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R2F > Benign and Malignant conditions of the Vulva and Vagina > Flashcards

Benign and Malignant conditions of the Vulva and Vagina Flashcards

1
Q

Female Pseduohermaphroditism

A
  • masculinization in utero of the female terus
  • CAH, exogenous H’s, androgen secreting tumors
  • clitormegaly, hypospadic urethra meatus, malpositioned vaginal orifice
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2
Q

Male Pseudohermaphroditism

A
  • results from mosaicism
  • virtualization and mullerian development
  • AIS (testicular feminization)
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3
Q

Androgen Insensitivity

A
  • def in androgen Rs
  • 46,XY
  • external female phenotypic development
  • testes are undescended
  • mullerian inhibiting substance- absent uterus
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4
Q

True hermaphroditism

A
  • rare

- male and female development externally and internally

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5
Q

labial agglutination

A
  • tx by estrogen cream

- separate labia majora

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6
Q

fox-fordyce disease

A
  • pruritic raised yellow retention cyst in axilla and labi majora/minora
  • from keratin-plugged infl of apocrine glands
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7
Q

inclusion cyst

A
  • most dont require tx
  • mobile, nontender, spherical, slow growing
  • epidermal= most common type of genital yst
  • hair follicles are obstructed
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8
Q

vulvar varicosities

A
  • enlarge, painful in pregnancy

- blue color

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9
Q

lentigo and nevi

A
  • lentigo (freckles)
  • nevi (moles)
  • need to distinguish from melanomas!!!
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10
Q

Urethral caruncles

A
  • small fleshy red outgrowth at distal edge of urethra

- children and post menopausal women

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11
Q

Vulvar vestibulitis

A
  • minor vestibular glands become infected
  • extremely tender!!! erythematous dots
  • severe introital dyspareunia
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12
Q

sebaceous cyst

A

infl blockage of sebaceous gland ducts

-cheesy sebaceous material

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13
Q

fibromas

A

-most common benign solid tumors of vulva!!!

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14
Q

traumatic lesions of vulva

A
  • vulvar hematoma- straddle injury, birth trauma
  • female genital circumcision
  • obstetric related trauma
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15
Q

Atrophic vaginitis

A
  • due to loss of estrogen- menopause, surgical
  • atrophy external genitalia- minora regresses, majora shrinks, loss of vaginal rugae
  • tx- topical estrogen
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16
Q

Lichen Simplex Chronicus (Squamous Cell Hyperplasia)

A
  • local thickening of epit- from prolonged itch!!
  • pruritus!!
  • white/reddish, thickened, leathery, raised surface
  • bx- elongated rete ridges, hyperkeratosis
  • tx- steroid
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17
Q

Lichen Sclerosis

A
  • on vulva of menopausal women
  • can develop SCC of vulva
  • pruritus!!
  • thin, white, parchment like
  • bx- thin epit, loss of rete ridges, infl cells
  • tx- steroid
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18
Q

Lichen Planus

A
  • purplish, polygonal papules
  • vulvar-vaginal-gingival syndrome
  • vulvar burning, severe insertional dyspareunia
  • tx- steroids
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19
Q

psoriasis

A
  • AD

- appears velvety

20
Q

Aphthous ulcers

A
  • superficial, painful

- common in mouth

21
Q

Decubitus ulcer

A

-from chronic pressure, moist due to urinary incontinence

22
Q

Contact dermatitis

A
  • specific irritant!!

- erythema, edema, ulceration

23
Q

Vagina- congenital anomalies

A
  • imperforate hymen

- transverse or midline longitudinal septum

24
Q

vaginal agenesis

A

-RKHS (mullerian agenesis)

25
Q

adenosis

A
  • columnar cells in normal squamous epit-

- DES!!

26
Q

gartner’s duct cyst

A
  • remnant of wolffian duct
  • lateral walls of vagina
  • most are asx
27
Q

Urethral diverticula

A
  • projections in ant vagina along post urethra

- can cause TI, dysuria

28
Q

inclusion cyst

A
  • infolding of vaginal epit
  • post or lateral wall of vagina
  • childbirth
29
Q

Bartholin’s cyst

A
  • most common vulvovaginal tumor!!!
  • asx
  • bx- rule out bartholin’s carcinoma
30
Q

Bartholin’s gland abscess

A
  • blockage and accum of purulent material
  • word catheterization
  • marsupialization
31
Q

ulvar neoplasms

A
  • most are SCC!!!
  • postmenopausal women
  • hx of chronic vulvapriritis
  • VIN (SCC in situ)
32
Q

preinvasive cancer of vulva

A
  • VIN (SCC in situ)
  • VIN usual-type- HPV, smoking, immunocompromised!!
  • differentiated type IVN- not assoc with HPV pr smoking!!!- assoc with LS
33
Q

VIN- sx, tx

A

-pruritus!!
-bx!
tx- superficial surgical excision

34
Q

Paget’s disease of vulva

A
  • postmenopausal
  • also in nipple areas of breast
  • itching, tenderness!!
  • white plaque lesions
  • large pale Paget’s cells
  • local superficial excision
35
Q

Squamous cell vulvar carcinoma

A
  • postmenopausal, 70-80 yo
  • vulvar lump
  • pruritic, raised, ulcerated, pigmented
  • bx!!!
  • direct extension, lymphatic, hematogenous
36
Q

Rare vulvar carcinomas

A
  • malignant melanoma
  • verrucous carcinoma
  • bartholin’s gland carcinoma
  • basal cell carcinoma
37
Q

malignant melanoma

A
  • 2nd most common vulvar cancer

- postmenopausal

38
Q

Verrucous carcinoma

A
  • variant of SCC
  • cauliflower-like- can be confused with condyloma!!
  • *Radiation is contraindicated- may induce anaplastic transformation!!!
39
Q

Vaginal Intraepit Neoplasia (VAIN)

A
  • HPV!!!
  • most have prior/coexistent neoplasia of cervix or vulva
  • asx!
  • colposcopic directed vaginal bx!!!
40
Q

carcinoma of vagina

A
  • 60 yo
  • SCC- most common
  • sx- abnormal vaginal discharge/bleeding, hematuria
  • ulcerative, exophytic growth
  • dx- punch bx
  • tx- radiation or chemoradiation
41
Q

normal microecology of vagina

A
  • vagina- non keratinized stratified squamous epit

- lactic acid and H2O2- lactobacilli- pH is 3.8-4.2

42
Q

factors that alter the protective microflora

A
  • abx
  • douching
  • intercourse
  • foreign body
43
Q

vaginal discharge- investigation

A
  • nitrazine paper- pH

- microscope

44
Q

Bacterial vaginosis

A
  • most common cause of vaginitis
  • Gardnerella
  • malodorous fishy amine odor
  • clue cells!!
  • KOH-positive whiff test- amine-like odor
  • vaginal pH> 4.5
  • tx- metronidazole
  • not a STI
45
Q

Vulvovaginal candidiasis

A
  • Candida
  • risk factors- inc estrogen levels, DM, abx, steroid use
  • vulvar pruritus, burning
  • cottage cheese like discharge
  • budding yeast- KOH wet prep
  • pH < 4.5
46
Q

Trichomoniasis

A
  • 50% asx
  • dyspareunia
  • green-yellow frothy vaginal discharge
  • wet mount- trichomonads, pH> 4.5
  • strawberry cervix!!!
  • tx- metronidazole
  • STI!!!

R2F (18 decks)

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