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Clin Med II - Exam 5 > Seibert - Disorders of the Vulva, Vagina, Cervix > Flashcards

Seibert - Disorders of the Vulva, Vagina, Cervix Flashcards

1
Q

commonly seen conditions of the vulva

A

lichen sclerosis

lichen simplex chronicus

lichen planus

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2
Q

mc non-neoplastic vulvar epithelial d.o

A

lichen sclerosus

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3
Q

intense vulvar pruritis usually in women > 60 yo

A

lichen sclerosus

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4
Q

what is this

A

lichen sclerosus

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5
Q

benign epithelial thickening and hyperkeratosis resulting from chronic irritation

A

lichen simplex chronicus

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6
Q

which type of lichen needs bx to r.o cancer

A

lichen simplex chronicus

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7
Q

what is this

A

lichen simplex chronicus

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8
Q

inflammatory AI lichen

A

lichen planus

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9
Q

tx for the lichens

A

steroids

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10
Q

what do you think when you see: recurrent oral ulcers, recurrent genital aphthae/ulcerations, and uveitis

A

bechet’s syndrome triad

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11
Q

what is this

A

bachet’s

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12
Q

sexually transmitted conditions

A

pediculosis pubis

condyloma acuminatum

HSV

molluscum contagiosum

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13
Q

crab louse transmitted through sexual contact or shared infected bedding or clothing

A

pediculosis pubis

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14
Q

std that has distinctly verrucous lesions and involves asymptomatic papillary growths

A

condyloma acuminatum

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15
Q

condyloma acuminatum is caused by

A

HPV

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16
Q

what do you think when you see vesicles that erode rapidly resulting in painful ulcer, surrounded by red halo

A

HSV

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17
Q

main complication of HSV

A

transmission to neonate during birth

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18
Q

prodrome of HSV mimics

A

flu

(covid)

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19
Q

benign epithelial poxvirus that is dome shaped w. a typical umbilicus; typically not itchy

A

molluscum contagiosum

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20
Q

molluscum contagiosum is usually seen in __

but can also be __

A

kids

sexually transmitted

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21
Q

what is this

A

molluscum contagiousum

fleshy warts

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22
Q

in adults, molluscum contagiosum is considered

A

STI

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23
Q

obstruction of main duct of bartholin gland

A

bartholin duct cyst and abscess

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24
Q

fxn of bartholin gland

A

moisturize vulva/vagina → obstruction causes cyst/abscess

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25
Q

sx of bartholin cyst/abscess

A

pain

tendernes

dyspareunia

difficult walking

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26
Q

what is this

A

bartholin gland cyst

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27
Q

tx for bartholin gland cyst

A

I&D

catheter placement

marsupialization

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28
Q

atrophy 2/2 diminished estrogen levels; mc in post-menopausal women; pH of vagina abnormally high

A

atrophic vaginitis

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29
Q

tx for atrophic vaginitis

A

supplemental estrogen therapy

if no contraindications

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30
Q

topical estrogens

A

premarin

estrace

vagifem

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31
Q

90% of vulvar malignancy is

A

squamous cell carcinoma

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32
Q

what might you see on the hx of a pt w. vulvar malignancy

A

lichen sclerosis

Bachet’s

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33
Q

rf for vulvar malignancy

A

smoking cigs

HPV

immunodeficiency

hx cervical carcinoma

chronic vulvar irritation

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34
Q

vulvar malignancy is sensitive to

A

chemo

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35
Q

in situ adenocarcinoma in epithelium of vulva and perianal regions

A

paget dz of the vulva

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36
Q

itchy, red crusted lesions usually on labia majora; +/- superficial white coating, “cake icing”

A

paget dz of vulva

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37
Q

tx for paget dz of the vulva

A

refer to gyn

bx

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38
Q

normal vaginal environment is

A

acidic

lots of vaginal flora

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39
Q

how should the vagina be cleaned

A

it is a self cleaning system!!

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40
Q

mc reason for pt visits to gynecology offices

A

vulvovaginitis

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41
Q

mc causes of vulvovaginitis

A

bacterial vaginosis (BV)

trichomoniasis

candidiasis

can be associated w. all 3

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42
Q

which of the 3 causes of vulvovaginitis is considered an STI

A

trichomoniasis

43
Q

bv is caused by

A

gardnerella vaginalis

44
Q

vaginal candidiasis is caused by

A

c albicans

45
Q

what promotes c. albicans infxn (4)

A

systemic abx

DM

pregnancy

OCP

46
Q

what do you think when you see: motile, pear-shaped flagellated cells and strawberry cervix

A

trichomoniasis vulvovaginitis

47
Q

5 tests for vulvovaginosis

A

vaginal pH

amine whiff test

KOH

saline (wet prep)

DNA of gardnerella vaginalis, trichomonas vaginalis

48
Q

if a non sexually active pt presents w. a yeast infxn that you determine to be candidiasis, do you need to test for chlamydia/gonorrhea

A

no!

candidiasis is not an STI

49
Q

90% of vulvovaginal candidiasis is caused by

A

candidia albicans

50
Q

what do you think when you see: itching, white vaginal discharge, vulvar erythema, high pH, odorless

A

vulvogainal candidiasis

51
Q

gold standard dx for vulvovaginal candidiasis

A

vaginal culture

52
Q

branching pseudohyphae and spores; spaghetti and meatballs

A

KOH finding for vulvovaginal candidiasis

53
Q

tx for vaginal candidiasis

A

creams, suppositories, oral:

fluconazole

clotrimazole

miconazole

nystatin

54
Q

for dx of BV you need 3 out of what 4 criteria

A

abnormal gray discharge

pH > 4.5

(+) whiff test

presence of clue cells

55
Q

thin gray-white to yellow discharge

A

gardnerella vaginitis

56
Q

ground glass appearance

A

clue cells → BV

57
Q

tx for bv

A

metronidazole

clindamycin

58
Q

tx for pregnant pt w. BV

A

metronidazole

59
Q

flagellate protozoan that lives in vagina, skene ducts, and male or female urethra

A

trichomonas vaginitis

60
Q

what do you think when you see: vulvar itching, burning, copious discharge w. odor, dysuria, dyspareunia

A

trichomonas vaginitis

61
Q

thin, frothy discharge, foul smelling, yellow-green, pH > 5, strawberry cervix

A

trichomonas vaginitis

62
Q

dx for trichomonas vaginitis

A

wet-mount prep

63
Q

tx for trichomonas vaginitis

A

systemic metronidazole

64
Q

thick, frothy, foul flagellates

A

trichomonas

65
Q

grey, pH, whiff, clue

A

BV

66
Q

itchy, white, adherent, no odor

A

candidiasis/yeast

67
Q

what do you think when you see: abnormal malodorous vaginal discharge, intramenstrual bleeding

A

foreign bodies

68
Q

retained tampons usually cause

A

ulcerative lesions

69
Q

toxic shock syndrome is caused by what pathogen

A

staph vaginal infxn

70
Q

when would you use abx for foreign body

A

cellulitis

systemic sx → fever

71
Q

recommendation for tampons

A

least absorption for the least amount of time

72
Q

sx of TSS are similar to flu, how do you differentiate

A

menstruating woman who uses tampons

BP changes

rash

73
Q

any menstruating woman presenting w. sudden onset of febrile illness should be evaluated and treated for

A

TSS

74
Q

tx for TSS

A

remove tampon

vaginal cultures

copious irrigation

b-lactamase resistant PCN or vano

75
Q

can patients who have had TSS use tampons again

A

no! → high risk to get it again

76
Q

inflammatory disorder of the upper genital tract that is a serious cause of morbility, mortality, and infertility

A

PID

77
Q

PID is often caused by

A

n. gonorrhea

78
Q

PID can also be caused by

A

c trachomatis

anaerobes

79
Q

PID can easily be confused with

A

TSS

acute appendicitis

80
Q

6 rf for PID

A

< 25 yo

previous PID

untreated STI

multiple sex partners

douching

IUD

81
Q

what can be a unique sx of PID (2)

A

irregular vaginal bleeding

cervical motion tenderness

82
Q

vague sx of PID

A

abd pain

fever

vaginal/cervical d.c

pain or bleeding w. intercourse

83
Q

minimum criteria for PID dx

A

cervical motion tenderness

OR

uterine motion tenderness

OR

adnexal tenderness

PLUS

fever, cervical d.c, elevated ESR/CRP, documented cervical infxn

84
Q

should you wait confirm PID dx before treating it to

A

no!

85
Q

tx for PID

A

ceftriaxone IM PLUS doxycycline

+/- metronidazole

86
Q

all tx protocols for PID must treat

A

gonorrhea

chlamydia

87
Q

education regarding sexual intercourse during PID tx

A

avoid intercourse for entire tx course

88
Q

you must do a __ on all patients w. suspected PID

A

pelvic exam

89
Q

85% of malignant diseases of the vagina are

A

squamous cell cancers

90
Q

what is DES

A

diethylstilbestrol → synthetic nonsteroidal estrogen

increases risk for vaginal clear cell carcinoma and other GU tract abnormalities in utero

91
Q

what is a cystocele

A

bladder prolapse

92
Q

what is a cystourethrocele

A

bladder and urethra prolapse together

93
Q

eversion of columnar epithelium onto ectocervix; cervix appears red, granular, inflamed

A

ectropion

94
Q

ectropion is benign and associated w. __ (2)

but needs __

A

hormone changes → pregnancy/puberty

cervical ca work up

95
Q

very common, typically asymptomatic translucent-yellow mucous-filled cyst on the surface of the cervix

A

nabothian cyst

96
Q

cervicitis indicates

A

spread of vaginal infxn

97
Q

major concern w. cervicitis

A

infxn will spread and cause PID

98
Q

2 major sign of cervicitis

A

cervical friability →

spotting

post coital bleeding

99
Q

major sx of chronic cervicitis

A

leukorrhea

100
Q

major cause of amenorrhea

A

cervical stenosis

101
Q

condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy

A

incompetent cervix

102
Q

tx for incompetent cervix

A

cervical cerclage

progesterone

103
Q

if you ever have a doubt about a diagnosis, you should

A

refer!

104
Q

think __

treat __

save __

A

infection

infection

fertility

Clin Med II - Exam 5 (23 decks)

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