VIN, VAIN, CIN Flashcards
1
Q
Two types of VIN
A
- usual type (associated with HPV)
- differentiated VIN (not HPV assoc)
2
Q
Risk factors for usual type VIN
A
- younger
- HPV
- smoking
- intra-epithelial neoplasia at multiple anogenital sites
3
Q
Medical treatment of usual VIN (HSIL)
A
- imiquimod
- topical chemo (5-fluorouracil)
- photodynamic therapy
- therapeutic HPV vaccines
- anti-viral therapies
- interferons
4
Q
Surgical treatment of usual VIN
A
- CO2 laser
- excision biopsy
5
Q
Treatment of differentiated VIN
A
Wide excision and histology
6
Q
How does Imiquimod work?
A
- activates macrophages, dendritic cells causing release of IFN-a and pro-inflammatory cytokines
7
Q
Associations with differentiated VIN
A
- lichen sclerosis
- squamous carcinoma
8
Q
Primary malignant vulval lesions
A
- squamous carcinoma
- melanoma
- Basal cell
- Batholin’s gland
- verrucous
- sacroma
9
Q
Secondary malignant vulval leisons
A
- cervix
- endometrium
- kidney
- urethra
10
Q
Gold standard management of primary malignant vulval lesions
A
- radical WLE or radical vulvectomy with
- inguinofemoral node dissection/ sentinel nodes
- radical primary chemoradiation
11
Q
Management of groin lymph nodes in vulval cancer
A
- sentinel lymph nodes or dissection
12
Q
When is a vulval biopsy useful?
A
- to make a diagnosis
- no response to initial empiric therapy
- uncharacteristic appearance
- to determine appropriate management
13
Q
Instrument used to biopsy in outpatient settin
A
Keye’s punch
