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A 21-year-old female comes into your family medicine office complaining of an abnormal discharge with a foul odor. She has been sexually active with four to five partners over the past year, uses condoms inconsistently.

Which of the following can be seen on a wet prep?

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Final answer:

A wet prep for a 21-year-old female with a foul-smelling vaginal discharge can show a white to yellow discharge, a fishy odor after the addition of KOH, a pH greater than 4.5, and the presence of clue cells, which indicate bacterial vaginosis if present.

Step-by-step explanation:

A wet prep examination of vaginal discharge can reveal various diagnostic signs that help in identifying the cause of vaginitis. In a case of a 21-year-old female presenting with abnormal discharge and a foul odor, the following can be observed on a wet prep:

  • A white to yellow discharge
  • A fishy odor, which becomes more noticeable when 10% KOH is added; this is a characteristic test called the amines or "whiff" test
  • A pH greater than 4.5, which indicates an alkaline environment often associated with bacterial overgrowth, such as that seen in bacterial vaginosis
  • The presence of clue cells; these are vaginal epithelial cells that have a stippled appearance due to being covered with bacteria

In Clinical Focus Part 3, it is mentioned that an overgrowth of yeast cells was observed on a wet-mount slide, indicating candidiasis (a yeast infection). However, the absence of clues would make bacterial vaginosis less likely as a diagnosis.

Treatment for vaginitis depends on the underlying cause and may involve oral or topical anti-fungal or antibiotic medications.

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