Question

A 27 year old female patient comes to the clinic with complaints of an unpleasant and fish-like vaginal oder that worsens following sexual intercourse. Upon examination, there is no vulvar or vaginal redness. The nurse practitioner would suspect all of the following for this patient except:

a. Clue cells
b. WBC
c. White to gray vaginal discharge
d. Positive whiff test

Answer 1

The symptoms presented by the patient are indicative of bacterial vaginosis, which is identified by clue cells, a white to gray discharge, and a positive whiff test, but not typically by increased white blood cells (WBC).

Step-by-step explanation:

The patient's symptoms described in the question are suggestive of a condition known as bacterial vaginosis (BV). This infection is characterized by an overgrowth of certain bacteria in the vagina, resulting in a fishy odor that can be more pronounced after sexual intercourse. Indicators of bacterial vaginosis include the presence of clue cells (epithelial cells of the vagina that have bacteria adhering to their surface observable under a microscope), a white to gray vaginal discharge, and a positive whiff test (a fishy odor detected when a sample of vaginal discharge is combined with a potassium hydroxide solution).

However, the presence of white blood cells (WBCs) in the discharge is not a typical finding in bacterial vaginosis. Elevated numbers of WBCs usually indicate an inflammatory response to infection and are more commonly seen in conditions like vaginitis or sexually transmitted infections (STIs) where there is potential vulvar or vaginal inflammation. Therefore, the nurse practitioner would expect to find all of the listed options in a patient with bacterial vaginosis, except an increased number of white blood cells.