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ENRP Exam I > Vulva and Vagina (Moulton) > Flashcards

Vulva and Vagina (Moulton) Flashcards

1
Q

Pathogenesis of clitoral agenesis?

A

failure of the genital tubercle to form

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2
Q

Cloaca

A

no definite separation between the vagina and bladder

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3
Q

with ambiguous genitalia, what gender is the infant usually assigned at birth?

A

female

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4
Q

female pseudohermaphroditism

A

caused by masculinization in utero of the female fetus; usually caused by endogenous hormonal milieu

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5
Q

male pseudohermaphroditism

A

results from mosaicism and varying degrees of virulization and mullerian development (ie androgen insensitivity)

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6
Q

Androgen insensitivity

A

46 XY; x linked; deficiency in androgen receptors; testes are undescended

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7
Q

Labial agglutination

A

benign neoplastic condition of the vulva; treated by estrogen cream and massage

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8
Q

Fox-Fordyce disease

A

benign neoplastic condition of the vulva severe pruritic raised yellow retention cyst in the axilla and labia major and minor, resulting from keratin-plugged inflammation aprocrine glands

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9
Q

Inclusion cyst

A

benign neoplastic condition of the vulva; located beneath the epidermis and are mobile, nontender, spherical and slow growing; no treatment required

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10
Q

Vulvar varicosities

A

benign neoplastic condition of the vulva; can enlarge during pregnancy and become very painful; have characteristic blue color

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11
Q

Urethral caruncles

A

benign neoplastic condition of the vulva; small fleshy red outgrowth at the distal edge of the urethral; caused by prolapse of the urethral epithelium

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12
Q

Vulvar vesitbulitis

A

benign neoplastic condition of the vulva; infected minor vestibular glands; presents with SEVERE over the top pain (severe introital dyspareunia)

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13
Q

Sebaceous cyst

A

benign neoplastic condition of the vulva; caused by blockage of sebaceous gland; contain cheesy sebaceous material

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14
Q

Fibromas of the vulva

A

benign neoplastic condition of the vulva; most common solid tumor of the vulva; slow growing but can become gigantic (250 lbs)

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15
Q

What is most common solid tumor of the vulva?

A

Fibroma; slow growing but can become gigantic (250 lbs)

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16
Q

Lipoma

A

slow growing tumor comprised of adipose tissue

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17
Q

Hidradenoma

A

benign neoplastic condition of the vulva arising from sweat glands

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18
Q

Syringoma

A

benign tumor of the vulva arising from an eccrine gland

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19
Q

Neurofibroma

A

benign neoplastic condition of the vulva from Von Recklinghausen’s disease

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20
Q

Vulvar hematoma

A

located collection of blood that collect following trauma; bike injuries - straddle injury, birth trauma or sexual assault

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21
Q

Atrophic vaginitis

A

dermatologic condition of the vulva; due to loss of estrogen; atrophy of external genitalia; treat with topical estrogen

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22
Q

Lichen Simplex Chronic

A

AKA Squamous cell hyperplasia; dermatologic condition of the vulva; thickening of epithelium due to prolonged itch-scratch cycle; biopsy will show **rete ridges and hyperkeratosis of keratin layer

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23
Q

Lichen Sclerosis

A

dermatologic condition of the vulva; menopausal women; 10% of untreated will develop SCC of the vulva; intense pruritus, dyspareunia and burning pain; **NO rete ridges and inflammatory cells lining the BM; “onion skin, cigarette paper, parchment like”

24
Q

Characteristic finding on examination for lichen sclerosis

A

“onion skin, cigarette paper, parchment like” appearance; biopsy NO rete ridges and inflammatory cells lining the BM

25
Q

What is the most striking feature of lichen sclerosis?

A

presence of a hyaline zone in the superficial dermis

26
Q

Lichen Planus

A

dermatologic condition of the vulva; purplish, polygonal papules; tx w/ topical and systemic steroids

27
Q

Two types of a vaginal septum

A
  1. transverse - upper and middle thirds of vagina; intercourse is impeded
  2. midline longitudinal - creates double vagina; blind vagina pouch
28
Q

Vaginal agenesis

A

total absence of the vagina EXCEPT most distal portion derived from the urogenital sinus

29
Q

Vaginal agenesis where uterus is absent but fallopian are spared

A

Rokintansky-Kuster-Hauser Syndrome AKA Mullein agenesis

30
Q

Gartner’s Duct Cyst

A

remnant of the Wolffian duct; asymptomatic and require no intervention

31
Q

Bartholin’s Cyst

A

most common vulvovaginal tumor; usually asymptomatic; NEED biopsy in women 40+ to rule out Bartholin’s carcinoma

32
Q

What is the most common vulvovaginal tumor?

A

Bartholin’s Cyst; usually asymptomatic; NEED biopsy in women 40+ to rule out Bartholin’s carcinoma

33
Q

Why is a biopsy required in women 40+ who have an asymptomatic Bartholin’s cyst?

A

to rule out Bartholin’s carcinoma

34
Q

Treatment of a bartholin’s gland abscess?

A

Marsupialization; created new ductal opening by evening the cyst wall onto the epithelial surface where it sutured with interrupted absorbable sutures

35
Q

Cystocele

A

anterior vaginal prolapse

36
Q

Rectocele

A

posterior vaginal prolapse

37
Q

Most common vulvar neoplasm?

A

Squamous cell carcinoma (90%); frequently reported with long history of chronic vulvar pruritus; requires a biopsy

38
Q

VIN Usual type

A

vulvar intraepithelial neoplasia IVIN) III - squamous cell carcinoma in situ; associated with HPV (type 16) and smoking; younger pts; associated with hx of STDs and condyloma

39
Q

VIN Differentiated type

A

vulvar intraepithelial neoplasia IVIN) III - squamous cell carcinoma in situ; NOT associated with HPV (type 16) and smoking; associated with lichen sclerosis; older patients

40
Q

Radiation is contraindicated in which vulvar carcinoma?

A

Verrucous carcinoma b/c may induce anapestic transformation; variant of SCC; lesions are caulk-flower like

41
Q

Verrucous carcinoma

A

a variant of SCC of the vulva; lesions are caulk-flower like; radiation is contraindicated b/c may induce anapestic transformation

42
Q

Bartholins gland carcinoma

A

painless vulvar mass can arise from a bartholin cyst; reoccurrence is common; 5 yr survival rate 85%

43
Q

VAIN

A

Vaginal intraepithelial neoplasia (VAIN); HPV related; asymptomatic; abnormal Pap test; usually pt is post hysterectomy; diagnosis with colposcopes directed vaginal biopsy

44
Q

What is required to diagnosis carcinoma of the vagina?

A

a punch biopsy; usually SCC (85%)

45
Q

Sarcoma botryoides

A

pediatric vaginal cancer (2-3 yrs); present with grape-like polyps protruding from the Introits; embryonal rhabdomyosarcoma

46
Q

Normal physiology of the vagina

A

lined by nonkeratinized stratified squamous epithelium; contains lactic acid and hydrogen peroxide producing lactobacilli; pH 3.8-4.2 (acidic); semen rises pH (pH 7.2 for 6-8 hrs)

47
Q

What is the normal pH of the vagina?

A

pH 3.8-4.2 (acidic)

48
Q

Bacterial Vaginosis (BV)

A

most common vaginitis; most common organism is Gardnerella vaginalis; risk factors are multiple sex partners; saline mount “clue cells”, “fishy” odor; KOH positive whiff test; vaginal pH >4.5; NOT a sexually transmitted infection

49
Q

Is Bacterial Vaginosis (BV) a sexually transmitted infection?

A

NO. so do no have to treat sexual partners

50
Q

Most common organism of Bacterial Vaginosis?

A

Gardnerella vaginalis

51
Q

Diagnosis of bacterial vaginosis?

A

saline mount “clue cells”, “fishy” odor; KOH positive whiff test; vaginal pH >4.5

52
Q

Vulvovaginal candidiasis (VVC)

A

yeast infection; second most common vaginitis; caused by Candida albicans (90%); risk factors high estrogen levels; discharge is white adherent and clumpy “cottage cheese”; KOH positive for budding yeast; vaginal pH <4.5

53
Q

Diagnosis of Vulvovaginal candidiasis (VVC)

A

discharge is white adherent and clumpy “cottage cheese”; KOH positive for budding yeast; vaginal pH <4.5

54
Q

Trichomoniasis

A

STI - evaluate and treat all partners; caused by flagellated protozoan T. vaginalis; unprotected sexual encounters; “frothy” vaginal discharge; saline mount reveals motile trichomonads, pH > 4.5 and strawberry cervix

55
Q

Diagnosis of Trichomoniasis

A

“frothy” vaginal discharge; saline mount reveals motile trichomonads, pH > 4.5 and strawberry cervix

ENRP Exam I (24 decks)

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