Chapter 35 Management of Diseases of the Vulva and Vagina

Question 1

hpv dna is often associated with vain and vaginal cancer. over 90% of VAIN lesions harbored hpv dna with __ found most frequently among VAIN lesions

Answer 1

hpv 16

Question 2

diagnosis of VAIN

Answer 2

colposcopic findings similar to cerical intraepithelial neoplasia (CIN1)lesions.
Lugol’s solution may be helpful in delineating lesions.
biopsy with alligator jaw forceps.

Question 3

management of VAIN:

Answer 3

local excision
co2 laser ablation
intravaginal 5-fluorouracil (5fu)

Question 4

pigmented lesions often harbor

Answer 4

carcinoma in situ

Question 5

management of VAIN:

Answer 5

surgical exision, 5mm disease free margins.
co2 aser: must rule out invasive disease, depth of destruction 3mm in hair-bearing skin, deep burns heal slowly and may be painful.
recurrences common: regular f/u surveillance, biopsy of suspicious lesions.

Question 6

topical __ 5% cream, originally developed to treat genital condyloma, has been found to be active in the treatment of some VIN lesions. imiquimod treatment associated with shrinkage in lesion size ove 20 weeks of treatment. 9 pts had a complete response at 20 weeks and remained disease free for 12 months.

Answer 6

imiquimod 5%

Question 7

invasive cancer of the vagina, only _ to _ % of all genital cancers

Answer 7

1-3%

Question 8

most vaginal cancers in the upper __ of vagina

Answer 8

1/3

Question 9

invasive cancer of the vulva - 80% are

Answer 9

squamous cell carcinomas