Lab dxs: cervicitis and vaginitis Flashcards Preview

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Flashcards in Lab dxs: cervicitis and vaginitis Deck (13)
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1
Q

Normal vaginal pH? How is pH testing done?

A
  • normal vaginal pH: 3.8-4.5
  • this is done with pH paper placed on lateral wall of the vagina
  • use pH with range 4.0-5.0
2
Q

What could cause of vaginal pH of greater than 4.5 be?

A
  • bacterial vaginosis, trichomoniasis, and atrophic vaginitis
3
Q

Indications and interfering factors for vaginal wet mount?

A
  • indications: vaginal itching, burning, rash, odor, or d/c
  • interfering factors:
    can’t be done during menses, should avoid vaginal meds for 2-3 days prior, vaginal irritation from tampons or intercourse can alter results
4
Q

Technique of vaginal wet mount?

A
  • vaginal secretions are obtained with cotton tipped swab and speculum is used to facilitate obtaining the sample
  • sample of vaginal secretions placed on slide with drop of saline and eval. using microscopy
  • or can put 1 ml salin in test tube and place swab in test tube to agitate then transfer some over (helps thin secretions)
  • slide cover is then placed
5
Q

What cells might be seein in saline wet mount?

A
  • white cells
  • clue cells
  • lactobacilli
  • trichomonads
6
Q

When are white cells seen in wet mount?

A

normally there should just be a few of them (less than 10)

- should be more epithelial cells than white cells in sample

7
Q

What are clue cells? What does this indicate?

A
  • normal epithelial cells have sharp, distinct borders
  • clue cells are vaginal epithelial cells that are covered with bacteria
  • clue cells have shaggy borders and the epithelial cells take on a stippled appearance
  • this indicates bacterial vaginosis
8
Q

What are lactobacilli? Indication?

A
  • part of normal flora

- there will be less seen with conditions such as yeast and bacterial vaginosis

9
Q

What are trichomonads?

A
  • have small tails, mobile

- WBCs that are seen are slightly smaller than trichomonads

10
Q

Process of KOH prep?

A
  • few drops of 10% KOH soln added to vaginal secretions on microscopic slide
  • heating slide will hasten process of destruction of cellular debris
  • KOH removes normal cells and bacteria clearing the field so that yeast buds and hyphae may be seen
11
Q

What is the Whiff test?

A
  • when preparing the KOH slide to evaluate for yeast, note whether or not there is an amine (fishy) odor after addition of KOH
  • presence of this odor is indicative of bacterial vaginitis
  • sensitivity: 67%, specificity: 93% for bacterial vaginosis
  • sensitivity 67%, ,specificity 65% for trichomoniasis
12
Q

When is NAAT testing used? Process of this?

A
  • Nucleic acid amplification testing
  • for N. gonorrhoeae, C. trachomatis
  • swab of vaginal fluid or endocervix
  • if unable to obtain above can be done on urine sample
  • sensitivity usually well above 90%, specificty usually greater than 99%
  • NAATs typically detect 20-50% more chlamydial infections than could be detected by culture or earlier nonculture tests (ID of organism on micro)
13
Q

Process of NAAT urine specimens?

A
  • should be obtained as directed by test manufacturer in package insert or use swab supplied by test manufacturer
  • if possible, specimen collection should be delayed for more than 1 hr after pt has voided
  • first catch urine (first 10-30 cc voided after initiating stream) should be used