Vaginal and Vulval Disorders Flashcards

1
Q

What is a Bartholin’s cyst?

A

Fluid-filled sac within one of the Bartholin’s glands

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2
Q

Where are the Bartholin’s glands located?

A

Deep to the posterior aspect of the labia majora

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3
Q

Where are the openings of the Bartholin’s cysts?

A

Either side of the vaginal orifice at 4 and 8 o’clock

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4
Q

What is the role of the Bartholin’s glands?

A

Secrete mucus to lubricate the vagina

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5
Q

What are the Bartholin’s glands also known as?

A

Greater vestibular glands

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6
Q

What pathogens commonly cause abscesses to form in Bartholin’s glands?

A

E. coli
MRSA
STI

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7
Q

What are the risk factors for Bartholin’s cyst?

A

Prev event
Sexually active
History of vulval surgery
Nulliparous

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8
Q

How do Bartholin’s cysts present?

A

Small - asymptomatic
Large - vulvar pain
Rupture - acute onset pain

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9
Q

How does a Bartholin’s abscess present?

A

Acute onset pain

Difficulty passing urine

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10
Q

How does a Bartholin’s cyst feel on examination?

A

Soft, fluctuant, non-tender

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11
Q

How does a Bartholin’s abscess feel on examination?

A

Tense, hard lump

Surrounding cellulitis

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12
Q

Which diagnosis should be excluded in investigation of a Bartholin’s cyst in >40s?

A

Vulval carcinoma

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13
Q

How is a small Bartholin’s cyst managed?

A

None if asymptomatic

Recommend warm baths

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14
Q

How is a large Bartholin’s cyst managed?

A

Drainage by either
Word Catheter
Masupialisation

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15
Q

In which scenario would excision of a Bartholin’s cyst be performed?

A

High suspicion of malignancy

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16
Q

What is lichen sclerosus?

A

Chronic inflammatory skin disease of anogenital skin

17
Q

What are the two peaks in age of presentation of lichen sclerosus?

A

Prepubescent girls

Post-menopausal women

18
Q

What are the antibodies against in lichen sclerosus?

A

ECM protein 1

19
Q

What are the clinical features of lichen sclerosus?

A

White atrophic patches on skin
Itching
Dyspareunia

20
Q

What features may be seen on examination of lichen sclerosus?

A

Clitoral hood fusion
Fusion of labia
Loss of vaginal opening

21
Q

How is lichen sclerosus managed?

A

Immunosuppression with topical steroids