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AUBF > M5: Vaginal Secretions (Part 2: Diagnostic Tests) > Flashcards

M5: Vaginal Secretions (Part 2: Diagnostic Tests) Flashcards

1
Q

What are the 3 diagnostic tests for vaginal fluid?

A
  1. pH test
  2. Wet mount preparation
  3. Amine whiff test
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2
Q

What are the other (4) diagnostic tests mentioned?

A
  1. Gram stain
  2. Culture
  3. DNA Testing
  4. POCT
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3
Q

3 diagnostic tests for vaginal fluid

  • Uses litmus paper
A

pH test

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4
Q

DIAGNOSTIC TEST

Factors that can interfere with pH test

a. cervical mucus
b. semen
c. blood
d. lactic acid
e. lactobacilli
f. a and e
g. a, b, d
h. a, b, c
i. ALL
j. NONE

A

h. a, b, c

lactic acid from glycogen metabolism

lactobacilli is part of normal flora

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5
Q

If you see this card

A

twerk ka muna, eme please see the pH test procedure

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6
Q

MICROSCOPIC PROCEDURES

How many glass slides are used?

if gram stain is requested

A

3 clean glass slides

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7
Q

T or F

the three clean glass slides should be labelled with patient’s age and unique ID

A

F (should be labelled with patient’s name and unique IDentifier)

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8
Q

For wet mount examinations, cells and organisms are observed under what objective?

A

quantified per high power field (hpf) (40×)

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9
Q

for Gram stains, cells and organisms are observed under what objective?

A

reported per oil immersion field (100×)

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10
Q

Microscopic examination of vaginal secretion are reported like?

A

urinary sediment

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11
Q

T or F

One matter of reporting of microscope sediments found under vaginal secretion

A

T

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12
Q

3 diagnostic tests for vaginal fluid

  • Observed under LPO and HPO
  • Uses NSS and Vaginal fluid
A

Wet mount examination

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13
Q

WET MOUNT EXAMINATION

Typical constituents in vaginal fluid wet mounts

A
  • squamous epithelial cells
  • RBCs
  • Clue cells
  • parabasal cells
  • basal cells
  • bacteria
  • yeast
  • WBCs
  • Clue cells
  • basal cells
  • motile T. vaginalis
  • hyphae/pseudohyphae
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14
Q

iF YOU SEE THIS CARD PATINGIN NALANG NG PROCEDURE SA WET MOUNT LAMAT

A

ok

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15
Q

WET MOUNT EXAMINATION

How many drops of vaginal fluid specimen should be placed on slide?

A

1 drop

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16
Q

WET MOUNT EXAMINATION

epithelial cells and any budding yeast cells or pseudohyphae shiuld be exmained under what objective

A

10 x (LPO)

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17
Q

WET MOUNT EXAMINATION

quantifying organisms and cells should be observed under what objective

A

40 x (HPO)

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18
Q

QUANTITATION SCHEME FOR MICROSCOPIC EXAMINATION

Determine result based of number of organisms:

Fewer than 10 organisms or cells/slide

A

RARE

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19
Q

QUANTITATION SCHEME FOR MICROSCOPIC EXAMINATION

Determine result based of number of organisms:

Fewer than 1 organisms or cells/hpf

A

1+

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20
Q

QUANTITATION SCHEME FOR MICROSCOPIC EXAMINATION

Determine result based of number of organisms:

1-5 organisms or cells/hpf

A

2+

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21
Q

QUANTITATION SCHEME FOR MICROSCOPIC EXAMINATION

Determine result based of number of organisms:

6-30 organisms or cells/hpf

A

3+

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22
Q

QUANTITATION SCHEME FOR MICROSCOPIC EXAMINATION

Determine result based of number of organisms:

> 30 organisms or cells/hpf

A

4+

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23
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

  • originate from the linings of the vagina and female urethra
  • present in significant numbers in the vaginal secretions of a healthy female
A

Squamous EC

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24
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

  • abnormal variation of the squamous epithelial
  • coccobacillus bacteria attached in clusters on the cell surface
  • Bacterial Vaginitis (BV) caused by
    G. vaginalis
A

Clue cells

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25
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

These bacteria are attached in clusters on the cell surface

Clue cells

A

Coccobacillus bacteria

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26
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

T or F

In clue cells, bacteria should cover at least
85% of the epithelial cell

Clue cells

A

F (atleast 75% of EC)

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27
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Clue cells are indications of bacterial vaginitis (BV) caused by?

Clue cells

A

G. vaginalis

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28
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

For WBCs be reported as abnormal what should the report be?

clue: no.

A

3+ WBC

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29
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

  • vaginal candidiasis
  • atrophic vaginitis
  • infections with
    Trichomonas
  • Chlamydia
  • N. gonorrhoeae,
  • Herpes Simplex Vurus
    (HSV)
A

WBC

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30
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

menstruation or due to a desquamative inflammatory process

A

RBC

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31
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

This substance is used to lyse RBC and differentiate it from WBC, bacteria, and yeast

A

KOH (Potassium Hydroxide)

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32
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

    • marked basophilic granulation or amorphic basophilic structures (“blue blobs”) in the surrounding cytoplasm
  • immature SEC
  • Inc in Desquamative inflammatory vaginitis (DIV)
A

Parabasal cells

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33
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

  • located deep in the basal layer of the vaginal stratified epithelium
  • Inc in Desquamative inflammatory vaginitis (DIV)
A

Basal cells

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34
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

  • vary with the age and hormonal status
  • Hydrogen peroxide, produced by lactobacilli subgroups, also can help to suppress the overgrowth of other organisms
A

Bacteria

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35
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

This substance produced by lactobacilli subgroups helps supress overgrowth of other organism

Bacteria

A

H2O2

Hydrogen peroxide

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36
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

  • The “jerky” motion of the flagella and undulating membrane characteristic is observed in wet mount
  • Stored at room temperature
  • Preserves up to 2 hours
A

Trichomonas vaginalis

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37
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Trichomonas vaginalis should be stored at what temp?

38
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Trichomonas vaginalis can be preserved up to how many hours?

39
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

Determine organism

  • Candida albicans and non Candida spp. cause most fungal infections
  • Occational organisms of these is considered part of the normal flora
A

Yeast cells

40
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

T or F

occasional yeast in vaginal secretions is considered part of the normal flora

41
Q

ORGANISMS FOUND IN VAGINAL FLUID WET MOUNTS

These (2) species cause most fungal infections

Yeast cell

A

Candida albicans and non-Candida spp

42
Q

IF YOU SEE THIS CARD, HINGA KA MUNA AND LOOK AT KOH PREPARATION SA TRANS

43
Q

KOH Preparation

Concentration of KOH used?

44
Q

KOH Preparation

(1) How many drops of vaginal fluid and 10% KOH should be used?

A

one drop both

45
Q

KOH Preparation

(2) After KOH preparation in slide, slide should be rest up to?

46
Q

KOH Preparation

For overall assessment and for yeast pseudohyphae, what objective is used?

A

10x objective (LPO)

47
Q

KOH Preparation

For examining for budding yeast
cells (smaller blastopore blastospore), what objective is used?

A

40x objective (HPO)

48
Q

KOH Preparation

Yeast or RBC?

If the round spots in the slide are still visible after addition of KOH

49
Q

KOH Preparation

Yeast or RBC?

If the round spots in the slide are no longer visible after addition of KOH

50
Q

THE LACTOBACILLI ARE OFTEN REPLACED BY INCREASED NUMBERS OF ANY OF THE FOLLOWING SPECIES?

A
  • Mobiluncus spp. (thin, curved, gram-negative, motile rods)
  • Porphyromonas spp.
  • Gardnerella vaginalis (short, gram-variable coccobacilli)
  • Enterococcus spp. (gram-negative cocci)
  • Ureaplasma urealyticum
  • Prevotella spp.
  • Bacteroides spp. (anaerobic gram-negative rods)
  • Peptostreptococcus spp. (gram-positive cocci)
  • Mycoplasma hominis
51
Q

3 diagnostic tests for vaginal fluid

  • The odor results from trimethylamine, a volatilization product of amines, when the KOH is added
  • Detects increase in G. vaginalis in conjunction with Mobiluncus spp. and with T. vaginalis
A

Amine whiff test

52
Q

Amine whiff test

After KOH is added in vaginal fluid this causes volatilization product of amines called?

Amine whiff test

A

trimethylamine

53
Q

Amine whiff test

Positive test for Amine whiff test indicates what condition?

A

Bacterial Vaginitis

increased G. vaginalis. mobiluncus spp, T. vaginalis

54
Q

Amine whiff test

IF YOU SEE THIS CARD TWERK MUNA, SEE THE PROCEDURE FOR AMINE WHIFF TEST PLEASEEE

A

PLEASE UWU

55
Q

Amine whiff test

How many drop of specimen and 10% KOH?

56
Q

Amine whiff test

T or F

One should vigorously wave their hand above the surface of slide to smell for any fishy amine odor

A

F (GENTLY FAN only)

57
Q

Amine whiff test

Positive or Negative result for amine whiff test?

The presence of a fishy odor after adding KOH

58
Q

Amine whiff test

Positive or Negative result for amine whiff test?

The absence of a fishy odor after adding KOH

59
Q

(4) Other diagnostic test

  • Has more specified reporting
  • gold standard in identifying the causative organisms for BV
A

Gram stain

60
Q

Normal, Intermediate, Abnormal

Nugent score of 0 to 3 is considered?

Gram staining

61
Q

Normal, Intermediate, Abnormal

Nugent score of 4 to 6

A

Intermediate

62
Q

Normal, Intermediate, Abnormal

Nugent score of >7

A

Abnormal (BV)

63
Q

IF YOU SEE THIS CARD, PASEE NALANG NG NG BACTERIAS DETECTED AND CORRESPONDING AMOUNTS

64
Q

PER FIELD RESULT ESTIMATION:

1/ field

Gram stain

65
Q

PER FIELD RESULT ESTIMATION:

1-5/ field

Gram stain

66
Q

PER FIELD RESULT ESTIMATION:

6-30/field

Gram stain

67
Q

PER FIELD RESULT ESTIMATION:

30/ field

Gram stain

68
Q

(4) Other diagnostic test

  • Diamond medium is required for determining the presence of T. vaginalis
  • InPouch TV, Biomed Diagnostics, White City, OR
69
Q

is required for determining the presence of T. vaginalis

Culture

A

Diamond medium

70
Q

InPouch TV, Biomed Diagnostics, White City, OR

a. 30 minutes of collection
b. incubated for 4 days in 37 c in CO2 atmosphere
c. both
d. NOTA

A

a. 30 minutes of collection

b. incubated for 4 days in 37 c in CO2 atmosphere - for 5 days in 37 c in CO2 atmosphere

71
Q

(4) Other diagnostic test

  • DNA probe testing system, Affirm VPIII (Becton, Dickinson, Franklin Lakes, NJ), is available for differential diagnosis of G. vaginalis, Candida spp., and T. vaginalis
  • Results within 1 hr; 95% sensitivity
A

DNA Testing

72
Q

DNA Testing results are within? what is its sensitivity?

A

results of DNA test are within 1 hour, sesitivity is 95%

73
Q

(4) Other diagnostic test

  • Proline aminopeptidase activity in vaginal secretions can be detected by rapid antigen tests to identify G. vaginalis
  • OSOM Trichomonas Rapid Test immunochromatographic strip test
  • OSOM BVBLUE test
  • Measure an elevated vaginal pH and the presence of amines
A

Point-of-care test (POCT)

74
Q

POINT-OF-CARE TEST (POCT)

This is in vaginal secretions can be detected by rapid antigen tests to identify G. vaginalis

A

Proline aminopeptidase activity

75
Q

POINT-OF-CARE TEST (POCT)

What are the (2) examples of POCT

A
  • OSOM Trichomonas Rapid Test immunochromatographic
  • OSOM BVBLUE test
76
Q

POINT-OF-CARE TEST (POCT)

strip test for T. vaginalis Ag (10 mins)

(2) examples of POCT

A

OSOM Trichomonas Rapid Test immunochromatographic

g vaginalis is also positive

77
Q

POINT-OF-CARE TEST (POCT)

detects vaginal fluid sialidase, an enzyme
produced by the bacterial pathogens associated with BV, such as Gardnerella, Bacteroides, Prevotella, and Mobiluncus (1 min.

A

OSOM BVBLUE test

78
Q

POINT-OF-CARE TEST (POCT)

OSOM Trichomonas Rapid Test immunochromatographic or OSOM BVBLUE test

T. vaginalis Ag , G. vaginalis

A

OSOM Trichomonas Rapid Test immunochromatographic

79
Q

POINT-OF-CARE TEST (POCT)

OSOM Trichomonas Rapid Test immunochromatographic or OSOM BVBLUE test

10 mins

A

OSOM Trichomonas Rapid Test immunochromatographic

80
Q

POINT-OF-CARE TEST (POCT)

OSOM Trichomonas Rapid Test immunochromatographic or OSOM BVBLUE test

1 min

A

OSOM BVBLUE test

81
Q

POINT-OF-CARE TEST (POCT)

OSOM Trichomonas Rapid Test immunochromatographic or OSOM BVBLUE test

Gardnerella, Bacteroides, Prevotella, and Mobiluncus

A

OSOM BVBLUE test

82
Q

POINT-OF-CARE TEST (POCT)

OSOM BVBLUE test

positive
negative

what are the results

A

OSOM BVBLUE test

positive: blue/green
negative: yellow

83
Q

POCT KITS

PAMG-1 or IGFBP-1

  • More in amniotic fluid> vaginal fluid
  • Determine whether it is vaginal or amnioitc
  • Premature rupture
    (amniotic sac)
  • 1,000 - 10,000 higher in
    amniotic fluid
84
Q

If you see this card, look at the poct procedure

85
Q

POCT PROCEDURE

Area in vagina where swab should be made contact

A

lower one-third of the vaginal wall

86
Q

T or F

After specimen collection, it should be put in tube vessel and mix vigorously

A

F (gently swirl in tube vessel)

87
Q

Let the BV test vessel containing the swab stand for how many minutes?

A

10 minutes

between 17 and 37°C

88
Q

After letting swab stand, one should add how many drops of developer solution?

A

1 drop of developer

89
Q

POCT Positive or Negative?

A blue or green color in the BV test vessel or on the head of the swab

90
Q

POCT Positive or Negative?

A yellow color in the BV test vessel

AUBF (45 decks)

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