Vulva and Vagina Flashcards
What is the genotype of androgen insensitivity patients?
- 46 XY
- it’s X linked
how do you treat labial agglutination?
-estrogen cream and massage to separate the labia majora
What is vulvar Vestibulitis?
- rare condition in which one or more of the minor vestibular glands becomes infected
- eyrethematous dots
- extremely tender
- severe introital dyspareunia
What is the most common benign solid tumor of the vulva?
- Fibroma
- slow growing
- can be really big
What is a neurofibroma on the vulva from?
-Von Recklinghausen’s disease
Where is a bartholin cyst usually?
-5 or 7 o clock
Sebaceous cyst clock thing
-more like 11 or 1
What is it when there is a bunch of bumpy stuff around the urethra?
-urethral caruncle
What can a vulvar hematoma commonly result from?
straddle injury
What does atrophic vaginitis result from?
- menopause
- minora regresses and majora shringks
- from loss of estrogen
What does squamous cell hyperplasia come from?
- prolonged itch- scratch cycle
- biopsy will have elongated rete ridges
What is Lichen Sclerosis?
- the parchment paper thing
- menopause
- intesnse pruritus, dyspareunia, burning pain
- loss of rete ridges and inflammatory cells lining the basement membrane
- treat with moderate strength steroid ointments
Tx for lichen sclerosis?
-clobetasol
What was that main difference between lichen simplex chronicus and lichen sclerosis?
- the presence of rete ridges
- lichen slcerosis does not have them, chronicus does
What is the most striking feature of lichen sclerosis?
-the presence of a hyaline zone in the superficial dermis
If there is acanthosis nigricans, what do we think of?
-insulin resistance
What syndrome has vaginal agenesis?
- Rokintansky-Kuster-Hauser Syndrome
- mullerian agenesis (paramesonephros)
What is a Gartner’s duct cyst a remant of?
- wolffian duct
- mesonephros
Where are bartholin gland abscesses again?
-5 and 7 o clock
Most common cause of vaginal trauma?
-sexual assault
What is the most common symptom with VIN?
-pruritus
managing VIN III?
-local superficial surgical excisioin
What are the histologic features associated with Paget’s disease?
- Paget’s cells
- large and pale
What are most vulvar cancers?
-SCC’s
In which rare vulvar carcinoma is radiation contraindicated?
- Verrucous carcinoma
- radiation may induce anaplastic transformation
If there is VAIN, how do we manage it?
- with laser therapy
- or topical 5-FU
- if unsuccessful, may require vaginectomy
What kind of epithelium lines the vagina?
-nonkeratinized stratified squamous epithelium
What do the bacteria in the vagina produce?
- lactic acid and H202
- keeps pH 3.8-4.2
What organism do we think of if there is a more basic vagina?
-G. Vaginalis
What is the most common cause of Vaginitis?
- Bacterial vaginosis
- Gardnerella
Tx of Vaginitis?
- Metronidazole
- not a STI so do not have to treat partner
What is the hallmark for G. Vaginalis?
-clue cells
What is the second most common cause of vaginal infections?
- Candida
- the pH will be low
Tx of Candidiasis?
-Diflucan
Buzz word for Trichomonas?
-strawberry cervix
Tx of Trichomonas?
Metronidazole again
