Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB/GYN > Vulva and Vagina > Flashcards

Vulva and Vagina Flashcards

1
Q

clue cells

A

epithelial cells with bacteria on them- in BV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Layers of vagina

A

adventitia (inner), muscularis (middle), mucosa (outer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are secretions from vagina composed of?

A

mucous from the cervix, moisture from the endometrial fluid, and exudates from bartholin and skene’s glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what type of cells shed from the vagina?

A

squamous cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

rugae of vagina composed of what layers? What is purpose of rugae?

A

composed of the epithelial and mucosal layers. stimulate penis during intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where does vagina get its acidity from?

A

mucosal (outer layer) of vagina releases glycogen which is metabolized by anaerobic bacteria. This causes the acidity which is hostile to sperm and protects the vagina from infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

raised ridges of mucosal layer-

A

rugae of vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

recess around cervix=

A

vaginal fornix (anterior, posterior, and lateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

difference between vulva and vagina

A

vulva- stratified squamous epithelium, associated hair follicles, sebaceous glands, apocrine gland, “covering”. Vagina- non-keratinized squamous cells, no associated hair follicles, no sebacous glands, no apocring glands, “sheath”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pudendum=

A

vulva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is homogenous to prostate gland in males

A

skene’s glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

equivalent to bulbourethral glands in males

A

bartholins glands (greater vestibular glands)- secrete mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name anomalies of the humen

A

imperforate hyman, microperforate humen, septate hymen, acquired labial adhesions, hematocolpos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hematocolpos, an anomaly of the hymen is when vagina fills with menstrual blood. often occurs in combination of…

A

menstruation and imperforate hymen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

vaginal opening not visiible, completely closed by hymen=

A

imperforate hymen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

vaginal opening not visible, mostly covered by hymen=

A

microperforate hymen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

vaginal opening visible behind hymen tissue=

A

septate hyman (might have trouble getting tampon on)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name vaginal anomalies:

A

transverse vaginal septa, longitudinal vaginal septum, vaginal agenesis, partial vaginal agenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what anomaly results when distal ends of mullerian ducts fail to fuse properly?

A

longitudinal vaginal septum (double barreled vagina)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how does transverse vaginal septa result?

A

faulty fusion of urogenital sinus and mullerian ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Rare complete vs. incomplete transverse vaginal septa

A

rare complete- diagnoses usually after menarche. Incomplete- diagnosis usually after intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

normal female karyotype woman presents with primary amenorrhea. you do an assessment and observe a vaginal anomaly….

A

vaginal agenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how does partial vaginal agenesis result?

A

when urogenital sinus fails to contribute to the lower portion of vagina- lower portion of vagina consists of fibrous tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

vaginitis

A

inflammation of vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

vulvovaginitis

A

inflammation of vulva and vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

vaginosis

A

bacterial overgrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Types of vulvodynia

A

Generalized and Localized (each can be provoked, unprovoked, or mixed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

types of localized provoked vulvodynia

A

primary, secondary, pure, and complicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pure localized provoked vulvodynia

A

without concomitant vulvovaginitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

secondary localized provoked vulvodynia

A

pain after an initial period of pain free intercourse

31
Q

complicated localized provoked vulvodynia

A

with recurrent vulvovaginitis

32
Q

vulvar pain in absence of relevant visible physical findings

A

vulvodynia

33
Q

25 year old young women comes into clinic with complaint of dyspareunia, vestibular tenderness. The pain is localized to her vestibule. Upon PE, you don’t see any physical findings to explain the symptoms. What may it be? There is no redness or swelling. How would you treat this?

A

localized provoked vulvodynia- 3 months of pelvic floor rehabilitation, maintain vulvar hygiene, topical 5% lidocaine once daily, soothing oils, estrogenic cream, low oxalate diet. If not improved, next 3 months TCA. If still nto improved surgical tx, refer to pain clinic.

34
Q

Remember the 3 LEVEL TX PLAN in this disorder

A

localized provoked vulvodynia

35
Q

65 year old woman complains of random pains in her vestibular area from time to time. It is a painful burning that sometimes occurs with periods of reliefs and flares. You r/o infections, neuropathic viruses, and don’t see anything significant on PE (no redness, swelling). Patient also has history of HTN. What do you suspect and how to treat?

A

Generalized Unprovoked Vulvodynia (DIAGNOSIS OF EXCLUSION)- TCA (amitriptyline), maintain vulvar hygiene- keep away from irritants. If no relief after 3 months, anticonvulsants.

36
Q

Patient presents with pain in vulvar area (not related to any visible Physical findings), edema, pain during sex. You notice she has difficulty walking with adducted thighs. Upon physical exam, you can palpate a fluctuant tender mass unilaterally. What is your next step?

A

Suspect Bartholin gland cyst. Need to drain the infected cyst. Mucopurulent secretions need to be cultured to make diagnosis. If surrounding cellulitis- Abx

37
Q

Cause of bartholin gland cyst

A

infection, trauma

38
Q

how does bartholin gland cyst develop?

A

obstruction of main duct of bartholin’s gland- results in retention of secretions and cystic dilation

39
Q

the most common NON-neoplastic epithelial vulvar condition

A

vulvar lichen sclerosis

40
Q

Patient presents with pruritis, burning, irritation, and vaginal discharge. When asking about history, admitted to an allergic reaction condition with latex male condoms upon last sexual encounter. Tx?

A

Switch from latex to non-latex, short course of corticosteroid tx, sitz baths, topical vegetable oils

41
Q

Describe vulvar lichen sclerosis in 4 words

A

benign, chronic, inflammatory, and progressive

42
Q

“cigarette paper” appearance of vulva

A

vulvar lichen sclerosis

43
Q

Match these histological findings with disorder: Flattening of papillae, thin hyperkeratotic layer, depp lymphocytic infiltration, thinning of epithelial layer, homogenation of stroma

A

vulvar lichen sclerosis

44
Q

RETE PEGS on histology:

A

vulvar lichen sclerosis. represent flattening of papillae

45
Q

complications of vulvar lichen sclerosis

A

3-5% can become squamous cell carcinoma- if goes untreated or . BIOPSY!!

46
Q

Women that is 65 years old comes in complaining of intense itching of her vulva region. She just cannot stop. She also complains of difficulty with sex, it has become painful. Upon physical examination of the skin, you note the vulvar skin is thin, wrinkled, white, with areas of lichenification and hyperkeratosis. The anterior parts of the labia majora are fused as well. There is an “8” around the vulva and anus indicating perianal region involvement. What do you suspect and how would you treat?

A

vulvar lichen schlorosis. This has potential to be malignant- need to biopsy. Tx: stop itch-scrath cycle, oral anti-histamine at night for itching, vulvar hygiene (avoid tight underwear, unsceneted soap, tampons rather than pads), CLOBETASOLE DIPROPINATE 0.05% ointment- BID x 2 weeks, then 1 everyday x 2 weeks, then twice a week for 2 weeks

47
Q

F/U with vulvar lichen sclerosis

A

every 3 Months, then yearly or every 6 months indefinitely

48
Q

Benign epithelial thickening and hyperkeratosis of vulva. Itch scratch, itch scratch- women suffering and finally comes in. What do you suspect and tx?

A

vulvar lichen simplex chronicus. Biopsy to exclude intraepithelial neoplasia and invasive tumor. Tx includes vulvar hygiene, oral anti histaimines, white cotton gloves at night, TOPICAL MEDIUM POTENCY CORTICOSTEROID BID- hydrocortisone valerage

49
Q

how long does it take for vuvar epithelium to heeal

A

6 weeks

50
Q

Women 50 yo comes in with mild itching of vulva region. painful as well. Upon physical examination, you notice papulosquamous papules and plaqyes on vulva with white lacy pattern. What are you thinking? tx?

A

Lichen planus. tx with topical steroids

51
Q

is it common to have vaginal involvement in lichen planus?

A

yes- in 70% of women

52
Q

destructive, scarred lichen planus on the vulva with a desquamative vaginitis, variable erosions plus atrophy. PAIN, BURNING, IRRITATION, not so much itching. Skin of vulva has glazed erythema. tx?

A

EROSIVE lichen planus. aka vulvovaginal gingival syndrome. tx tends to be resistant

53
Q

lichen planus that is intensely itchy, looks a lot like lichen sclerosis. tx tends to be resistant

A

hypertrophic lichen planus

54
Q

5 characteristics of vulvovaginities

A

abnormal discharge, vulvodynia, foul odor, irritaiton, pruritis

55
Q

PE of vulvovaginitis

A

examine vulva and speculum examination of vagina and cervix. specimen of vaginal discharge- wet mount (saline, KOH) and sample of cervix for gonococcus or chlamydia. Check vaginal pH

56
Q

Amsel’s criteria

A

for BV-3 of 4 must be positive: Whiff test positive (amine, fishy smell), pH greater than 4.5, clue cells,a nd maladorous, gray, slightly frothy discharge

57
Q

most common infection of BV

A

gardnerella vaginosis

58
Q

BV tx

A

metronidazole 500 mg BID x 7 days, tell patient to avoid douching, use of panty liners (stays on panty- irritaition), tampons instead of pads, pantyhose, occlusive pants and undergarments. Regular use of condoms may also help because less exposure to semen

59
Q

Patient presents with intense pruritis, burning sensation after urination, vulvar erythema, and white curd like discharge. how would you diagnose and tx?

A

candidiasis- get wet mount with 10% KOH solution to look for yeast. Gold standard: Vaginal culture. OTC Miconazole or fluconazole for 1-7 days, gentian violet (warn- can turn teeth/lips purple if have oral sex)

60
Q

Put patient on fluconazole for candidiasis. what precautions do you make sure to check before administering tx?

A

make sure not preggo. also advise patient to avoid alcohol.

61
Q

most common CURABLE sexually transmitted infection

A

trichomonas vaginitis

62
Q

Strawberry spots on cervix and profuse, frothy, greenish, foul smelling discharge

A

trichomonas vaginits- get wet mount. pH greater than 5. Metronidazole 500 mg BID x 7 days OR 2 grams once. treat partner. Evaluate for gonorrhea, chlamydia, trachomatis, syphilis, and HIV

63
Q

wet prep of vulvovaginities shows…

A

NORMAL

64
Q

normal discharge at midcycle estrogen surge

A

clear, elastic, mucoid secretions form cervical os. profuse

65
Q

normal discharge at luteal phase and pregnancy

A

vaginal secretions thicker, white

66
Q

normal vaginal pH

A

3.4-4.5- promotes normal vaginal flora (lactobacilli and acideogenic corynebacteria)

67
Q

patient presents with vaginal bleeding, foul smelling vaginal discharge, dysuria, pelvic pain

A

foreign body often tampon

68
Q

causes of primary irritant contact dermatitis

A

overwashing, use of creams with drying bases, wetness (urine, feces, menstruation)

69
Q

causes of allergic contact dermatitis

A

neomycin, benzocain, preservatives

70
Q

difference between irritant vs. allergic contact dermatitis

A

allergic takes 1-2 days, irritant is immediate

71
Q

what effect does estrogen have on vaginal epithelium

A

it THICKENS it. so when you have lack of estrogen, the epidermal barrier gets weakened, thinned

72
Q

Acute onset of intense itching plus vesiculation and weeping

A

suspect allergic contact dermatitis

73
Q

vulvar contact dermatitis tx

A

stop irritant or allergic exposure, clobetasol or halobetasol ointment BID x 5-7 days, then daily, mineral oil, antihistamine for sleeping aid, . if very severe- prednisone

74
Q

rugae of vagina composed primarily of

A

epithelial and mucosal layers

OB/GYN (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions