Family Nurse Practitioner Exam

What would be observed on a wet-mount slide for bacterial vaginosis?

1. A large amount of leukocytes and epithelial cells

2. A large amount of bacteria coating squamous cells and few leukocytes

3. Epithelial cells with a small amount of blood

4. Tzanck cells

The correct answer is: A large amount of bacteria coating squamous cells and few leukocytes

Bacterial vaginosis (BV) is characterized by a specific alteration in the normal vaginal flora, often leading to an increase in certain types of bacteria. When a wet-mount slide is prepared for evaluation in cases of bacterial vaginosis, what is typically observed is a large number of bacteria coating the vaginal squamous epithelial cells, along with a relatively low number of leukocytes. This observation is significant because it reflects the shift from a normal flora, which predominantly includes lactobacilli, to an overgrowth of various anaerobic bacteria often associated with bacterial vaginosis, including Gardnerella vaginalis. The presence of these bacteria can give the epithelial cells a distinct "clue cell" appearance, where the cells appear to be covered with a thin layer of bacteria. The low number of leukocytes is also noteworthy, as this contrasts with other infections such as bacterial or yeast infections, where you would typically find a higher leukocytic response. Recognizing this pattern is essential for accurate diagnosis and management of bacterial vaginosis, as it guides appropriate treatments.