vagina

Question 1

anterior vs posterior vaginal prolapse

Answer 1

anterior: cystocele or cystourethrocele
posterior: enterocele or rectocele

Question 2

vaginal prolapse tx (3)

Answer 2

pelvic floor exercises, vaginal pessaries, surgery

Question 3

prolapse grading 0-4

Answer 3

0: no descent
1: descent between nml position and ischial spines
2: descent between ischial spines and hymen
3: descent within hymen
4: descent through hymen

Question 4

types of vaginal cancer in post menopausal and younger women

Answer 4

post menopausal: squamous

younger women: histologic types (adenocarcinoma or clear cell adenocarcinoma from DES)

Question 5

vaginal cancer symptoms

Answer 5

abnormal vaginal bleeding, abnormal discharge, post coital bleeding

Question 6

location of vagina for cancer

Answer 6

75% located in upper third

Question 7

vaginal cancer dx tests (3)

Answer 7

cytology, colposcopy, biopsy

Question 8

vaginal cancer tx

• small
• extensive involvement
• invasive disease

Answer 8

• small: local excision
• extensive involvement: partial or complete vaginectomy
• invasive disease: radiation or radical surgery

Question 9

most common vaginitis

Answer 9

BV

Question 10

which vaginitis is not an infection

Answer 10

BV; shift in vaginal flora

Question 11

which vaginitis has no odor

Answer 11

yeast

Question 12

strawberry petechiae

Answer 12

trichomonas

Question 13

grayish white, fishy odor discharge

Answer 13

BV

Question 14

yellow green frothy, profuse, malodorous discharge

Answer 14

trichomonas

Question 15

clue cells

Answer 15

BV; epithelial cells covered in bacteria

Question 16

motile cells on wet mount

Answer 16

trichomonas

Question 17

+ whiff test

Answer 17

fish smell, BV; KOH prep

Question 18

BV tx

Answer 18

flagyl BID for 7 days or clinda

Question 19

trichomonas tx

Answer 19

single dose flagyl; treat partners

Question 20

normal vaginal pH

Answer 20

4.5 or less

Question 21

DM, pregnancy, moisture/heat, tight clothes, OCP, antibx

Answer 21

risk factors for yeast infection

Question 22

frequent douching, pregnancy, female sex partner, multiple partners

Answer 22

risk factors for BV

Question 23

vaginal pH over 4.5

Answer 23

yeast infection

Question 24

pseudohyphae

Answer 24

yeast on KOH prep

Question 25

flagellated protozoan

Answer 25

trichomonas; STD

Question 26

condylomata acuminata - which HPV - dx tests (2) - 4 tx

Answer 26

- HPV 6 and 11 - do acetic acid(turns it white) and colposcopy - cryotherapy w/ liquid nitrogen, trichloroacetic acid, CO2 laser, surgical removal

Question 27

if there are many WBCs and no organism on saline smear

Answer 27

suspect chlamydia

Question 28

common kind of cells in vaginal/vulvar malignancies

Answer 28

squamous and usually in post menopausal women

Question 29

rare gyne cancer

Answer 29

vaginal

Question 30

HPV, hx of VIN or CIN, hx of cervical ca, HIV, smoker

Answer 30

risk factors for vaginal/vulvar cancer

Question 31

most common complaint of vulvar ca

Answer 31

vulvar itching

Question 32

common characteristics of pts with vulvar ca (4)

Answer 32

obese, HTN, DM, arteriosclerosis

Question 33

vulvar cancer in younger women associated with what 2 things

Answer 33

HPV infection and smoking

Question 34

what can co-exists with vulvar ca

Answer 34

25% pts have cervical carcinoma

Question 35

sx of VIN

Answer 35

most are asymptomatic; or postmenopausal bleeding or bloody discharge

Question 36

DES women with vag/vulvar cancer have increased risk for what (3)

Answer 36

miscarriage, premature delivery, ectopic pregnancy

Question 37

vaginal/vulvar cancer tx - early lesion(3) - most neoplasms - primary vaginal cancer - clear cell lesions(3)

Answer 37

- early lesion: local excision, topical 5 fluorouracil, laser therapy - most neoplasms: surgical excision - primary vaginal cancer: radiotherapy - clear cell lesions: radical hysterectomy and vaginectomy, and radiation therapy