Clue cells are seen in:

Ans: A (Gardenella vaginits) Ref: Dm to gynae pgl56Explanation:GARDNERELLA VAGINOSISAlteration in normal vaginal floraDecrease in number of lactobacilli in vaginal discharge - lactobacilli reduce pH and release hydrogen peroxide toxic to other bacteria100 fold increase in anerobic bacteriaHemophilus vaginalis, Gardnerella, Mohi- 1 uncus and Mycoplasma horn inis--causeVaginal discharge without dischargeWhite , milky non-viscous discharge. pH of discharge more than 4.5Whiff Test - Fishy odour when vaginal discharge is mixed with 10% KOH - due to release of amino metabolites from various organismsPresence of Clue Cells - epithelial cells with granular cytoplasm caused by gram negative bacilli adhering on the surfaceWet smear, gram stain and culture are investigationsTreatment--Metronidazole 500mg bd for 7 days Ampicillin 500mg or cephalosporin 500mg bd for 7 days Tetracycline 500mg 4 times a day Doxycycline l00mg bdSulphafurazole Ig 4 times daily for 10-14 daysClindamycin 300mg daily for 7 daysClindamycin 2%cream locallyOrnidazole 500mg vaginal tablet for 7 daysLacteal is protein free acidifying lactate gel neutralises vaginal ph 5ml applied for 7 daysAMSEL CRITERIA for diagnosing Bacterial VagninosisThin, white, yellow, homogeneous dischargeClue cells on microscopypH of vaginal fluid >4.5Release of a fishy odor on adding alkali--10% potassium hydroxide (KOH) solution.At least three of the four criteria should be present for a confirmed diagnosis.