Vaginal Path II Flashcards
What can cause yeast infections
DM
antibiotics
pregnancy
immunosuppression
Sx yeast infection
leukorrhea
pruritis
erythema
Sx trichomonas vaginalis
yellow frothy discharge pruritis, dysuria, dysparenuia
strawberry cervix
trichomonas vaginalis
patient has gray green malodorous discharge that smells fishy
what is this and what will histo show?
gardnerella vaginalis with “clue cells” on pap smear
what culture (agar) do you use to Dx garderella
chocolate
pseudohyphae
candida
when do you see mycoplasma hominis vaginitis or cervicitis
spontaneous abortion and chorioamnionitis
gram - bacillus that causes vaginitis with fishy odor
gardnerella
see a bunch of gram - sticking to squamous epthelial cells
gardnerella
thayer martin media
gonorrhea
pH of candidiasis secretions
<4.5
pH of trich or gardnerella
> 4.5
what type of pox virus is most commonly sexually transmited
type 2 molluscum contagiosum
raised lesions with central pitting all over buttocks
molluscum contagiosum
definition of PID
infection of pelvic organs beyond the uterine corpus
Sx PID
lower abdominal pain, tender to cervical manipulation
+/- fever
complications of PID
rupture of tuboovarian abscess
infertility from scarring of tubes
ectopic pregnancy
intestinal obstruction from fibrous bands and adhesions
where do most ectopic pregnancies take place
in fallopian tubes
where does fertilizaiton take place
in ampulla of fallopian tube
what are the primary infections of endometrium in PID can occur how
postpartum endometritis
IUD
curettage (abortion)
what pathogens are introduced via sexual intercourse that can contribute to PID
gonococcus
chlamydia
mycoplasma
ureaplasma
all patients Dx with acute PID should be tested for what infection
HIV
what cells present in acute inflammation
what cells present in chronic inflammation
acute- neutros
chronic- plasma
role of bartholin gland cyst/abscess
secrete mucous to lubricate the vagina (mostly outside
where are bartholin glands located
4 and 8 o clock
what cause bartholin abscesses
infections that may be polymicrobial (microbiome) or gonorrhea/chlamydia
Tx methods for bartholin abscess
word catheter
marsupialization( cyst wall everted and sewed to vesticular mucosa)
what is lichen planus
autoimmune disorder, T cell regulated
signs lichen planus
planar, pruritic, purple, papular
wickham’s striae in mucosa
tx lichen planus
topical corticosteroids
prognosis lichen planus
usually goes away in year or 2
what is LS&A
lichen sclerosis and atrophy
lichen sclerosis occurs in what age gorup and what does it look like
elderly and post menopausal females usually affected
atrophic changes
white “parchment-like” areas
what will you see on histo of lichen sclerosis
hyalinization
atrophy of squamous epithelium
chronic inflammation below
Sx of lichen simplex chronicus
rubbing scratching and clinically leukoplakia
what occurs in lichen simplex chronicus
squamous hyperplasia
hyperkeratosis
no cytologic atypia!!
what HPV strands are associated with condyloma acuminatum
6 and 11
what venereal warts should you monitor
ones caused by HPV high risk 16 18 33 because can go on to VIN 2-3 and carcinoma
micro of condyloma acuminatum
koilocytosis, mitoses
frequently regress
Tx for condyloma acuminatum
cryo, chemical, laser or excisional
condylomata types
warty- looks like cauliflower multifocal papules
coalescing papules- “bowenoid papulosis”
what is koilocytosis
little nuclei with lots of cleared area
what causes vulvar intraepithelial Neoplasm
multistep progression from dysplasia to invasive SCC
What is bowden disease
VIN3/CIS
need surgery
how can you tell stages of VIN
Bx
VIN3 full thickeness enlarged nuclei
what stages of VIN do you treat as high grade
VIN 2, 3
