Vulvar and Vaginal Disease Flashcards

1
Q

What is the most common cause of vaginal infection?

A

bacterial vaginosis

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2
Q

What are the 4 Amsel criteria for diagnosis of BV that needs 3 for diagnosis?

A

1) thin, gray homogenous vaginal discharge
2) positive whiff test from KOH releasing amines
3) presence of clue cells on saline microscopy
4) elevated vaginal pH>4.5

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3
Q

What is treatment of BV?

A

500mg metronidazole BID x7 days or vaginal metronidazole .75% gel QHS for five days

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4
Q

What is lichen sclerosis and how does it present?

A

chronic inflammatory skin condition most commonly affects Caucasian premenarchal girls and postmenopausal women; presents with extreme vulvar pruritis and may also present with vulvar burning, pain and introital dyspareunia; ultimately, introital stenosis, resorption of clitoris(phimosis) and labia minora may occur; 5% risk of developing SCC

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5
Q

What is treatment for lichen sclerosis?

A

high potency topical steroids

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6
Q

How can vulvovaginal candidiasis be diagnosed?

A

in a women with signs and symptoms of vaginitis with either a)wet prep or gram stain of vaginal discharge demonstrates yeast or pseudohyphae or b)a vaginal culture or other test yields positive yeast; microscopy might be negative in up to 50% of confirmed cases

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7
Q

How is uncomplicated vulvovaginal candidiasis treated?

A

short course of topical Azole formulations

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8
Q

What is lichen planus?

A

chronic dermatologic disorder involving the hair bearing skin and scalp, nails, oral mucous membranes and vulva

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9
Q

What is vestibulodynia syndrome?

A

severe pain on vestibular touch or attempted vaginal entry, tenderness to pressure and erythema of various degrees

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10
Q

How is vestibulodynia syndrome treated?

A

TCAs to block sympathetic afferent pain loops, pelvic floor rehabilitation, biofeedback and topical anesthetics; surgery with vestibulecotmy is reserved for patients who do not respond to standard therapies and are unable to tolerate intercourse

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11
Q

What is lichen simplex chronicus?

A

vulvar non-neoplastic disorder that results from chronic scratching and rubbing, which damages the skin and leads to loss of its protective barrier

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12
Q

what are symptoms of lichen simplex chronicus?

A

severe vulvar pruritus, which can be worse at night. thick, lichenified, enlarged and rugose labia giving labia a leather like appearance with or without edema

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13
Q

What are etiologies of lichen simplex chronicus?

A

environmental factors such as excessive heat and feminine hygiene products, and conditions such as yeast infections or lichen sclerosis

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14
Q

How is lichen simplex chronicus diagnosed and treated?

A

based on clinical history and findings, as well as vulvar biopsy and cultures to determine underlying cause; treatment involves short course of high potency topical corticosteroids and antihistamines

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15
Q

How is muculopurulent cervicitis treated?

A

therapy should include coverage for both organisms, such as azithromycin or doxycycline for chlamydia and cephalosporin or quinolone for gonorrhea; ceftriaxone 125mg in a single dose

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16
Q

Most cases of recurrent genital herpes are caused by ___.

A

HSV-2

17
Q

Up to 30% first episode cases of genital herpes are caused by ___.

A

HSV-1, but recurrences are much less frequent than in genital HSV-2

18
Q

What are symptoms of primary genital herpes infection?

A

no history of previous genital herpetic lesions and seronegative for HSV antibodies; fever, headache, malaise and myalgias

19
Q

How is genital herpes diagnosed and treated?

A

viral culture, antigen detection or serologic tests; acyclovir, famciclovir and valacyclovir

20
Q

How is vulvodynia treated?

A

estrogen cream and clobetasol