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Ob Gyn > vulvar/vaginal disease > Flashcards

vulvar/vaginal disease Flashcards

1
Q

musty, fishy odor with incr thin gray-white to yellow discharge; mild vulvar irritation, pH >4.5

A

BV

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2
Q

incr in WBC, loss of normal lactobacilli, clue cells “ ground glass”

A

BV

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3
Q

gold standard for BV

A

gram stain

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4
Q

clinical dx of BV made with 3/4 of what criteria

A
  1. abnormal gray discharge
  2. pH >4.5
    • whiff test
    • clue cells
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5
Q

BV tx (2)

A
  1. oral or topical metronidazole

2. topical clindamycin

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6
Q

itching, burning, external dysuria, dyspareunia, thick odorless cottage cheese, pH 4-5

A

candida

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7
Q

dx of candida

A

visualization of blastospores or pseudohyphae on saline or KOH microscopy

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8
Q

tx of candida

A

vaginal application of imidazole, miconazole, clotrimazole, terconazole

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9
Q

what sort of azole to use in pregnancy for tx of candida infxn

A

oral fluconazole

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10
Q

if recurrence of candida within 1 month of tx

A

oral fluconazole x 6 mon

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11
Q

tx of T glabrata

A

intravaginal boric acid capsules or gentian violet

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12
Q

where does trich live?

A

vagina, skene ducts, urethra

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13
Q

transmission of trich

A

sexual, pools, hot tubes

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14
Q

trich pH

A

> 4.5

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15
Q

appearance of vulva with trich

A

edema or erythema

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16
Q

strawberry cervix

A

trich

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17
Q

dx of trich

A
  1. microscopic exam

2. nucleic acid probe test

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18
Q

trich tx

A

oral metronidazole or tinidazole

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19
Q

tx of trich in pregnancy

A

oral metronidazole or tinidazole

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20
Q

atrophy of vaginal epithelium due to decr estrogen levels

A

atrophic vaginitis

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21
Q

expected pH in atrophic vaginitis

A

> 4.7

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22
Q

decr vaginal discharge, dryness, ithcing, burning, dyspareunia, urinary urgency, recurrent UTI

A

atrophic vaginitis

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23
Q

tx of atrophic vaginitis (2)

A
  1. local water-based moisterizers

2. topical or oral estrogen tx

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24
Q

pruritis that can interfere with sleep, pruritis ani, inflammatory process

A

lichen sclerosis

25
Q

tx of lichen sclerosis

A
  1. improve general care

2. superpotent steroid ointment (clobetasol)

26
Q

an itch that rashes

A

lichen simplex chronicus

27
Q

develops secondary to an irritant dermatitis

A

lichen simplex chronicus

28
Q

labia majora/minora and perineal body can be diffusely reddened with occ hyperplastic plaques of red-brown

A

lichen simplex chronicus

29
Q

tx of lichen simplex chronicus

A
  1. d/c irritant
  2. antipruritic: diphenhydramine or hydroxyzine + mod strength steroid cream
  3. antidepressant
30
Q

presents as a desquamative lesion of the vagina on the inner labia minora and vuvlar vestibule

A

lichen planus

31
Q

whitish lacy bands or keratosis (wickham striae)

A

lichen planus

32
Q

presents with chronic vulvar burning, insertional dyspareunia, profuse vaginal discharge

A

lichen planus

33
Q

does biopsy of lichen planus show any atypia?

A

no

34
Q

tx of lichen planus

A

topical steroids

35
Q

between lichen simplex chronicus and lichen planus, which requires a shorter course of tx?

A

lichen planus

36
Q

between lichen simplex chronicus and lichen planus, which is more likely to recur?

A

lichen planus

37
Q

tx of psoriasis

A
  1. coal tar + UV light

2. topical steroids

38
Q

inflammatino of sebaceous glands with lesions that are pale red to yellow-pink; may be covered by oil appearing scaly crust

A

seborrheic dermatitis

39
Q

tx of vulvar dermatitis

A
  1. remove offending agent
  2. 5% soln Al acetate
  3. topical corticosteroids
40
Q

small smooth nodular material on vulva that may be excised

A

sebaceous (inclusion) cysts

41
Q

collection of peritoneal fluid within round ligament insertion into labia majora

A

cyst of the canal of nuck

42
Q

when to tx bartholin’s gland cyst with Abx

A

+ N. gonorrhea OR cellulits

43
Q

premalignant conditions of the vulva

A
  1. paget’s disease

2. Vulvar intraepithelial neoplasia (VIN)

44
Q

chronic pruritis, velvety-red lesions that become eczematous & scar into white plaques, age >60

A

paget’s disease

45
Q

tx of paget’s disease

A

wide local excision

46
Q

dx of VIN

A

colposcopy + biopsy

47
Q

tx of VIN

A

wide local excision or laser excision

48
Q

f/u of VIN: colposcopy every____ until

A

every 6 months until disease free x 2 years

49
Q

most common type of vulvar cancer

A

squamous cell carcinoma

50
Q

where is vulvar cancer usus found?

A

labia majora

51
Q

dx of vulvar cancer

A

need to have annual exam & do a biopsy if indicated

52
Q

tx of vulvar cancer

A

wide local excision with inguinal lymph node dissection

53
Q

how to dx premalginant disease of vagina

A
  1. PAP
  2. colposcopy
  3. biopsy
54
Q

tx of VaIN

A

local resection, laser ablation or 5FU

55
Q

in utero exposure to DES assc’d with

A

clear cell adenocarcinoma

56
Q

peak incidence for vaginal cancer

A

age 60

57
Q

watery, blood tinged vaginal discharge, postmenopausal bleeding, vaginal pruritis

A

vaginal cancer

58
Q

tx of stage I, II vaginal cancer

A

surgical resection

59
Q

tx of stage III, IV vaginal cancer

A

radiation

Ob Gyn (33 decks)

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