Vulva

Question 1

The vulva is lined by what type of cell?

Answer 1

Squamous epithelium

Question 2

Anatomical composition of vulva

Answer 2

skin and mucosa of the female genitalia external to the hymen (labia major, labia minor, mons pubis, and vestibule)

Question 3

One BLANK is present on each side of the vaginal cancel and produces mucus-like fluid that drains via ducts into the lower vestibule

Answer 3

Barotholin galdn

Question 4

what do you call cystic dilation of the Bartholin gland

Answer 4

bartholin cyst

Question 5

what causes a bartholin cyst?

Answer 5

inflammation and obstruction of gland, usually in women of reproductive age

Question 6

Bartholin cyst clinical presentation

Answer 6

presents as a unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal

Question 7

warty neoplasm of vulvar skin, often large

Answer 7

condyloma

Question 8

what is the most common cause of condylomas?

Answer 8

HPV types 6 or 11 (condyloma acuminatum)

Question 9

less common cause of condylomas

Answer 9

Secondary syphilis (condyloma latum)

Question 10

Histologically, HPV-associated condylomas are characterized by

Answer 10

koilocytes

Question 11

risk of carcinoma with HPV 6 or 11

Answer 11

low-risk HPV rarely progresses to carcinoma

Question 12

characterized by thinning of the epidermis and fibrosis (sclerosis) of the dermis; presents as a white patch (leukoplakia) with parchment-like vulvar skin

Answer 12

Lichen sclerosis

Question 13

what is the typical population for lichen sclerosis?

Answer 13

postmenopausal women

Question 14

likely etiology for lichen sclerosis

Answer 14

autoimmune

Question 15

prognosis of lichen sclerosis

Answer 15

benign, but associated with a slightly increased risk for squamous cell carcinoma

Question 16

Carcinoma arising from squamous epithelium lining the vulva

Answer 16

Vulvar carcinoma

Question 17

Frequency of vulvar carcinoma

Answer 17

relatively rare, only a small percentage of female genital cancers

Question 18

presentation of vulvar carcinoma

Answer 18

leukoplakia (biopsy may be required to distinguish from other causes of leukoplakia)

Question 19

etiology of vulvar carcinoma

Answer 19

can be non-HPV or related to high risk HPV (16 or 18)

Question 20

risk factors for vulvar carcinoma

Answer 20

related to HPV exposure

1. multiple partners
2. early first age of intercouse
3. generally occurs in women of reproductive age

Question 21

from what does vulvar carcinoma arise?

Answer 21

vulvar intraepithelial neoplasia (VIN)

Question 22

describe VIN

Answer 22

a dysplastic precursor lesion characterized by koilocytic change, disordered cellular maturation, nuclear atypic, and increased mitotic activity

Question 23

Non-HPV vulvar carcinoma arises most often from

Answer 23

long-standing lichen sclerosis; chronic inflammation and irritation eventually lead to carcinoma

Question 24

non-HPV vulvar carcinoma is generally seen in what population?

Answer 24

elderly women (average age > 70)

Question 25

characterized by malignant epithelial cells in the epidermis of the vulva

Answer 25

Extramammary Paget disease

Question 26

clinical presentation of extramammary paget disease

Answer 26

erythematous, pruritic, ulcerated vulvar skin

Question 27

unlike paget disease of the nipple, extramammary paget disease is

Answer 27

not associated with underlying carcinoma

Question 28

have to distinguish extramammary paget from what?

Answer 28

melanoma

Question 29

extramammary paget stains

Answer 29

PAS+, keratin+, S100-

Question 30

melanoma stains

Answer 30

PAS-, keratin-, s100+