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Womens Health > vaginal disorders > Flashcards

vaginal disorders Flashcards

1
Q

vaginal cancer epidemiology?

A

Rare → 1% of gyn malignancies → Usually secondary to another cancer

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2
Q

peak incidence of vag ca

A

60-65 yo

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3
Q

types of vag ca

A

Squamous Cell → 95%
Clear cell if DES exposure in utero

DES (Diethylstilbestro: estrogen)

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4
Q

s/sx of vag ca

A

Asymptomatic

Changes in menstrual period

Abnormal vaginal bleeding

Vaginal discharge

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5
Q

tx of vag ca

A

radiation

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6
Q

vulvar ca types

A

90% squamous

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7
Q

rf for vulvar ca

A

HPV 16, 18, 31

linked to DES exposure

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8
Q

when is peak incidence of vulvar cancer

A

50 yo

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9
Q

s/sx of vulvar ca

A

Pruritus → Most Common Presentation → Vaginal itching, irritation

Asymptomatic (20%)

Post-coital bleeding

Vaginal discharge

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10
Q

dx of vulvar ca

A

Red/White ulcerative, crusted lesions → Biopsy

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11
Q

tx of vulvar ca

A

Surgical Excision, radiation therapy, chemotherapy (Ex: 5FU)

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12
Q

types of infection vaginitis

A

Bacterial vaginosis, Trichomoniasis, Candida, Cytolytic

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13
Q

types of atrophic vaginitis

A

postmenopausal, allergic rxn

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14
Q

bacterial vaginosis PP

A

Decreased Lactobacillus acidophilus → Normally maintains vaginal pH → Overgrowth of normal flora such as GARDNERELLA VAGINALIS, anaerobes (Mobiluncus, Peptostreptococcus)

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15
Q

Most Common cause of vaginitis

A

bacterial

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16
Q

s/sx of bacterial vag

A

Vaginal odor worse after sex
+ Pruritus

> 50% asymptomat

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17
Q

vag d/c in bacterial vag

A

Copious discharge
Thin, homogenous, watery
→ GREY-WHITE with “FISH ROTTEN” smell

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18
Q

vag pH in bacter vag

A

> 5

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19
Q

whiff test results in bac vag?

A

Positive → Fishy Odor

10% KOH Prep

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20
Q

microscopic results ofBV

A

clue cells, few WBC, few lactobacili

21
Q

what are clue cells?

A

epithelial cells covered by bacteria

22
Q

tx of BV

A

METRONIDAZOLE (Flagyl) x 7 days → Gel or PO
Safe in pregnancy
CLINDAMYCIN → Gel or PO

23
Q

preventing BV

A

Avoid douching → Promotes loss of Lactobacilli

Treating partner unnecessary → Unclear if sexually transmitted but reduced recurrence if male uses condom

24
Q

complications of BV

A

Pregnancy → PROM, PTL, chorioamnionitis

25
Q

trichomoniasis PP?

A

TRICHOMONAS VAGINALIS → Pear shaped flagellated protozoa

Sexually transmitted

26
Q

s/ sx of trich

A

Vulvar pruritus,
erythema,
dysuria
Dyspareunia

27
Q

trich d/c?

A

Copious malodorous discharge
FROTHY YELLOW GREEN DISCHARGE
Worse with menses

28
Q

what does the cervix look like in trich?

A

strawberry cervix!!

cervical petechiae

29
Q

vag pH in trich?

A

> 5

30
Q

whiff test in trich

A

+/- positive

31
Q

what would you see microscopically in a trch infxn?

A

mobile protozoa on wet mount

wbc

32
Q

tx of ttrick

A 
METRONIDAZOLE (Flagyl)
2g oral dose x 1 dose         
                       OR 
500mg BID oral x 7 days
Safe in pregnancy
Oral preferred
33
Q

prevent trich

A

Spermicidal Agents → Ex: Nonoxynol 9 reduces transmission

MUST TREAT PARTNER

34
Q

complications of trich

A

Perinatal complications

↑HIV transmission

35
Q

candida PP

A

Candida albicans overgrowth → Part of normal flora due to change in normal vaginal environment (ex: use of abx)

36
Q

what are RF for candida?

A

↑ with DM, steroid, pregnancy

37
Q

s/sx of candida

A

Vaginal & vulvar erythema, swelling, burning, pruritus,
Burning when urine touches skin
Dysuria
Dyspareunia

38
Q

candida d/c?

A

THICK CURD-LIKE/COTTAGE CHEESE DISCHARGE

39
Q

vag pH in candida

A

normal (3.8-4.2)

40
Q

what will you see microscopically with candida?

A

hypae, yeast, and posrts on KOH wet prep

41
Q

tx of candida?

A

FLUCONAZOLE (PO x 1 dose)

42
Q

what are types of intravaginal antifungals

A

Clotrimazole, Nystatin
Butoconazole
Miconazole

43
Q

prevention of candida

A

Keep vagina dry, 100% cotton underwear, avoid tight-fitting clothes, avoid use of feminine deodorants & bubble baths

44
Q

what is cytolytic vaginitis

A

Overgrowth of LACTOBACILLI

45
Q

s/sx of vaginitis

A

Vaginal or vulvar pruritus & burning

Dysuria

46
Q

cytolyitc vaginitis d/c?

A

non-odorous d/x white to opaque

47
Q

cytolytic vaginitis ph?

A

normal

48
Q

what will you see microcoscopically in cytolytic vag?

A

copious lactobacili

large # of epithelial cells

Womens Health (24 decks)

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