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Gross but true (OBGYNE) > Vulva and Vagina Disorders > Flashcards

Vulva and Vagina Disorders Flashcards

1
Q

Normal vaginal pH

A

4.0-4.5

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2
Q

What would you suspect if you saw erythema, lesions or fissures on the vulva?

A

dermatitis

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3
Q

pH range for trichomoniasis vaginal infection

A

5.0-6.0

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4
Q

pH range for candidial infection

A

4.0-4.5

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5
Q

Not helpful in evaluation of vaginosis

A

bacterial cultures

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6
Q

Most common cause of discharge of women of childbearing age

A

bacterial vaginosis

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7
Q

Pathophysiology of bacterial vaginosis

A

Decrease in hydrogen-peroxidase lactobacilli. Increase in primarily gram negative rods

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8
Q

Exam findings may include: fishy odor, clue cells, and thin, white/gray discharge

A

bacterial vaginosis

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9
Q

Preferred treatment for bacterial vaginosis

A

Metronidazole: Oral 500mg BID for 7 days

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10
Q

How does bacterial vaginosis affect pregnancy?

A

associated with preterm birth

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11
Q

Primary etiologic agent for vulvovaginal candidiasis

A

Candida albicans

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12
Q

On speculum exam: Thick, white, sometimes “cottage cheese”, discharge. In severe cases a gray membrane

A

Vulvovaginal Candidiasis

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13
Q

Prescription treatment vulvovaginal candidiasis

A

Fluconazole (Diflucan)

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14
Q

Most common STI WORLD wide. Flagellated protozoan

A

Trichomonas vaginalis

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15
Q

On speculum exam may seen green, malodorous, frothy discharge

A

trichomonas vaginitis

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16
Q

Characteristic look of cervix with a trichomonas infection due to irritation of protozoan

A

“strawberry” cervix

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17
Q

Treatment for trichomonas for both partners in addition to abstaining from sex until tx is completed

A

Tinadazole (Tindamax) or metronidazole (Flagyl)

1 time dose of 2 grams

18
Q

Presenting symptoms include painful genital ulcers, itching, dysuria, tender inguinal lymphadenopathy

A

genital herpes

19
Q

What would you expect to see on physical exam with a patient who has genital herpes?

A

multiple vesicles on erythematous base

20
Q

How do you confirm diagnosis of genital herpes?

A

viral cell culture or PCR

21
Q

What is the treatment for primary infection of genital herpes?

A

acyclovir (Zovirax), famcyclovir (Famvir), or valocyclovir (Valtrex) for 7-10 days

22
Q

Length of duration for recurrent genital herpes treatment

A

1-3 days

23
Q

MOST common viral sexually transmitted disease in the U.S. Etiologic agent is often HPV serotypes

A

Codylomata acuminata (anogenital warts)

24
Q

Clinical manifestations include pruritis, burning, pain that can interfere with defecation and coitus

A

Codylomata acuminata (anogenital warts)

25
Q

Chemical treatment of Codylomata acuminata (anogenital warts) for pregnant women

A

Trichloroacetic acid

26
Q

Multiple, 1-2 mm raised, painless lesions. Dome-shaped with central dimple. Contain cheesy-white material

A

Mulloscum Contagiosum

27
Q

Can occur in women of any age who experience a decrease in estrogenic stimulation of urogenital tissue

A

Atrophic Vaginitis

28
Q

Clinical presentation includes: 2 yrs since natural menopause, loss of labial/vulvar fullness, pallor of urethral/vaginal epithelium, narrow introitus, minimal vaginal moisture

A

atrophic vagnitis

29
Q

Most effective therapy for Atrophic Vaginitis

A

vaginal estrogen therapy

30
Q

Caused by intense inflammatory reaction. Diagnosed by biopsy.

A

lichen sclerosis

31
Q

Symptom that is a hallmark for lichen sclerosis

A

vulvar pruritis that is so intense it interferes with sleep

32
Q

PE findings include well-demarcated white, finely wrinkled, atrophic patches

A

lichen sclerosis

33
Q

Treatment for lichen sclerosis

A

clobetasol propionate 0.05% cream for 6-12 weeks (topical steroids)

34
Q

Most common large cyst of the vulva—average 1-3 cm size. Tx not necessary in asymptomatic women < 40 yrs

A

Bartholin Duct Cyst

35
Q

Clinical manifestations include exquisite pain, erythematous, warm, tenderness of swollen Bartholin gland

A

Bartholin Duct Abscess

36
Q

Intraepithelial adenocarcinoma. Lesions are brick red, scaly, velvety eczematoid plaque with sharp border

A

Paget’s Disease

37
Q

Treatment for Paget’s disease of genitalia

A

excision with > 3 mm border from visible margin

38
Q

Risk factors include HPV infection, cigarette smoking, lichen sclerosis, northern european ancestory

A

vulvar cancer

39
Q

What are the clinical manifestations of vulvar cancer?

A

Unifocal vulvar plaque, ulcer or mass

40
Q

Most common histological cell type of vulvar cancer

A

squamous cell

41
Q

Why should we continue pap smears after hysterectomy?

A

risk of vaginal Intraepithelial Neoplasia

Gross but true (OBGYNE) (17 decks)

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