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Gynecology > Disorders of the Vulva and Vagina > Flashcards

Disorders of the Vulva and Vagina Flashcards

1
Q

Vulva may contain?

A

Breast tissue

Can become swollen after delivery

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2
Q

Vaginitis

A

Inflammation or infection of the vagina.

Change of volume, color, odor of discharge

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3
Q

Normal vaginal pH

A

3.5 - 4.5

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4
Q

Trich infection pH

A

5.0 - 6.0

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5
Q

Bacterial Vaginosis pH

A

> 4.5

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6
Q

Candidial infxn pH

A

4.0 - 4.5

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7
Q

Clue cells on saline wet mount

A

Bacterial Vaginosis

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8
Q

KOH Prep

A

Reveals hyphae and budding of yeast

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9
Q

Bacterial vaginosis usually only causes

A

Malodorous or copious discharge

Does not cause painful urination or inflammation

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10
Q

BV Tx

A

Flagyl 500mg BID x 7 days

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11
Q

BV Tx for pregnant and nursing

A

Clindamycin

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12
Q

Candidiasis

A

Thick, white cottage cheese discharge
Usually colonize from anus
Rarly transmitted sexually

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13
Q

Candidiasis prevention

A

Keep external area clean and dry
Avoid douches, irritating soaps
Change tampons frequently
Wear loose underwear

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14
Q

uncomplicated yeast infxn tx

A

Fluconazole (Diflucan) 150mg x 1 dose

OTC intravaginal ointments

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15
Q

Complicated infxn tx

A

Floconazole (diflucan) 150mg 2-3 doses 72 hrs apart.
Topical therapy
Intravaginal boric acid tablets for 2 wks
Flucytosine cream qHS for 2 wks

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16
Q

Intravaginal boric acid is …

A

Fatal if swallowed

17
Q

Most common STI in the world

A

Trichomonas Vaginitis

18
Q

Trichomonas Vaginitis

A

Flagellated protozoan
Infects both males and females
Males generally asymptomatic

19
Q

Trich presentation

A

Malodorous, thin green/yellow d/c
Burning, dysuria, frequency
Pruritis, painful sex, post-coital bleeding

20
Q

Trich dx

A

pH 5-6
Mobile organisms on wet mount
Rapid antigen test
Strawberry cervix

21
Q

Trich tx

A

For everyone: 2 g flagyl one dose

For HIV: 7 day course BID

22
Q

Genital Herpes

A

Painful ulcers and itching
Dysuria
Tender inguinal lymphadenopathy
Constitutional sx

23
Q

Herpes Tx

A

Treat within 72 hrs

Acyclovir (zovirax) 400mg TID for 7-10 days

24
Q

Most common viral STD in the US

A

Condylomata Acuminata

Anogenital Warts

25
Q

Anogenital Warts

A

Condylomata Acuminata
women 67% of pop
HPV 6 and 11

26
Q

Warts tx

A

Chemical destruction
Immunologic
Surgery

27
Q

Molluscum Contagiosum

A

Painless domes

Can be sexually transmitted

28
Q

Atrophic vaginitis

A

Caused by decreased estrogen (menopause)
Dryness, burning itching
Decreased lubrication during sex
Bleeding, discharge

29
Q

Atrophic vaginitis tx

A

Moisturizers, lubricants

Estrogen therapy

30
Q

Lichen sclerosis

A

Intense inflammatory rxn in non-child-bearing pop.

Painful pruritis and itching - may interfere w/ sleep

31
Q

Lichen sclerosis PE

A

Chronic inflammation
Well demarcated white atrophic patches
Labia minora shrinks and clitorous may be lost

32
Q

Lichen sclerosis tx

A

Clobetasol propionate .05% cream for 6-12 weeks
then
Maintenance therapy 1-3 x/wk

33
Q

Bartholin glands

A 
2-3% of women develop cysts or abscesses
Most common large cyst of vulva
Mostly asymptomatic
Must exclude carcinoma in women over 40
No tx for women under 40
34
Q

Bartholin abscess s/s

A

Swelling and exquisite pain
Erythematous and warm
Polymicrobial

35
Q

Bartholin abscess tx

A

I&D

Word catheter for 4 wks

36
Q

Cystocele

A

Bladder prolapse into vagina

37
Q

Pagets Dz

A

Intraepithelial carcinoma of genital, perianal and axillary areas.
Red, scaly velvety esions
Itching, burning and bleeding
Excise.

38
Q

Vulvar CA

A

4th most common GYN CA
Pruritis most common complaint
Many pts are asymptomatic
Mostly squamous cell

39
Q

Vaginal Intraepithelial Neoplasia (VAIN)

A

Caused by HPV 6 and 11

Gynecology (6 decks)

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