the three major causes of the most common gynecologic complaints: vaginal discharge, vaginal discomfort, and vaginal odor

the four direct microscopy tests to differentiate causes of gynecologic complaints

toxic to Neisseria gonorrheae

toxic to Chlamydia trachomatis

used for appropriate collection to obtain vaginal secretions to make sure that pathogen is not killed

usual pH of vaginal secretions

pH associated with bacterial vaginitis, trichomoniasis and atrophic vaginitis

absence associated with bacterial vaginosis

performed immediately to ensure detection of motile Trichomonas vaginalis

used for amine or whiff test

performed to detect bacteria

present in vaginal secretions in health, but higher during ovulation and menses

not usually present unless during menses

account for 50-90% of microbes of healthy vagina; nonmotile, gram-positive that produce large amounts of lactic acid; responsible for acidic environment

visualized with KOH prep in order to lyse RBCs; seen on gram stain as gram positive organism

yeast that can be present in normal vaginal secretions

indicated with increased (1+ or greater) of yeast or presence of hyphae or pseudohyphae

predominant cell type in wet mounts of healthy vagina

formed when numerous bacteria adhere to membranes of epithelial cells; most diagnostic indicator of bacterial vaginosis

percentage of cell surface covered with bacteria for it to be called a clue cell; bacteria must also extend beyond cell's cytoplasmic borders

not present in normal vaginal samples; increased in menses or postmenopausal period; seen in atrophic vaginitis and desquamative inflammatory vaginitis; oval to round with small NC ratio (1:1-2) 15-40um

abnormal if seen in wet mount; accompanied by numerous WBCs; seen in desquamative inflammatory vaginitis

flagellated protozoans that infect and cause inflammation of vaginal epithelium

has an optimal growth at 6.0 pH and prefers anaerobic environment; identified by jerky movement due to four anterior flagella and undulating membrane; nonmotile or dead resemble WBCs

digests cellular elements in order to visualize fungal elements

released from polyamines when pH changes due to KOH produced in bacterial vaginosis in whiff test

most common cause of vaginal infection due to alteration in normal bacterial flora

overgrowth along with a facultative anaerobe and replaces lactobacilli leading bacterial vaginosis, most common cause of vaginal infection: foul discharge, presence of clue cells; pH usually greater than 4.5

second most common cause of vaginitis; part of normal flora, but overgrowth causes pH and normal flora changes; curdlike discharge; revealed through wet mount and KOH; normal pH and amine test negative

most common parasitic gynecologic infection; transmitted sexually, humans are only host; pH 5-6; numerous clumped WBCs, mixed bacterial flora, positive whiff; DNA probe

thinning of vaginal epithelium and decrease in glycogen production resulting in dryness, soreness, and spotting; pH greater than 5; treated with estrogen

test performed to identify possibility of preterm delivery

diagnostic of higher risk of preterm labor

test performed to identify pregnant women for premature rupture of fetal membranes; increased amount indicates increased risk