L5: Pruritis Vulvae & Vaginal Discharge Flashcards by Ahmed Farag

Q

Def of Pruritis Valvae

A

A burning vulval sensation, with a tendency to get relief by scratching.
It is a distressing symptom commonly encountered in gynecological practice.

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Q

Types of Pruritis Valvae

A

Pruritus vulvae with vaginal discharge.
Pruritus vulvae without vaginal discharge

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Q

Incidence of Pruritus Vulvae with vaginal discharge

A

Commonest type (80%)

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Q

Causes of Pruritus Vulvae with vaginal discharge

A

Monilial vaginitis.
Trichomonal vaginitis.

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Q

Incidence of Pruritus vulvae without vaginal discharge

A

Less common (20%).

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Q

Etiology of Pruritus vulvae without vaginal discharge

A

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Q

Etiology of Pruritus vulvae without vaginal discharge

Medical

A

DM, CRF, liver cirrhosis, obstructive jaundice & polycythemia.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Dermatological

A

Allergy, eczema, contact dermatitis, psoriasis &
Lichen planus.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Nutritional

A

Vitamin A deficiency.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Parasitic

A

Pediculosis, scabies & threadworms.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Neoplasm

A

VIN, Paget’s disease of vulva & cancer vulva.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Hygienic

A

Excessive use of vaginal antiseptics & vulval deodorants & sprays.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Urinary

A

Incontinence or fistula.

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Q

Etiology of Pruritus vulvae without vaginal discharge

Rectal

A

Rectovaginal fistula or complete perineal tear.

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Q

Dx of Pruritus Vulvae

A

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Q

Dx of Pruritus Vulvae

Hx

A

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Q

Dx of Pruritus Vulvae

Ex

A

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Q

Dx of Pruritus Vulvae

INVx

A

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Q

TTT of Pruritus Vulvae

A

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Q

TTT of Pruritus Vulvae

Cause

A

…..

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Q

TTT of Pruritus Vulvae

Local Hygiene

A

Avoid irritant soap, vaginal deodorants and perfumes.

Q

TTT of Pruritus Vulvae

General

A

Antihistaminics and sedatives.

Q

TTT of Pruritus Vulvae

Local

A

Antihistaminic cream.
Corticosteroid cream.
Estrogen (Premarin cream) for postmenopausal women.
Treatment of infection.

Q

TTT of Pruritus Vulvae

Surgical

A

Composition of **Normal Vaginal Discharge**

Characters of **Normal Vaginal Discharge**

Def of **Leukorrhea**

Causes of **Leukorrhea**

Dx of **Leukorrhea**

TTT of **Leukorrhea**

* It requires no treatment apart from reassurance

Causes of **Increased Vaginal Discharge**

Causes of **Vaginal Discharge**

Causes of **Vaginal Discharge** - Mucoid

as the causes of leukorrhea.

Causes of **Vaginal Discharge** - Muco-Purulent

Cervicitis

Causes of **Vaginal Discharge** - Yellowish Offensive

- Candidiasis, trichomoniasis, bacterial v., cervicitis and foreign bodies.

Causes of **Vaginal Discharge** - Sanguineous

Senile vaginitis, ulcers, cervical polypi, vascular erosions & neoplasms

Causes of **Vaginal Discharge** - Offensive

- Foreign bodies, malignancies, rectovaginal fistula & pregnancy complications like septic abortion or puerperal infection.

Causes of **Vaginal Discharge** - Watery

- Urinary fistula, intermittent hydrosalpinx, hydrorrhoea gravidarum, molar pregnancy and cystic degeneration with malignancies.

Dx of **Increased Vaginal Discharge**

Dx of **Increased Vaginal Discharge** - Hx

Dx of **Increased Vaginal Discharge** - Ex

Examination of Sample in Dx of **Increased Vaginal Discharge**

Examination of Sample in Dx of **Increased Vaginal Discharge** - Fresh drop examination of the discharge

By adding a drop of saline and examine under light microscopy. - Mobile flagellated protozoa (trichomonas vaginalis) - Presence of clue cells (bacterial vaginosis.

Examination of Sample in Dx of **Increased Vaginal Discharge** - Add 10% KOH te the discharge

- The smell of amine or fishy odor is characteristic for bacterial vaginosis. - The presence of pseudohyphae and spore are diagnostic of candidiasis.

Examination of Sample in Dx of **Increased Vaginal Discharge** - Gram Stain

- For the presence of the gram -ve intracellular diplococci (gonorrhea) or other bacteria strains.

Examination of Sample in Dx of **Increased Vaginal Discharge** - Culture

Dx of **Increased Vaginal Discharge** - Serology

Dx of **Increased Vaginal Discharge** - Cytology

for malignancy.

Dx of **Increased Vaginal Discharge** - Biopsy

from any ulcers or lesions.

Dx of **Increased Vaginal Discharge** - Urine & Stool Analysis

for parasites (Entrobius).

Dx of **Increased Vaginal Discharge** - Plain X-Ray

for foreign bodies.

Dx of **Increased Vaginal Discharge** - Cystoscopy

for urinary fistula.