help on a random FA detail

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zephyr01

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on page 135 of FA08... case is 19 yo female college student presents w/ vaginal itching and a thick curdy discharge... diagnosis was candida albicans

but i was wondering if it could be trichomonas vaginalis
pg 157: vaginitis: foul smelling greenish discharge, itching and burning; sexual transmission

what makes the diagnosis candida instead? Thanks for your help.
 
on page 135 of FA08... case is 19 yo female college student presents w/ vaginal itching and a thick curdy discharge... diagnosis was candida albicans

but i was wondering if it could be trichomonas vaginalis
pg 157: vaginitis: foul smelling greenish discharge, itching and burning; sexual transmission

what makes the diagnosis candida instead? Thanks for your help.

i haven't covered either organism in my micro class yet, but my thinking would be:
is thick curdy discharge the same as a foul smelling greenish discharge?

albicans = white; curdy = like when you see curds of milk (also white)

is there burning in candida?
 
"what makes the diagnosis candida instead?"

You do a wet prep and KOH. For candida you see pseudohyphae. Trich infection you'd see motile sperm.

Hope that helps.
 
Is that the only diagnosis information they give you? If it is, then I agree, it has to be the color principally. Candida produces white lesions and discharge as opposed to greenish. I guess clinical experience would be enough to diagnose it then and there. Otherwise, the discharge material would have to be viewed under a microscope.
 
Thick, curdy discharge = characteristic for yeast infection. Note that not every woman with a yeast infection gets this "cottage cheese discharge." In fact, the majority don't. However, if you hear that description, the answer is Candida.

Trich causes a foamy, foul-smelling, greenish discharge.

Bacterial vaginosis causes a grayish, often thin/watery discharge with a foul odor.

How to tell them apart? Put the secretions on a slide and look under the microscope. With trich, upon adding saline, you'll see the organisms moving around. With BV, adding KOH produces a foul fishy odor (positive "whiff test"). Also, you'll see clue cells under the microscope on wet mount. With Candida, you'll see hyphae on microscopy after adding KOH.
 
Thick, curdy discharge = characteristic for yeast infection. Note that not every woman with a yeast infection gets this "cottage cheese discharge." In fact, the majority don't. However, if you hear that description, the answer is Candida.

Trich causes a foamy, foul-smelilng, greenish discharge.

Bacterial vaginosis causes a grayish, often thin/watery discharge with a foul odor.

How to tell them apart? Put the secretions on a slide and look under the microscope. With trich, upon adding saline, you'll see the organisms moving around. With BV, adding KOH produces a foul fishy odor (positive "whiff test"). Also, you'll see clue cells under the microscope on wet mount. With Candida, you'll see hyphae on microscopy after adding KOH.

ha....quite possibly the most aptly named test in medicine
 
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