13.1 Vulva Flashcards

1
Q

Define vulva

A

skin and mucosa external to the hymen

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2
Q

What 4 structures are part of the vulva

A

labia majora
labia minora
mons pubis
vestibule

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3
Q

What is the vulvar epithelium?

A

squamous

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4
Q

Where does the Bartholin gland drain

A

into the lower vestibule on each side of vaginal canal

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5
Q

What pop usually has a Bartholin cyst?

A

reproductive age (usually to STI)

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6
Q

CLinical presentation of Bartholin cyst

A

unilateral, painful cyst at lower vestibule adjacent to vaginal canal

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7
Q

define condyloma

A

warty neoplasm of the vulvar skin (can be in vagina or cervix too)–often large

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8
Q

What cuases condyloma

A

low-risk HPV infection

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9
Q

What are the low-risk HPV numbers?

A

6, 11

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10
Q

What are the low-risk HPV numbers? (4)

A

16, 18, 31, 33

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11
Q

histologic hallmark of a condyloma (describe the thing)

A

kiolocytic change - raisin nucleus

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12
Q

define Lichen SClerosis

A

thinning of epidermis and fibrosis of the underlying dermis

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13
Q

how does Lichen sclerosis present?

A

leukoplakia = “parchment like” vulvar skin

basically a white plaque

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14
Q

MC population seen with lichen sclerosis

A

post-menopausal women

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15
Q

Is lichen sclerosis benign or malignant

A

benign

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16
Q

what cancer is lichen sclerosis associted with

17
Q

what is cause/association of lichen simplex chronicus

A

chronic itching and scratching

18
Q

how does lichen simplex chronicus present

A

leukoplakia with thick, leathery vulvar skin

19
Q

define lichen simplex chronicus

A

hyperplasia of vulvar squamous epithelium

20
Q

From what cell does vulvar carcinoma arise

A

squamous epithelium (all carcinomas arise from epithelial tissue)

21
Q

how does vulvar carcinoma present

A

leukoplakia - need bx to diff from the lichens

22
Q

what are 2 etiologies of vulvar carcinoma

A

HPV related or Non-HPV related

23
Q

What HPV types is the HPV-related vulvar carcinoma due to?

A

high risk- types 16, 18, 31, 33

24
Q

What precursor condition gives rise to HPV-related vulvar carcinoma

A

VIN- vulvar intraepithelial neoplasia

25
What are 4 chcs of VIN
koilocytic change, disordered cellular maturation, nuclear atypia, increased mitosis
26
What precursor condition gives rise to non-HPV-related vulvar carcinoma
long-standing lichen sclerosis (chronic inflammation)
27
What population most often has non-HPV-related vulvar carcinoma and why
elderly >70 | it takes a while for the chroinic inflammation to cause carcinoma
28
define Extramammary Paget disease
malignant epithelial cells in the epidermis of the vulva
29
Extramammary Paget disease presnts as?
erythmatous, pruritic, ulcerated vulvar skin
30
What is diff bt Extramammary Paget disease and Paget disease of nipple other than location
Extramammary Paget disease is only in situ and unlike Paget disease of the nipple, represents no underlying carcinoma
31
What must Extramammary Paget disease be distinguished from
melanoma
32
What is marker profile for Melanoma (3)
PAS (-) - does not produce mucous- only epithleial cells keratin (-) ONLY PRESent in epithelial cells S100 (+) hallmark of melanoma
33
What is marker profile for extramammary pagets disease (3)
PAS (+) - produces mucuous keratin (+) - int filament of epi cells S100(-) only in melanoma