wet mount

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25
Q

for vaginal infection microscopic exam, what are the confirmatory test we can conduct

A

gram stain

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26
Q

how many clean glass slides are prepared for gram stain

A

3

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27
Q

total magnification for wet mount examination

A

400X

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28
Q

total magnification for gramstain examination

A

1000X

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29
Q

intravaginal medication can leave oil and interfere the test, to detect yeast and bacterial vaginosis, ____ is used to test the sample

A

gram stain

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30
Q

squamous epithelial cells measure _____ um in diameter

A

25-70um

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31
Q

what is the appearance of a squamous epithelial cells

A

polygonal “flagstone” and contain prominent centrally located nucleus about the size of a red blood cell and a large amount of irregular cytoplasm, lacking granularity, with distinct cell margins

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32
Q

these large, flat cells originate from the linings of the vagina and the female urethra and are present in significant numbers in the vaginal secretion of a healthy female

A

squamous epithelial cells

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33
Q

clumps of epithelial cells are an indication of the presence of __

A

yeast

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34
Q

are an abnormal variations of the squamous epithelial cell and are distinguised by cocobacillus bacteria attached in clusters on the cell surface, spreading past the edges of the cell making the border indistinct or stippled

A

clue cells

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35
Q

cell appearance is granular, irregular sometimes describes as shaggy

A

clue cells

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36
Q

clue cells are diagnostic of bacterial vaginosis caused by

A

Gardnerella vaginalis

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37
Q

wbc’s size in diameter

A

14-16 um

38
Q

greater than 3+ in wbc is significant to

A

vaginal candidiasis, atrophic vaginitis, Trichomona, chlamydia, gonorrhoeae, h.simplex

39
Q

how do we distinguished rbc and yeast in vaginal secretion

A

through KOH, it can lyse RBC and keep yeast

40
Q

parabasal cell shape

A

round to oval

41
Q

N:C ratio of parabasal cells

A

1:1 to 1:2 with marked basophilic granulation or amorphic basophilic structures “blue blobs” in the surrounding cytoplasm

42
Q

how to distinguised basal cells to wbc

A

they are round rather than lobed nucleus

N:C ratio 1:2

43
Q

basal cells is not normal in vaginal secretions, if present + wbc and altered vaginal flora, these suggests ____

A

desquamative inflammatory vaginitis

44
Q

which genus normally comprise the largest portion of vaginal flora

A

lactobacillus spp

45
Q

is an arterial flagellated protozoan that can cause vaginal inflammation and infection in womer

A

trichomonas vaginalis

46
Q

movement of T vaginalis

A

jerky motion

47
Q

non motile trichomonas is mistaken as

A

wbc

48
Q

a sample tested for whiff/amine test must be checked for ___ after addition of 10% KOH

A

fishy odor - means positive

the odor results from the volatilization of amines when the KOH is added

49
Q

volatile amines are not present in normal vaginal secretions, which means a positive amine tests suggest ___

A

bacterial vaginosis

50
Q

gold standard for detcecting yeast and trichomonas

A

culture

51
Q

special media for T vaginalis is required, this is called ___

A

diamond’s medium

52
Q

appearance of a secretion caused by bacterial vaginosis

A

thin, homogenous, white-to-gray vaginal discharge

53
Q

appearance of a secretion caused by candidiasis

A

white, curd like vaginal discharge

cheese like

54
Q

appearance of a secretion caused by trichomoniasis

A

yellow- green frothy adherent vaginal discharge increased in volume

55
Q

appearance of a secretion caused by desquamative inflammatory vaginitis

A

excessive purulent vaginal discharge, vaginal erythema

56
Q

appearance of a secretion caused by atrophic vaginitis

A

excessive purulent vaginal discharge, vaginal erythema

57
Q

are there wbc in bacterial vaginosis

A

rare or absent

58
Q

are there wbc in candidiasis

A

3+ to 4+

59
Q

are there wbc in trichomoniasis

A

2+ to 4+

60
Q

are there wbc in desquamative inflammatory vaginitis

A

3+ to 4+

61
Q

are there wbc in atrophic vaginitis

A

3+ to 4+

62
Q

is the common cause of vaginitis

A

bacterial vaginosis

63
Q

bacterial vaginosis affects ___ to ___ percent of childbearing age women

A

40% to 50%

64
Q

it occurs when there is an imbalance in the ratio of normal vaginal flora

A

bacterial vaginosis

65
Q

associated with new or multiple sex partners, frequent douching, use of intrauterine devices, pregnancy, and a lack of protective lactobacilli

A

bacterial vaginosis

66
Q

a risk factor for the premature rupture of membranes and preterm labor for pregnant women.

A

bacterial vaginosis

67
Q

can cause pelvic inflammatory and endometritis as well as an increased risk for acquiring STD

A

bacterial vaginosis

68
Q

recommended treatment for bacterial vaginosis is/are

A

metronidazole gel
clindamycin cream

69
Q

patients may present with a strawberry cervix because of puncture hemorrhages

A

trichomoniasis

70
Q

recommended tx for Trichomoniasis

A

metronidazole

tinidazole for allergic with metronidazole

71
Q

common cause of vaginitis and nearly 75% of adult women experience it atleast once in their lifetime

A

candidiasis

72
Q

it is part of a normal flora but occurs when the there’s a change in environment and causes candida to overgrow

A

candidiasis

73
Q

predominant in women of childbearing age who are producing large amount of estrogen

estrogen causes vagina to mature, matured vagina produces glycogen, which is a source for nutrient

A

candidiasis

74
Q

b hemolytic gram positive streptococci are the common found in culture

A

desquamative inflammatory vaginitis

75
Q

a syndrome characterized by profuse purulent virulent vaginal discharge , erythema, and dyspareunia

A

desquamative inflammatory vaginitis

76
Q

can occur secondary to atrophic vaginitis in post menopausal women as a result of decreased estrogen

A

desquamative inflammatory vaginitis

77
Q

wet mount and gram stain revels large number of rbc, wbc, parabasal, and basal cells, squamous epithelial cells, reduced or absent lactobacilli, replaced by gram positive cocci

A

desquamative inflammatory vaginitis

78
Q

desquamative inflammatory vaginitis is treated with

A

2% clindamycin

hormone replacement therapy is effective for patients with desquamative inflammatory vaginitis secondary to atrophic vaginitis

79
Q

is a syndrome found in post menopausal women

A

atrophic vaginitis

80
Q

this syndrome is caused by thinning of the vaginal mucosa due to reduced estrogen and glycogen production

A

atrophic vaginitis

81
Q

clinical symptoms include vaginal dryness, soreness, dyspareunia, inflamed vaginal mucosa, purulent discharge

A

atrophic vaginitis

82
Q

microscopic is same with DIV but gram negative rods are also observed

A

atrophic vaginitis

83
Q

tx for atrophic vaginitis

A

estrogen replacement
vaginal ointments are initially used
for recurrent infection, oral or transcutaneous (patch) modes

84
Q

a premature rupture of fetal membrane and a high risk for preterm labor, _______ are test to detect amniotic fluid protein to evaluate these conditions

A

fetal fibronectin test and amnisure test

85
Q

a vaginal pH greater than 7 and a positive fern test are a strong indication of

A

amniotic sac rupture

86
Q

is an adhesive glycoprotein in the extracellular matrix at the maternal and fetal interface within the uterus

A

fetal fibronectin (fFN)

87
Q

seen between 24 to 34 weeks of gestation and indication of pretem labor

A

fibronectin enzyme

88
Q

the methods to detect fFN are

A

solid phase ELISA
lateral flow
etc

89
Q

this test if focused on detection of rupture of fetal membranes.

A

amnisure

90
Q
A

AUBF (29 decks)

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