vagina Flashcards
anterior vs posterior vaginal prolapse
anterior: cystocele or cystourethrocele
posterior: enterocele or rectocele
vaginal prolapse tx (3)
pelvic floor exercises, vaginal pessaries, surgery
prolapse grading 0-4
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
types of vaginal cancer in post menopausal and younger women
post menopausal: squamous
younger women: histologic types (adenocarcinoma or clear cell adenocarcinoma from DES)
vaginal cancer symptoms
abnormal vaginal bleeding, abnormal discharge, post coital bleeding
location of vagina for cancer
75% located in upper third
vaginal cancer dx tests (3)
cytology, colposcopy, biopsy
vaginal cancer tx
- small
- extensive involvement
- invasive disease
- small: local excision
- extensive involvement: partial or complete vaginectomy
- invasive disease: radiation or radical surgery
most common vaginitis
BV
which vaginitis is not an infection
BV; shift in vaginal flora
which vaginitis has no odor
yeast
strawberry petechiae
trichomonas
grayish white, fishy odor discharge
BV
yellow green frothy, profuse, malodorous discharge
trichomonas
clue cells
BV; epithelial cells covered in bacteria
motile cells on wet mount
trichomonas
+ whiff test
fish smell, BV; KOH prep
BV tx
flagyl BID for 7 days or clinda
trichomonas tx
single dose flagyl; treat partners
normal vaginal pH
4.5 or less
DM, pregnancy, moisture/heat, tight clothes, OCP, antibx
risk factors for yeast infection
frequent douching, pregnancy, female sex partner, multiple partners
risk factors for BV
vaginal pH over 4.5
yeast infection
pseudohyphae
yeast on KOH prep
flagellated protozoan
trichomonas; STD
condylomata acuminata
- which HPV
- dx tests (2)
- 4 tx
- HPV 6 and 11
- do acetic acid(turns it white) and colposcopy
- cryotherapy w/ liquid nitrogen, trichloroacetic acid, CO2 laser, surgical removal
if there are many WBCs and no organism on saline smear
suspect chlamydia
common kind of cells in vaginal/vulvar malignancies
squamous and usually in post menopausal women
rare gyne cancer
vaginal
HPV, hx of VIN or CIN, hx of cervical ca, HIV, smoker
risk factors for vaginal/vulvar cancer
most common complaint of vulvar ca
vulvar itching
common characteristics of pts with vulvar ca (4)
obese, HTN, DM, arteriosclerosis
vulvar cancer in younger women associated with what 2 things
HPV infection and smoking
what can co-exists with vulvar ca
25% pts have cervical carcinoma
sx of VIN
most are asymptomatic; or postmenopausal bleeding or bloody discharge
DES women with vag/vulvar cancer have increased risk for what (3)
miscarriage, premature delivery, ectopic pregnancy
vaginal/vulvar cancer tx
- early lesion(3)
- most neoplasms
- primary vaginal cancer
- clear cell lesions(3)
- 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
