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Pathology/ICM-GYN Module > Vulvar Disease > Flashcards

Vulvar Disease Flashcards

1
Q

what part of the genial tract does hpv affect?

A

lower genital tract

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2
Q

how do you treat condyloma acuminata?

A

surgical excision
topical cytotoxic agents (TCA)
immune modulators

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3
Q

What is molluscum contagiosum caused by?

A

benign pox virus

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4
Q

how is molluscum contagiosum spread

A

skin contact
auto inoculation
fomits

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5
Q

how does molluscum contagiosum look like ?

A

papule with central umbilication
single or multiple
commonly seen on vulva thighs or buttocks

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6
Q

How do you diagnose molluscum contagiosum ?

A

typically diagnosed clinically by gross inspection

giemsa gram or wright stain

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7
Q

how do you tx molluscum contagiosum?

A

spontaneously regress

or can remove by cryotherapy

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8
Q

where is pediculosis pubic/ crabs usually restricted too?

A

pubic perineal and perianal areas

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9
Q

how does crabs present?

A

mites and eggs

intense itching and rash

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10
Q

how to treat crabs/pediculousis pubic?

A

pediculicides-permethrin
pyrethrins with piperonyal but oxide
lindane

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11
Q

what are the signs and symptoms of sarcopties scabiei?

A

intense itching
hypersensitivity reaction to the mites
erythematous papule vesicles or nodules

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12
Q

where are the most common sites for sarcopties scabies?

A

hands wrist elbows groin and ankles

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13
Q

how to diagnose sarcopties scabiei?

A

history and appearance of burrows (females in them)

skin scraping with oil immersion

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14
Q

how to treat sarcopties scabiei?

A

pediculicides-Liane cream (EXCEPT IN PREGNANCY and children less than 2 yo)

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15
Q

how do you treat sarcopties scabiei if pregnant or less than 2 years old?

A

permethrin

crotamiton

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16
Q

what kind of infection is herpes?

A

viral

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17
Q

what is the etiology behind herpes (HSV)?

A

virus enters the sensory nerve endings and undergoes retrograde axonal transport to the dorsal root ganglion life long latency

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18
Q

what are the signs and symptoms of herpes?

A

vburning and severe pain itching

vesicle formation leading to ulceration and then crusting

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19
Q

how do you diagnose herpes?

A

viral culture

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20
Q

how do you treat herpes?

A

antiviral therapy

acyclovir, famciclovir, valacylovir

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21
Q

when is treponema palladium (syphilis) contagious?

A

only when mucocutaneous lesions are present

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22
Q

describe how primary treponema palladium (syphilis) looks like?

A

hard nontender ulcer
raised border
found on vagina vulva can be on mouth or anus

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23
Q

describe how 2nd treponema palladium (syphilis) looks like?

A

maculopapular rash that may involve entire body
palms soles and mucus membranes
presents 6w-6mo after infection

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24
Q

describe latent syphillis

A

seropositivity with no clinical manifestations

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25
Q

describe tertiary syphilis

A

up to 20 years after latency of untreated syphilis

involves bone skin cardiovascular cns

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26
Q

how do you diagnose treponema palladium (syphilis)?

A

dark field microscopy
or direct fluorescent antibody test (FTA-ABS)
TP-PA

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27
Q

how do you treat treponema palladium (syphilis)?

A

benzathine penicillin
or doxycline
or tetracylcine

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28
Q

what is chancroid caused by

A

haemophilus ducreyi

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29
Q

how long does who recommend between pregnancies?

A

18 months

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30
Q

what are the most effective methods of contraception

A 
#1. implant
#2male sterilization
#3 IUD hormonal
#4 IUD copper
#5 female sterilization
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31
Q

what can hormonal contraceptives be used for?

A

control acne
abnormal uterine bleeding (heavy period)
improvement in dysmenorrhea

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32
Q

what is infertility?

A

the inability of couples of reproductive age to establish pregnancy by having sex within a year

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33
Q

what is fecundabiliy and what is the normal value?

A

rate of conception

20%

34
Q

what is a good indicator of ovarian reserve(the pool of viable oocytes remaining wishing the ovary)?

A

Day 3 FSH

35
Q

where are gonadotropins secreted from?

A

anterior lobe of the pituitary gland

36
Q

what role do gonadotropins play in ovulation?

A

FSH-follicular development (granulose cells)

LH- acts not he follicle to stimulate plasminogen and prostaglandins to promote follicular rupture (theca cells)

37
Q

what is the most common cause of ovulatory dysfunction that will lead to infertility?

A
  • PCOS (also most common cause for oligiomenorrhea and amenorrhea in all women)
  • advanced maternal age (perimenopause)
38
Q

what is the criteria for diagnosis of PCOS?

A
  • menstrual irregularity due to oligo-ovulation or an ovulation
  • hyperandrogenism
39
Q

what is hystrosalpingogram

A

use of fluoroscopy to examine the inside of the uterus and fallopian tubes
is diagnostic but in some instances may be therpeutic

40
Q

what are examples of tubal factor infertility?

A

PID?salpingitis
Pelvic adhesions
Tubal ligation
Endometriosis

41
Q

How are most cases of tubal factor infertility treated?

A

1 with “ART”-Assisted Reproductive technology

ovulation induction
tubal surgery

42
Q

how do you induce ovulation?

A

metformin
clomiphene citrate
gonadotrophin/GRH

43
Q

explain the steps of ART?

A
  • controlled ovarian hyperstimulation ( clomiphrene or HMG)

- Intrauterine Insemination one day prior to ovulation on morning following LH surge (fresh sperm)

44
Q

pregnancy loss at 10 or less weeks is usually due too ?

A

chromosomal abnormality

45
Q

pregnancy loss at 18-20 weeks is usually due too?

A

structural problems with the cervix or uterus

46
Q

what is the most common chromosomal cause of SAB?

A

autosomal trisomy 16

47
Q

What are endocrine cause of SAB?

A

progesterone deficiency
thyroid disease
diabetes
Factor V Liden

48
Q

how do you treat chancroid?

A

azithromycin
ceftriaxone
ciprofloxacin
erythromycin

49
Q

what are the signs and symptoms of chancroid?

A

erythematous papule that becomes pustular and ulcerates within 48 hours

50
Q

What is Lichen Simplex Chronicus?

A

thickening of the epidermis and stratum corneum

51
Q

What causes Lichen Simplex Chronicus?

A

persistent rubbing, scratching or scrubbing of the vulva

52
Q

How do you treat Lichen simplex chonicus?

A

topical steroids

53
Q

what is lichen sclerosis?

A

thin skin

itchy vulva may include perianal region

54
Q

how do you treat lichen sclerosis?

A

vulvar hygiene

topical steroids

55
Q

which has the tendency to become malignant lichen sclerosis or lichen simplex chronicus?

A

lichen sclerosis

can turn into squamous cell carcinoma

56
Q

Is lichen sclerosis seen in post menopausal or pre menopausal women?

A

postmenopausal

57
Q

What are signs and symptoms of vulvar cancer?

A 
itching pain 
painful intercourse (dypamrenuia)
58
Q

what is the most common vulvar cancer?

A

squamous cell carcinoma

59
Q

what is a bartholian gland duct cyst?

A

when obstruction of the gland leads to cyst enlargement

60
Q

What is a complication of a bartholian gland cut cyst?

A

it may become infected and result in an ascess

61
Q

What are the signs and symptoms of bartholian gland duct cyst?

A

sever vulvar pain making walking and sitting difficult

62
Q

how do you treat bartholain gland duct cyst?

A

incision and drainage
cather placement
marsupialization
excision

63
Q

What version of the MCV virus is the std?

A

mcv2

64
Q

which herpes is the genital one?

A

herpes one

65
Q

describe HSV?

A

multinucleated squamous cells
intranuclear eosinophilic
ground glass appearance

66
Q

what cells does hpv infect?

A

immature basal epithelium

67
Q

What is seen in lichen simplex chonicus?

A

leukoplakia (white plaques)
may enlarge or coalesce
may cause itching and schooling
most common in post-menopausal women

68
Q

what is condyloma datum?

A

sphillis

69
Q

what is condyloma accuminatum

A

hpv

70
Q

what does vulvar carcinoma arise form>?

A

an in situ lesions (classic VIN)

lichen sclerosis

71
Q

is the vulvar squamous cell carcinoma not related to hpv, keratinizing or non keratinizing?

A

keratinizing squamous cell carcinoma

72
Q

what age do hpv negative vulvar carcinomas occur?

A

eight decade

73
Q

at what age do hpv positive vulvar squamous cell carcinomas occur?

A

reproductive age women

74
Q

is extrammmary pagets disease associated with underlying cancer?

A

no

75
Q

where is pagets disease confined too

A

epidermis

76
Q

what causes a septet or double vagina?

A

failure of the mullein duct to fuse

accompanied by double uterus

77
Q

what causes gartner duct cyst (common lesions)

A

lateral walls of vagina

derived from wolffian (mesonephric) duct rest

78
Q

what does vaginal intraepithelial neoplasia turn into ?

A

squamous cell carcinoma

79
Q

what age group do you see embryonal rhabdomyosarcoma of the vagina?

A

it is found in infants and children less than 5 years old

grow as polypoid rounded bulky masses

80
Q

what is a complication of embryonal rhabdomyosarcoma?

A

may invade locally penetrate into the peritoneal cavity or cause obstruction of the urniary tract

81
Q

what is another name for Embryonal rhabdomyosarcoma ?

A

sarcoma botryoids

Pathology/ICM-GYN Module (11 decks)

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