Vulvar Disease

Question 1

what part of the genial tract does hpv affect?

Answer 1

lower genital tract

Question 2

how do you treat condyloma acuminata?

Answer 2

surgical excision
topical cytotoxic agents (TCA)
immune modulators

Question 3

What is molluscum contagiosum caused by?

Answer 3

benign pox virus

Question 4

how is molluscum contagiosum spread

Answer 4

skin contact
auto inoculation
fomits

Question 5

how does molluscum contagiosum look like ?

Answer 5

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

Question 6

How do you diagnose molluscum contagiosum ?

Answer 6

typically diagnosed clinically by gross inspection

giemsa gram or wright stain

Question 7

how do you tx molluscum contagiosum?

Answer 7

spontaneously regress

or can remove by cryotherapy

Question 8

where is pediculosis pubic/ crabs usually restricted too?

Answer 8

pubic perineal and perianal areas

Question 9

how does crabs present?

Answer 9

mites and eggs

intense itching and rash

Question 10

how to treat crabs/pediculousis pubic?

Answer 10

pediculicides-permethrin
pyrethrins with piperonyal but oxide
lindane

Question 11

what are the signs and symptoms of sarcopties scabiei?

Answer 11

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

Question 12

where are the most common sites for sarcopties scabies?

Answer 12

hands wrist elbows groin and ankles

Question 13

how to diagnose sarcopties scabiei?

Answer 13

history and appearance of burrows (females in them)

skin scraping with oil immersion

Question 14

how to treat sarcopties scabiei?

Answer 14

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

Question 15

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

Answer 15

permethrin

crotamiton

Question 16

what kind of infection is herpes?

Answer 16

viral

Question 17

what is the etiology behind herpes (HSV)?

Answer 17

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

Question 18

what are the signs and symptoms of herpes?

Answer 18

vburning and severe pain itching

vesicle formation leading to ulceration and then crusting

Question 19

how do you diagnose herpes?

Answer 19

viral culture

Question 20

how do you treat herpes?

Answer 20

antiviral therapy

acyclovir, famciclovir, valacylovir

Question 21

when is treponema palladium (syphilis) contagious?

Answer 21

only when mucocutaneous lesions are present

Question 22

describe how primary treponema palladium (syphilis) looks like?

Answer 22

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

Question 23

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

Answer 23

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

Question 24

describe latent syphillis

Answer 24

seropositivity with no clinical manifestations

Question 25

describe tertiary syphilis

Answer 25

up to 20 years after latency of untreated syphilis | involves bone skin cardiovascular cns

Question 26

how do you diagnose treponema palladium (syphilis)?

Answer 26

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

Question 27

how do you treat treponema palladium (syphilis)?

Answer 27

benzathine penicillin or doxycline or tetracylcine

Question 28

what is chancroid caused by

Answer 28

haemophilus ducreyi

Question 29

how long does who recommend between pregnancies?

Answer 29

18 months

Question 30

what are the most effective methods of contraception

Answer 30

``` #1. implant #2male sterilization #3 IUD hormonal #4 IUD copper #5 female sterilization ```

Question 31

what can hormonal contraceptives be used for?

Answer 31

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

Question 32

what is infertility?

Answer 32

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

Question 33

what is fecundabiliy and what is the normal value?

Answer 33

rate of conception | 20%

Question 34

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

Answer 34

Day 3 FSH

Question 35

where are gonadotropins secreted from?

Answer 35

anterior lobe of the pituitary gland

Question 36

what role do gonadotropins play in ovulation?

Answer 36

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

Question 37

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

Answer 37

- PCOS (also most common cause for oligiomenorrhea and amenorrhea in all women) - advanced maternal age (perimenopause)

Question 38

what is the criteria for diagnosis of PCOS?

Answer 38

- menstrual irregularity due to oligo-ovulation or an ovulation - hyperandrogenism

Question 39

what is hystrosalpingogram

Answer 39

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

Question 40

what are examples of tubal factor infertility?

Answer 40

PID?salpingitis Pelvic adhesions Tubal ligation Endometriosis

Question 41

How are most cases of tubal factor infertility treated?

Answer 41

#1 with "ART"-Assisted Reproductive technology ovulation induction tubal surgery

Question 42

how do you induce ovulation?

Answer 42

metformin clomiphene citrate gonadotrophin/GRH

Question 43

explain the steps of ART?

Answer 43

- controlled ovarian hyperstimulation ( clomiphrene or HMG) | - Intrauterine Insemination one day prior to ovulation on morning following LH surge (fresh sperm)

Question 44

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

Answer 44

chromosomal abnormality

Question 45

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

Answer 45

structural problems with the cervix or uterus

Question 46

what is the most common chromosomal cause of SAB?

Answer 46

autosomal trisomy 16

Question 47

What are endocrine cause of SAB?

Answer 47

progesterone deficiency thyroid disease diabetes Factor V Liden

Question 48

how do you treat chancroid?

Answer 48

azithromycin ceftriaxone ciprofloxacin erythromycin

Question 49

what are the signs and symptoms of chancroid?

Answer 49

erythematous papule that becomes pustular and ulcerates within 48 hours

Question 50

What is Lichen Simplex Chronicus?

Answer 50

thickening of the epidermis and stratum corneum

Question 51

What causes Lichen Simplex Chronicus?

Answer 51

persistent rubbing, scratching or scrubbing of the vulva

Question 52

How do you treat Lichen simplex chonicus?

Answer 52

topical steroids

Question 53

what is lichen sclerosis?

Answer 53

thin skin | itchy vulva may include perianal region

Question 54

how do you treat lichen sclerosis?

Answer 54

vulvar hygiene | topical steroids

Question 55

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

Answer 55

lichen sclerosis | can turn into squamous cell carcinoma

Question 56

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

Answer 56

postmenopausal

Question 57

What are signs and symptoms of vulvar cancer?

Answer 57

``` itching pain painful intercourse (dypamrenuia) ```

Question 58

what is the most common vulvar cancer?

Answer 58

squamous cell carcinoma

Question 59

what is a bartholian gland duct cyst?

Answer 59

when obstruction of the gland leads to cyst enlargement

Question 60

What is a complication of a bartholian gland cut cyst?

Answer 60

it may become infected and result in an ascess

Question 61

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

Answer 61

sever vulvar pain making walking and sitting difficult

Question 62

how do you treat bartholain gland duct cyst?

Answer 62

incision and drainage cather placement marsupialization excision

Question 63

What version of the MCV virus is the std?

Answer 63

mcv2

Question 64

which herpes is the genital one?

Answer 64

herpes one

Question 65

describe HSV?

Answer 65

multinucleated squamous cells intranuclear eosinophilic ground glass appearance

Question 66

what cells does hpv infect?

Answer 66

immature basal epithelium

Question 67

What is seen in lichen simplex chonicus?

Answer 67

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

Question 68

what is condyloma datum?

Answer 68

sphillis

Question 69

what is condyloma accuminatum

Answer 69

hpv

Question 70

what does vulvar carcinoma arise form>?

Answer 70

an in situ lesions (classic VIN) | lichen sclerosis

Question 71

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

Answer 71

keratinizing squamous cell carcinoma

Question 72

what age do hpv negative vulvar carcinomas occur?

Answer 72

eight decade

Question 73

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

Answer 73

reproductive age women

Question 74

is extrammmary pagets disease associated with underlying cancer?

Answer 74

no

Question 75

where is pagets disease confined too

Answer 75

epidermis

Question 76

what causes a septet or double vagina?

Answer 76

failure of the mullein duct to fuse | accompanied by double uterus

Question 77

what causes gartner duct cyst (common lesions)

Answer 77

lateral walls of vagina | derived from wolffian (mesonephric) duct rest

Question 78

what does vaginal intraepithelial neoplasia turn into ?

Answer 78

squamous cell carcinoma

Question 79

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

Answer 79

it is found in infants and children less than 5 years old | grow as polypoid rounded bulky masses

Question 80

what is a complication of embryonal rhabdomyosarcoma?

Answer 80

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

Question 81

what is another name for Embryonal rhabdomyosarcoma ?

Answer 81

sarcoma botryoids