3: Vulva and Vagina

Question 1

examples of ambiguous genitalia

Answer 1

1. clitoromegaly or clitoral agenesis
2. bifid clitoris, midline fusion of labiascrotal folds
3. cloaca (no separation between vagina and bladder)

Question 2

next steps for a newborn with ambiguous genitalia

Answer 2

physical exam, US, hormonal studies, karyotyping

Question 3

with ambiguous genitalia, what gender is a newborn assigned?

Answer 3

female

Question 4

vaginal adenosis

Answer 4

columnar cells or glandular cells in the normal squamous epithelium of the vagina

Question 5

major cause of vaginal adenosis

Answer 5

DES exposure in utero

Question 6

Word catheterization for bartholin gland abscess

Answer 6

cath left in for 4-6 weeks to promote an epithelialized tract for secretion drainage

Question 7

marsupialization for bartholin’s gland abscess

Answer 7

creates new ductal opening by everting the cyst wall onto the epithelial surface with sutures

Question 8

MC cause of vaginal trauma

Answer 8

sexual assault

Question 9

structural changes in the vagina after menopause

Answer 9

vaginal rugations flatten, epithelia becomes thin, pale, and inelastic, pH rises

Question 10

two chemicals from lactobacilli in the vagina that keep the pH low

Answer 10

lactic acid, hydrogen peroxide

Question 11

normal vaginal pH

Answer 11

3.8-4.2

Question 12

three exam steps for investigating vaginal discharge

Answer 12

1. history: color, amount, texture, odor
2. nitrazine paper: for pH
3. microscope: for organisms