9

Question 1

vulvar lesions and their appearances

Answer 1

lichen sclerosis- crumped tissue paper

condyloma verrucous- cauliflower

melanoma- pigmented

paget’s: erythematous with lacy white mottling

squamous cell carc- 90%, elevated, firm, ulcerated, erythematous

Question 2

risk factors for vulvar squamous cell cars.

Answer 2

older- 65
HPV
smoker
immunosuppressed
long standing lichen sclerosis

Question 3

treatment for VIN III

Answer 3

superficial excision

Question 4

treatment for VIN II

Answer 4

laser ablation

Question 5

treatment for warts

Answer 5

trichloroacetic acid

Question 6

if 21 year old gets ASCUS on pap and HPV neg, whats next step?

Answer 6

repeat pap in 3 years

Question 7

if she has ASCUS and HPV pos. , whats next step?

Answer 7

colpo and repeat pap in 1 year

Question 8

white plaque on cervix

Answer 8

leukoplakia!

biopsy or colpo regardless of pap

Question 9

next step in positive endocervical curettage for high grade lesion in cervix

Answer 9

cervical colonization

Question 10

punctuations, mosaicism, and atypical vessels

Answer 10

new vascular abnormalities during cervical dysplasia

punctuations: new vessels on end
mosaicism: new vessels on their sides

atypical vessels : greater degree of angiogenesis, more concerning

Question 11

ectropion

Answer 11

area of columnar epithelium that has not yet undergone squamous metaplasia

reddish tissue of tissue surrounding external os

Question 12

should you follow fibroids during pregnancy if they aren’t in scary locations and have no symptoms?

Answer 12

no

Question 13

indications for cesarean if fibroids found in which locations

Answer 13

below fetus

lower uterine segment

cervix

(because the cause of a soft tissue dystocia)

Question 14

which locations of fibroids would cause miscarriages?

Answer 14

submucosal or intracavitary

Question 15

treatment of fibroids for post menopausal women

Answer 15

sample endometrial cavity for cancer

reassurance and observation if no iron def. anemia

hysterectomy if done with child bearing

Question 16

treatment of fibroids for pre menopausal women

Answer 16

sample endometrial cavity for cancer

reassurance and observation if no iron def. anemia

GnRH analogues (for 3-6 mo)

myomectomy

Question 17

what happens when you cease GnRH agonists?

Answer 17

fibroid returns to pre-treatment growth rate in 3-4 months

menses returns in 4-10 weeks

Question 18

indication for finding pelvic mass in pre menopausal woman with minimal symptoms

Answer 18

pelvic/transvaginal US

Question 19

risk factors for endometrial carc

Answer 19

**complex atypical hyperplasia
**obesity
post menopausal state
HRT
nulliparous

Question 20

what percent of women with endometrial carcinoma present with symptoms

Answer 20

80-90% present with vaginal bleeding and discharge

Question 21

if endometrial carcinoma confirmed by biopsy, what is next step?

Answer 21

TH BSO

Question 22

risk factors for ovarian cancer

Answer 22

nulliparity
family history
early menarche, late menopause
white, N. america and europe

Question 23

by what percent does taking OCPs for 5 years reduce your chance of ovarian cancer?

Answer 23

by 50%

Question 24

functional ovarian cysts

Answer 24

result of normal ovulation

unilocular simple cyst

Question 25

whats main source of vag lubrication for sex

Answer 25

transudate of vaginal mucosa