Vaginal Disorders

Question 1

Name some vaginal developmental anomalies

Answer 1

septate or double vagina, vaginal adenosis, and gartner duct cysts

Question 2

septate or double vagina accompanied by

Answer 2

uterus didelphys (double uterus)

Question 3

causes of septate vagina

Answer 3

genetics, DES, unknown

Question 4

vaginal adenosis

Answer 4

tissue that is supposed to be in cervix (columnar endocervical epithelium) migrates to vaginal wall

Question 5

vaginal wall appearance normal vs. in vaginal adenosis

Answer 5

vaginal mucosa is usually pale pink, in vaginal adenosis- red granular area

Question 6

cause of vaginal adenosis

Answer 6

DES

Question 7

35-90% of women exposed to DES in utero will have what disorder

Answer 7

vaginal adenosis

Question 8

Mucus cysts vs. gartner duct cyst

Answer 8

developmental vaginal anomalies. mucus cyst derived from wolffian duct rests, gartner duct cyst derives from mullerian epithelium

Question 9

describe gartner duct cyst

Answer 9

1-2 cm fluid filled cyst in vaginal submucosa resulting from wolffiant duct rests

Question 10

most common causes of vaginites

Answer 10

bacterial vaginitis, candida (2nd), and Trichomonas vaginitis

Question 11

who does use of abx increase risk of vaginitis?

Answer 11

because abx kill lactobacillus and acideophilus in vaginal vault which increases alkalinity of vagina and makes it more susceptible to trich and Bacterial vaginitis

Question 12

acidic environment of vagina is protectful why?

Answer 12

because it prevents bacterial growth

Question 13

risk factors of bacterial vaginitis

Answer 13

pregnancy, IUD, douching

Question 14

risk factors of candida vaginitis

Answer 14

oral contraceptive use, IUD abx use, young at first intercourse, and immunocompromised

Question 15

greatest incidence of vaginitis

Answer 15

females 10-24 years old

Question 16

predisposing conditions of vaginitis that may cause pH change that is less protective against pathogens:

Answer 16

douching, deodorant pads, increased glycogen (abx use)

Question 17

name premalignant and malignant neoplasms of vagina

Answer 17

VAIN, SCC (malignant), embryonal rhabdomyosarcoma (malignant), adenocarcinoma (malignant), melanoma (malignant)

Question 18

VAIN classification

Answer 18

I- lower one third of epithelium, II- lower 2/3 of epithelium III- full thickness but not yet through B.M.

Question 19

VAIN and VIN are similar in that

Answer 19

they are both premalignant and both associated with HPV. VIN- 16, 18, 31. VAIN-16, 18

Question 20

what percent of those that have VAIN have intraepithelial neoplasia or carcinoma of cervix or vulva?

Answer 20

50-90%

Question 21

VAIN associated with HPV, specifics VAIN 1 vs. 2 and 3

Answer 21

99% of VAIN I a/w HPV. 93% of VAIN II and III a/w HPV

Question 22

mean age at vaginal SCC diagnosis

Answer 22

60

Question 23

is vaginal SCC associated with HPV?

Answer 23

Yes. arises from VAIN (premalignant lesions). VAIN a/w HPV, so is vaginal SCC

Question 24

why do more CIN progress to carcinoma than VAINs?

Answer 24

vaginal epithelium is more stable than cervical epithelium

Question 25

tumors of vaginal SCC describe

Answer 25

nodular, ulcerative, indurated, endophytic, or exophytic

Question 26

lesions in lower 2/3rds of vaginal SCC mets to…

Answer 26

inguinal nodes then to lungs and liver

Question 27

embryonal rhabdomyosarcoma aka

Answer 27

sarcoma botryoides

Question 28

what vaginal neoplasm is seen in kids less than 5 years?

Answer 28

embryonal rhabdomyosarcoma

Question 29

4 year old presents with grape like clusters projecting out of vagina- polypoid, rounded bulky masses. what do you suspect

Answer 29

embryonal rhabdomyosarcoma

Question 30

describe tumor cells of embryonal rhabdomyosarcoma

Answer 30

small oval nuclei, protrusion of cytoplasm from one end

Question 31

vaginal adenocarcinoma is rare and a/w

Answer 31

DES