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Gynaecology > Vagina Conditions > Flashcards

Vagina Conditions Flashcards

0
Q

What are the characteristics of postmenopausal atrophic vaginitis?

A

Burning
Itching
Dyspareunia
Vaginal discharge

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1
Q

How are disease of the vagina classified?

A
  1. Vaginitis
  2. Cystic lesions
  3. Solid tumours
  4. Vaginal adenosis
  5. Premalignant lesions
  6. Malignant lesions
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2
Q

What are the clinical findings of postmenopausal atrophic vaginitis?

A

Shiny, thin and almost transparent epithelium.
Small ulcers.
Or small areas of granulation.

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3
Q

What’s the treatment for postmenopausal atrophic vaginitis?

A

Local application of oestrogen cream
Initially daily, later weekly
Systemic oestrogen has a good effect.
Long term therapy is needed to prevent recurrences.

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4
Q

What’s emphysematous vaginitis?

A

Rare condition presenting with gas filled blisters in the vagina on occasion popping sounds being heard from the vagina.

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5
Q

What’s the cause of emphysematous vaginitis?

A

Aetiology unknown, but usually an association with bacterial or trichomonal vaginitis.

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6
Q

What are the features of toxic shock syndrome?

A 
High fever
Vomiting
Diarrhea
Headache
Irritability
Confusion
Muscle and abdominal pain
Erythematous rash
Profound hypotension
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7
Q

What’s the cause of toxic shock syndrome?

A

Patients using super absorbent vaginal tampons that may cause vaginal abrasions and ulcers. Staph aureus exotoxins is absorbed through ulcers or intact vaginal epithelium.

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8
Q

Name the 3 types of cystic lesions found in the vagina?

A
  1. Epidermal cysts
  2. Congenital cysts
  3. Endometriosis
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9
Q

Cause of epidermal vaginal cysts?

A

Obstetrical or other trauma to the vagina.

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10
Q

What are inclusion cysts?

A

Epidermal cysts caused by poor suturing of an episiotomy.

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11
Q

How are congenital vaginal cysts classified?

A
  1. Gartner duct cysts (Wolffian / Mesonephric duct system)

2. Paramesonephric / Müllerian duct cysts

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12
Q

What’s the aetiology of endometriotic cysts?

A

Secondary to intraperitoneal endometriosis involving the pouch of Douglas.

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13
Q

Where are nodules frequently palpated in the presence of endometriotic cysts?

A

Nodules on the uterosacral ligaments.

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14
Q

What’s the management of endometriotic cysts?

A
  1. Biopsy to exclude malignancy

2. Surgical excision

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15
Q

What’s the most common solid tumor of the vagina?

A

Condylomata acuminata

16
Q

How are the solid tumours of the vagina classified?

A

Condylomata acumimata
Polyps
Leiomyoma

17
Q

Cause of condyloma acuminata?

A

HPV 6 and 8

18
Q

How can small condylomata acuminata be detected?

A

Colposcopy and acetic acid staining

19
Q

What’s the management approach of condylomata acuminata?

A
  1. Surgical excision
  2. Electrodiathermy
  3. Laser vaporization
  4. 5-Fluorouracil topical application
20
Q

Which treatment option of condylomata acuminata is contra-indicated in vaginal condylomata acuminata and why?

A

Podophyllin solution

The drug is systemically absorbed which could lead to severe toxicity and even death.

21
Q

What causes the formation of vaginal polyps?

A

Proliferation of the lamina propria.

22
Q

What’s the treatment of vaginal polyps?

A

Surgical excision at the base of the polyp.

23
Q

What’s the differential diagnosis of vaginal polyp?

A
  1. Sarcoma botryoides

2. Pyogenic granulomas

24
Q

From which tissue does leiomyoma originate?

A

Smooth muscle of the vaginal wall.

25
Q

What’s the relationship between vaginal leiomyomas and uterine leiomyomas?

A

Vaginal leiomyomas are not related to uterine leiomyomata.

26
Q

What’s the management of vaginal leiomyoma?

A

Surgical excision by shelling the myoma out of its capsule.

27
Q

Define vaginal adenosis?

A

Adenosis signifies the abnormal presence of columnar epithelium in the vagina. Such epithelium can be of endocervical, endometrial or tubal nature.

28
Q

In which patients are vaginal adenosis detected?

A

Females who have had intra-uterine exposure to diethylstilboestrol (DES).

29
Q

What characterizes the DES syndrome?

A

Coexisting cervical and vaginal deformities:

  • cervical and vaginal ridges
  • collars
  • pseudo polyps
  • cock’s combs
  • ectropion
  • clear cell carcinoma of the vagina

Upper tract deformities:

  • T-shaped uterus
  • uterine hypoplasia
  • endometrial synechiae
  • uterine tube abnormalities
30
Q

How do pts with vaginal adenosis present?

A

Mucoid vaginal discharge (excessive mucous)
Post coital bleeding
Dyspareunia

31
Q

How are premalignant lesions of the vagina graded?

A

Vaginal Intraepithelial Neoplasia (VAIN)
VAIN I
VAIN II
VAIN III

32
Q

Management of VAIN lesions?

A

VAIN III - Surgical excision in posthysterectomy pts
If uterus is insitu -
CO2 laser
Electro diathermy

33
Q

What can be done to detect VAIN timeously?

A

Do vaginal vault cytology screen in pts who had previous hysterectomy for CIN.

Gynaecology (1 decks)

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