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GYNE CLERKSHIP > VULVAR INFECTIONS > Flashcards

VULVAR INFECTIONS Flashcards

1
Q

Condyloma Acuminatum

Etiology

A

: HPV
16, 18: aneuploid,
premalignant or malignant
lesions

6, 11: benign, euploid
lesions

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2
Q

Condyloma Acuminatum

Clinical Features

A

Raised & ragged lesions cauliflower lesions

(+) pruritus
(+) grows fast
spread by skin-to-skin contact

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3
Q

Condyloma Acuminatum

Diagnosis

A

EXCISION Biopsy

PATHOGNOMONIC: Koilocytes seen on cytology

Koilocytes - cells with
perinuclear halos)

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4
Q

Condyloma Acuminatum

Treatment

A

Electrocautery - in office
Cryotherapy
Chemical cautery - if lesion is thin

SMALL LESIONS: IMIQUIMOD (topical cream for small
multiple lesions)

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5
Q

Condyloma Acuminatum in a pregnant patient

A

Deliver CS if condyloma is so prolific
Baby might incur virus (laryngeal
papilloma)

In early pregnancy: Do not use chemical cauterizing drugs;
treat mechanically via excisions,
cauterization or cryotherapy

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6
Q

Herpes Genitalis

Describe lesion

A

Vesicles
Ulcers (vesicles that have ulcerated)
(+) painful

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7
Q

Herpes Genitalis

what is peculiar about this disease?

A

Recurrent & incurable STD
• 1st recurrence usually within 6 months
• May recur 4x in first year

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8
Q

Herpes Genitalis

Causative agent

A

Herpes Simplex
Virus Type 2 – resides in
dorsal root ganglia (S2, S3,
S4)

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9
Q

Before appearance of herpetic vesicles, what symptoms may arise first?

A 
Sacroneuralgia
vulvar burning
tenderness
pruritus
inguinal adenopathy
--> appear hours to 5 days before vesicle formation
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10
Q

What vulvar lesion causes tender inguinal lymphadenopathy

A

HSV 2

Herpes

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11
Q

HSV diagnosis

A
  1. PCR - most accurate and sensitive
  2. Tzanck smear (+) multinucleated giat cells
  3. viral culture or serologic testing
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12
Q

HSV Treatment

A

ACYCLOVIR (A mukhang 4)
400 mg
3x/day for 7-10
days

Daily suppression/prophylaxis: if >6 episodes/year (Acyclovir 400mg
orally BID)

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13
Q

Molluscum Contagiosum

Etiologic agent

A

Poxvirus

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14
Q

Molluscum Contagiosum

Mode of transmission

A

Asymptomatic

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15
Q

Molluscum Contagiosum

Lesion description

A

asymptomatic

Umbilicated papule
“water wart”

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16
Q

Molluscum Contagiosum

Diagnosis

A

Giemsa stain

Confirmatory intracytoplasmic molluscum bodies

17
Q

Molluscum Contagiosum

Treatment

A

Usually self-limiting
May be treated chemically or by
cryosurgery or electrocautery

18
Q

s (Bartholin’s
Adenitis)

Etiology

A 
Etiology:
1. Cystic dilatation of duct
2. Abscess formation
3. Mechanical obstruction
(inflammation/trauma)
19
Q

Soft swelling, fluctuant tissue on the vulva and

severe pain

A

Bartholin’s

Adenitis

20
Q

Swelling of the vulva Usually unilateral, tense, non-painful and
unilocular

A

Bartholin’s cysts

21
Q

Swelling of the vulva

Swelling, redness, tenderness, but NO mass

A

Bartholin’s adenitis

22
Q

Erythema, acute tenderness, edema,
cellulitis, asymmetrical vulvar swelling
• Fever and difficulty in walking

A

Bartholin’s Abscess

23
Q

Bartholin’s Abscess

Etiologic Agent

A

s. aureus

24
Q

Treatment of Bartholin’s Abscess:

A 
Marsupialization
Development of a fistulous
tract from Bartholin’s duct to
vestibule, to allow continuous
drainage

Drained pus sent for culture &
sensitivity

Give IV antibiotics first before
draining the abscess, to
prevent spread of infectious
emboli

25
Q

When is excision of duct and gland indicated if persistent deep infection, multiple recurrences of abscess, gland enlargement in women >40

A

Excision of duct & gland is indicated
if persistent deep infection, multiple
recurrences of abscess, gland
enlargement in women >40

26
Q

Function of the bartholin’s glands

A

Bartholin functions for lubrication during
coitus

Normal Bartholin’s glands not palpable
2 rounded pea-sized glands located at
entrance of vagina (5 & 7 o’ clock positions)

27
Q

Pediculosis Pubis

Etiologic agent

A

Phthirus pubis

28
Q

Pediculosis Pubis

A

Hallmark: constant pubic pruritus

29
Q

Most contagious of all STIs

A

pediculosis pubis

30
Q

Diagnosis of pediculosis pubis

A

Finding of eggs &
lice by visual
inspection

31
Q

Treatment pediculosis pubis

A

C/I: pregnancy,

lactation, children <2

32
Q

Scabies Etiologic Agent

A

sarcoptes scabiei

33
Q
  • Severe but intermittent pruritus

* More intense at night

A

sarcoptes scabiei

34
Q

• Pathognomonic: burrows in skin containing

mites

A

sarcoptes scabiei

35
Q

Diagnosis of sarcoptes scabiei

A

Scraping of burrows
& inspection under
microscope

36
Q

Treatment of Scabies

A

Permethrin 1% cream – apply to
affected areas, wash off after 10
minutes

Permethrin 5% cream – apply to all
areas of body from neck down, wash
off after 8-14 hours

GYNE CLERKSHIP (14 decks)

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