The Wet Prep

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The Wet Prep

• Just the Basics

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Learning Objectives

• 1. List the steps in performing a Wet prep
• 2. List the steps in performing a KOH prep
• 3. Identify the following in a wet prep
  trichomonas, bacteria, clue cells, white blood
  cells (WBCs)
• 4.Correlate laboratory findings with clinical
  symptoms.

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Differential Diagnosis of Vaginal Infections
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Normal Vaginal Flora

• pHlt 4.5
• Epithelial cells
• Lactobacillus
• WBCs

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Clue Cells

• Bacteria on surface of epithelial cell
• Cell margin intact
• 75 of cell margin covered

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Trichomonas vaginalis

• Measures 10-20 um in size
• Contains a single nucleus
• Motility caused by flagella undulating membrane

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Live Trichomonas
Click video to play
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Candida vaginitis

• Not part of normal vaginal flora
• Symptoms - itching discharge
• KOH prep

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Yeast with Pseudohyphae

• Extensions of budding yeast
• Indicative of prolonged infection

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Parasites

• Body louse Pedicularis pubis
• Pinworm Enterobius vermicularis

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Major Parts of the Microscope

• Objectives
• Stage
• Fine Adjustment
• Course Adjustment
• Condenser

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Collection of specimen

• From vaginal wall
• Use sterile swab

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The Wet Prep(Step 1)

• Place swab in sterile saline(0.85).
• Take to lab immediately

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The Wet Prep(Step 2)

• Mix solution well
• Place a drop of the specimen onto the slide

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The Wet Prep(Step 3)

• Place coverslip
• View with 10X then 40X objective
• Read at least 10 fields

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Agents seen in a Wet Prep

• Trichomonas
• WBC
• Budding yeast
• Clue cells

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Agents Seen in a Wet Prep

• Budding yeast
• Squameous epithelial cell

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The KOH Prep(Step 1)

• Add a drop of specimen to a clean slide

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KOH Prep(Step 2)

• Add drop of 10 KOH

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Whiff TestStep 3

• Smell for fishy odor

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KOH Prep(Step 4)

• Add coverslip
• Review 10 fields

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Yeast

• Pseudohyphae- extensions of the budding yeast

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Artifacts

• Plant fibers or body hair
• Air bubble

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Improve the Odds of an Accurate Test

• Use the saline tube method
• Adjust the microscope for optimum illumination
  (Köhler)
• Scan entire field using 10X
• Confirm findings using 40X
• Consider all factors
• Ph
• Microscopic findings
• Signs and symptoms

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Differential Diagnosis of Vaginal Infections
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TEST
short video delay