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OBGYN > Vulvar Disease > Flashcards

Vulvar Disease Flashcards

1
Q

What is the Clinical appearance of Bacterial Vaginosis? Treatment?

A 
Musty/Fishy odor
Gray/White to yellow discharge
pH >4.5
KOH test +Amine odor
\+ whiff test
Clue Cells
Oral or topical metronidozol
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2
Q

What are the S and S of Candidiasis?

A

Itching
External Dysuria
Cottage Cheese

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3
Q

How is Candidiasis diagnosed??

A

Visualization of blastophores or pseudohyphae on saline or KOH

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4
Q

What are the Treatments of Candidiasis?

A 
Imidazole
Miconazole
Clotrimazole
Terconazole
Fluconazole in Preggo
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5
Q

What are the S and S of Trichomoniasis?

A

Frothy discharge
Yellow-green discharge
Strawberry cervix
Edema, erethema of vulva

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6
Q

How is Trich Diagnosed?

A

Microscopic Exam

Nucleic Acid Probe test

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7
Q

How is Trich Treated?

A

Oral Metronidazole or Tinidazole

Tx partner too

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8
Q

What is the cause of Atrophic Vaginitis?

A

Dryness and Decreased Vaginal Discharge 2/2 decreased estrogen from Menopause

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9
Q

What is the Tx of Atrophic Vaginitis?

A

Moisturizing preparations

Topical or oral estrogen therapy

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10
Q

What are examples of Benign Vulvar disease?

A 
Lichen Sclerosis
Lichen Simplex Chronicus
Lichen Planus
Psoriasis
Dermatitis
Vulvar pain Syndrome
Vulvar Lesions
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11
Q

What is the Presentation of Lichen Sclerosis?

A

Intense itching

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12
Q

What is the Tx of Lichen Sclerosis?

A

Bland emollients
Cotton underwear
No soaps on vulva
Superpotent steroid ointment 2x daily for 1 mon then 1x day

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13
Q

What is Lichen Simplex Chronicus?

A

“an itch that rashes”

2/2 an irritant dermatitis that progresses to LSC

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14
Q

What is the Tx of Lichen Simplex Chronicus?

A

Stop irritant
Antipruritic: Diphenhydramine or hydroxyzine combined with steroid cream
Antidepressant

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15
Q

What is Lichen Planus?

A

Rare inflammatory skin condition
Desquamative lesion of the vagina
Whitish lacy bands of keratosis near reddish ulcerated-like lesions

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16
Q

What is the Treatment of Lichen Planus?

A

Topical Steroid Cream
Hydrocortisone cream
More likely to recurr

17
Q

What is the Tx of Vulvar Dermatitis?

A

Remove attending agent
Good perineal hygeine
Topical Corticosteroids
Oral antipruritics at bedtime

18
Q

What are the Tx of Psoriasis?

A

Coal tar followed by UV light

Topical Steroids more effective

19
Q

What is a Sebaceous Cyst?

A

Blockage of Sebaceous gland duct
Small, smooth nodular mass
Filled with cheesy sebaceous material

20
Q

What is the Cyst of the canal of Nuck?

A

Round Ligament inserts into labia majora
Peritoneal fluid collects within
Excision may be needed

21
Q

What is a Bartholin Gland Cyst?

A

Located at 4 and 8 on posterolateral aspect of Introitus
Mucus Secreting Gand
Cystic Dilation 2/2 obstruction of the duct

22
Q

What is the Tx of Bartholin cyst?

A

Incision and drainage if painful
Recurrent cyst may be marsupialized
Abtx if N. Gonnorhea
Cover S. Aureus if cellulitis occurrs

23
Q

What is seen in Paget’s disease of vulva?

A 
Chronic Pruritis
Velvety red lesions scar into white plaques
Biopsy
Wide local incision
Fatal if it spreads to LN
24
Q

What is Vulvar Intraepithelial Neoplasm?

A

50% asymptomatic
Vulvar Pruritis
Do colposcopy and biopsy

25
Q

What is the Tx of VIN?

A

Assume it will progress to Vulvar CA
Wide local excision
Laser Excision

26
Q

What is the most common type of Vulvar Cancer?

A

Squamous cell CA

27
Q

What is the appearance of Vulvar Cancer?

A

Found on labia majora

-Cauliflower like mass

28
Q

What are the risk factors of Vulvar Cancer?

A 
Manopausal Status
CIN, VIN, HPV
Cigarette smoking
Immunosupression
h/o cervical CA
29
Q

What is the Tx of Vulvar Cancer?

A

Wide local excision with inguinal LN dissection

Pelvic Rad of + mets to nodes

30
Q

What is Premalignant Disease of the Vagina?

A 
Vaginal intraepithelial Neoplasia
Similar to VIN and CIN 
Less common
Diagnosed:
on PAP
Colposcopy
Biopsy
31
Q

What is Tx and FU of VaIN?

A

Local Resection
Laser Ablation
5-FU

Colposcopy every 6 mon until disease free

32
Q

What predisposes someone to Clear Cell Adenocarcinoma?

A

in utero exposure to DES

33
Q

How is Vaginal Cancer Diagnosed?

A 
Watery, blood tinged vaginal discharge
Postmenopausal Bleeding
Vaginal pruritis
Found on PAP or Colposcopy
Biopsy!
34
Q

What is the Tx of Vaginal Cancer?

A

Stage 1, 2 surgical resection

Stage 3, 4 radiation

OBGYN (18 decks)

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