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WH > vulvar swellings > Flashcards

vulvar swellings Flashcards

1
Q

what are the classifications of FGM ?

A

type 1: partial or total removal of the clitoris and/or the prepuce
type 2: removal of the clitoris and the labia minora with or without the labia majora
type 3: tightening of the vaginal orifice by removing all parts of the external genitalia ( if=nfibulation)

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2
Q

what is the labia major homologous to in males ?

A

the scrotum

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3
Q

where are the round ligaments of the uterus inserted into ?

A

labia majora

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4
Q

what connects the posterior end of the labia majora ?

A

the posterior commissure

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5
Q

what connects the posterior end of the labia minora ?

A

posterior fourchette

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6
Q

what is the area inside or between the labia minora ?

A

the vestibule

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7
Q

what are the contents of the vestibule ?

A

the vagina
external urethral opening
2 bartholin glands

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8
Q

what is the vestibular bulb ?

A

Consists of 2 masses of erectile

tissue on each side of the vagina

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9
Q

what is the function of bartholin glands ?

A

The glands secrete thin mucus during

sexual excitement acting as a lubricant

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10
Q

what are bartholin glands homologous to in males ?

A

Cowper’s glands

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11
Q

what are the different shapes of the hymen ?

A
  • Annular.
  • Biperforate/Septate.
  • Cribriform.
  • Fringed.
  • Crescentic
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12
Q

what is Carunculae myritiformes ?

A

remains of torn or lacerated hymen

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13
Q

what is the blood supply of the vulva ?

A

mainly from the pudendal artery

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14
Q

what is the venous drainage of the vulva ?

A

from plexuses

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15
Q

what is the lymphatic drainage of the vulva ?

A 
superficial inguinal LN 
deep inguinal LN 
external iliac LN 
common iliac LN 
Para-aortic LN
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16
Q

what is the main nerve supply of the vulva ?

A

pudendal nerve

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17
Q

what are the traumatic lesions involving the vulva ?

A

hematoma , which may occur in labour or after vulvar surgery

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18
Q

what is the treatment for vulvar hematoma ?

A

incision and ligation of the bleeding vessels

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19
Q

what are the inflammatory conditions of the vulva ?

A

vulvitis
Bartholin’s abscess
Condylomata lata
Condyloma accuminata

20
Q

what is the difference between condyloma lata and condyloma accuminata ?

A

lata is due to secondary syphilis

accuminata is due to HPV

21
Q

what swellings can occur in the vulva due to circulatory disorders ?

A

varicose veins
edema
elephantiasis

22
Q

what are the causes of varicose veins in the vulva and what is the management ?

A

usually due to pregnancy and is ligated and excised

23
Q

what is the cause of elephantiasis in the vulva ?

A

due to chronic lymphatic obstruction

24
Q

what are the different retention cysts in the vulva ?

A 
bartholin cyst 
hydrocele of the canal of Nuck 
Endometrioma 
Inclusion dermoid cyst 
sebaceous cysts
25
Q

what is the cause of bartholin cysts ?

A

bartholinitis

episiotomy

26
Q

if the bartholin cyst were to be complicated by a secondary infection what would happen ?

A

formation of bartholin abscess

27
Q

what is the treatment of bartholin cyst ?

A

excision
or
marsupialization
if it is already a bartholin abscess then incision and drainage is required

28
Q

how does hydrocele of the canal of nuck happen ?

A

a peritoneal pouch that is accompanied by the round ligament during development remains instead of becoming obliterated , fluid accumulation occurs in this peritoneal pouch and causes hydrocele and may extend into the inguinal canal

29
Q

what is the treatment of hydrocele of the canal of Nuck ?

A

excision of the sac and repair of inguinal hernia if there is one

30
Q

what are inclusion dermoid cysts ?

A

small cysts containing sebaceous material due to burying of epithelium under the dermis during repair of an episiotomy

31
Q

what are sebaceous cysts ?

A

small multiple cysts caused by retention of sebum due to occlusion of the duct

32
Q

what is a hidradenoma ?

A

benign tumor of the sweat glands

33
Q

what is a caruncle ?

A

adenoma of Skene’s tubules

34
Q

what are skene tubules ?

A

glands on either side of the urethra which are homologous to the prostate in males

35
Q

what is granulomatous caruncle ?

A

resulting from chronic urethritis

36
Q

what is a nevus ?

A

benign cluster of melanocytes that is not a tumor but is removed because its pre-cancerous

37
Q

what are the precancerous disorders of the vulva divided into ?

A

squamous VIN

non squamous VIN

38
Q

what are the symptoms of squamous VIN ?

A

pruritus , cases may be asymptomatic

39
Q

on examination what is observed in squamous VIN ?

A

multicentric , raised lesions a with a rough surface which are variable in color
white - with hyperkeratinization
red - with epithelial thinning
brown - with melanin deposition

40
Q

how is a biopsy taken in squamous VIN ?

A

acetic acid is applied on the vulva and whatever turns white is taken for biopsy

41
Q

what is the treatment for squamous VIN ?

A

asymptomatic : repeated biopsies
symptomatic : repeated biopsies and topical steroid creams
small lesion : excision biopsy
multifocal lesions: skinning vulvectomy

42
Q

what is non-squamous VIN ?

A

also known as paget’s disease which is an adenocarcinoma in situ

43
Q

what is the clinical picture of non-squamous VIN ?

A

pruritus

red crusted plaques with sharp edges

44
Q

what are the associated malignancies with non-squamous VIN ?

A

adenocarcinoma of apocrine glands

cervical carcinoma

45
Q

what is the treatment for non-squamous VIN ?

A

very wide local incision , almost total vulvectomy

46
Q

what are the commonest secondary tumors due to retrograde flow ?

A

chorioamnionitis

WH (68 decks)

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