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Clin Med Final Material 5 > Disorders of the Vulva, Vagina, and Cervix- Seibert > Flashcards

Disorders of the Vulva, Vagina, and Cervix- Seibert Flashcards

1
Q

When in doubt what should you do?

A

Refer for bx

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2
Q

A patient presents with intense vulvur pruritis in a >60 year old woman. Her vulvar skin is thin and wrinkled and has a “cigarette appearance” with areas of linchenification and hyperkeratosis. What is the most likely diagnosis?

A

Lichen sclerosis

*Seibert referred to it as “simple itch”

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3
Q

What is the tx for lichen sclerosis?

A

*need bx w/ gyno
Stop the its scratch cycle
-antihistamine @ night and high potency topical steroid (Clobetasol)

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4
Q

Those with Lichen Sclerosis are at higher risk for what type of cancer?

A

LIchen scleroris = simple itch = squamous cell CA

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5
Q

A patient presents with a thickened, leathery appearance on her labia majora. She states she has been itching and rubbing the area and that it has become very irritated. What is the most likely dx?

A

Lichen Simplex Chronicus

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6
Q

Treatment for Lichen Simplex Chronicus?

A

*need bx w/ gyno

Oral antihistamines and medium potency steroid like triamicolone or betamethasone

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7
Q

A patient presents with sharply marginated, flat topped papules on skin and less sharply marginated white plaques that are itchy and burning. What is the most likely dx?

A

Lichen planus

*has a propensity for mucous membranes

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8
Q

Treatment for lichen planus?

A
  • need bx w/ gyno

- topical with hydrocortisone foam for vagina

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9
Q

The triad of reccurent oral ulcers, recurrent genital aphthae or painful ulcerations, uveitis is in what condition?

A

Behcet’s Syndrome

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10
Q

This is associated with the HLA-B51?

A

Behcet’s Syndrome (autoimmune)

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11
Q

Treatment for Behcet’s Syndrome?

A

topical and systemic corticosteroids

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12
Q

A patient presents with intense pubic and anogenital itching. Physical exam shows pale brown insects or ova may be seen on hair shafts. What is the most likely dx?

A

Pediculosis pubis (crabs)

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13
Q

What is the treatment for Pediculosis pubis (crabs)?

A

Permethrin cream or lindane shampoo

*MUST TREAT ALL CONTACTS and STERILIZE CLOTHING

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14
Q

A patient presents with asymptomatic papillary growths on the vulva. What could be the cause of this?

A

Condyloma Acuminatum caused by HPV

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15
Q

What is the tx for Condyloma Acuminatum?

A

Imiquimod

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16
Q

A patient presents with vesicles and painful ulcers on the genitals. WHat is the most likely dx?

A

HSV

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17
Q

What is the tx for HSV?

A

Acyclovir for all

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18
Q

On physical exam, a patient presents with pearly, dome-shaped papules with dimpled center. What is the tx?

A

-Reassurance bc goes away on own or you can do Imiquimod

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19
Q

A patient complains with a 2 day hx of pain, tenderness, difficulty walking and painful sex. She states there is swelling and pain around her vagina area. On examination you notice a pea size cyst at 5 o’clock. What is the most likely dx and what is the tx?

A

Batholin duct and abscess

Tx: I&D, catheter placement and abx

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20
Q

A post-menopausal woman complains of vaginal dryness, itching and burning. Physical exam shows thin vaginal epithelium and loss of elasticity. What could be the cause of this?

A

Atrophic vaginitis

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21
Q

Tx for Atrophic vaginitis?

A

Supplemental estrogen therapy

-Premetharin vaginal cream

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22
Q

What type of cancer is mc for vulvar malignancy?

A

Squamous cell carcinoma

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23
Q

A patient presents with a hx of vulvar irritation, pruritis, local discomfort and bloody discharge. It looks like she may have an ulcer on her vulva. What are the next steps? What is the most likely dx?

A

Refer for bx - vulvar malignancy

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24
Q

Treatment for vulvar malignancy?

A

Surgery

25
Q

A patient presents with itchy, red, crusted lesions usually on labia majora and may have superficial white coating “cake icing.” What is the most likely dx and what is the next step?

A

Paget disease of the vulva and refer to gyn for bx

26
Q

What is the normal pH of the vagina?

A

3.8-4.5

27
Q

What are the three most common causes of vulvovaginitis?

A

Bacterial vaginosis, candidiasis, trichomoniasis

28
Q

T/F: vulvovaginal candidiasis is an STD

A

False- its not an STD

29
Q

What is the GS for diagnosis of vulvovaginal candidiasis?

A

vaginal culture

30
Q

A patient presents with a 1-week hx of itching, white vaginal discharge and burning following urination. What is the most likely organism and cause?

A

Vulvovaginal candidiasis

and

Candidia albicans

31
Q

spachetti and meatballs on wet prep? or budding hyphae?

A

Candidiasis

32
Q

Treatment for Vulvovaginal candidiasis?

A

“Azoles”

Fluconazole

33
Q

What is the Amsel Criteria?

A

A criteria used to dx BV. Must have 3 of the following 4 criteria:

  1. Abnormal gray d/c
  2. pH >4.5
    • whiff test
  4. Presence of clue cells
34
Q

clue cells and ground glass appearance

A

BV

35
Q

What organism causes BV?

A

gardnerlla vaginitis

36
Q

Tx for BV?

A

Metronidazole

37
Q

strawberry cervix

A

Trichomonas vaginitis

38
Q

Pt complains of foul odorous and frothy green d/c x 3 days. On physical exam you notice a strawberry cervix. what is the most likely dx?

A

Trichomonas

39
Q

Wet mount of this condition shows motile flagellates?

A

Trichomonas

40
Q

Treatment for Trichomonas?

A

Metronidazole with partner prophylaxis

41
Q

Thick, frothy, foul flagellates

A

Trichomonas

42
Q

Grey, pH, whiff, clue

A

BV

43
Q

itchy, white, adherent, no odor

A

Candidiasis/yeast

44
Q

Toxic shock releases what toxin?

A

Staph exotoxin

45
Q

A menstruating women presents with sudden onset of febrile illness. What should we tx her for?

A

Toxic shock

46
Q

Tx for toxic shock?

A
  • Remove tampon
  • irrigation
  • B lactamase resistant PCN or vanco IMMEDIATELY
47
Q

This disease is caused by N. gonorrhoeae +/- trachomatis which can cause subtle signs like myalgias, aches, I don’t feel good

A

PID

48
Q

What are some risk factors for PID?

A
  • younger than 25
  • previous PID
  • untreated STI
  • multiple sexual partners
  • uses douche
  • IUD
49
Q

What is the minimum criteria for PID?

A

cervical motion tenderness OR uterine motion tenderness OR adnexal tenderness PLUS fever, cervical discharge, elevated ESR, elevated CRP, documented cervical infection

50
Q

Treatment for PID?

A

Ceftriaxone + Metro +/- doxy

51
Q

Most vaginal cancers are what type?

A

Squamous cell carcinoma

52
Q

What is the word for eversion of columnar epithelium onto ectocervix where the cervix appears red, granular and inflammed?

A

Ectropion

53
Q

This is when there is a translucent-yellow mucus filled cyst on the surface of the cervix

A

Nabothian cyst

54
Q

This commonly occurs after menopause and is where the the passageway through the cervix (from the vagina to the main body of the uterus) is narrow or completely closed.

A

cervical stenosis

55
Q

How is the dx for cervical stenosis made?

A

Diagnosis made when you are unable to pass a sound or dilator through the cervical opening

56
Q

If you suspect a cervical bx, what should you do?

A

Biopsy and refer!

57
Q

Occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy.

A

Incomptent cervix

58
Q

Treatment for Incomptent cervix?

A

Cerclage and progesterone

Clin Med Final Material 5 (18 decks)

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