Exam 2 Vulvar Dz Flashcards Preview

Q4 Women's Health > Exam 2 Vulvar Dz > Flashcards

Flashcards in Exam 2 Vulvar Dz Deck (26):
1

Lichen Sclerosus is?

Vulvar disorder:
Benign, chronic inflamm

Autoimm attacks all levels of skin

2

Lichen Sclerosus risk factors? (6)

FHx
Incontinence
Infection
Contact derm
Trauma
Hormones

3

Lichen Sclerosus presentation? (4)

U postmeno
ITCHING
Dysuria
Dyspareunia

4

Lichen Sclerosus exam findings? (4)

Sharp/well demarcated white plaques w/
cigarette paper, waxy or hyperkeratotic appearance

Hallmark: Fragility (purpura, erosion, fissure)

U starts periclitorally -> perineal skin

U NOT in keratinized/hairy labia majora or muc mem (vag, vestibule, rectal muc)

5

Lichen Sclerosus studies?

Tx?

Vulvar punch bx

Topical steroid OINTMENT (Clobetasol)
Hygiene
Long term f/u (chronic dz)

6

Lichen Sclerosus (P) risks?

SCC if tx neglected
Pigment ∆s take seriously

7

Bartholin Cyst is?

Vulvar disorder:
Bartholin mucus gland obstruction from trauma/inflamm

8

Bartholin Cyst presentation? (3)

Acute, painful, unilateral labial swelling
Dyspareunia
Pain w/ sit/walk

9

Bartholin Cyst exam findings? (5)

Tender, fluctuant mass
Erythema/Edema
Cellulitis
Abscess
Fever

10

Bartholin Cyst tx? (4)

I&D w/ Word catheter
ABx if cellulitis: Bactrim or Clinda if allergic
Sitz bath
No sex till catheter out

11

Vulvar Intraepithelial Neoplasm (VIN) is?

Neoplastic cells w/i squamous epith

12

VINu (usual) a/w?

Risk factors?

HPV 16/18
U younger

Smoking!
Immunosup
Sluts

13

VINu presentations?

C asympt
Vulvar burn/itch

14

VINu studies? (2)

C a/w Cervical IN -> colposcopy MANDATORY

Bx all pigmented lesions

15

Colposcopy is?

Acetic acid on vulva ->
Accentuates white and vascular lesions ->
Bx multiple sites (raise or flat, any color)

16

VINu tx:

CA suspected?

CA not suspected?

Wide local excision if CA suspected

No suspicion for CA then ->
CO2 laser full thickness of epith
Imiquimod (Aldara)

High recurrence

17

VINd (differentiated) is from?

NOT HPV related

a/w squamous cell hyperplasia (lichen sclerosus, lichen simplex)

Carcinogenic agent + chronic irritation causes dysplastic cells

18

VINd seen in?

Where?

U older

Lower 1/3 if epith (up 2/3 is normal)

19

VINd tx?

Prevent w/ underlying tx
Surgical excision

20

VINu/d F/U?

Post-tx colpos/inspection at 6 mo, 12 mo
then Annually for Lifetime!

21

Vulvar CA U seen when?

Younger w/ HPV
Older from irritation/co-factors
SMOKERS

22

Vulvar CA presentation? (3)

ASYMPT
Itching
Vulvar bleeding/pain

23

SCC presentation?

90% are this
Variable from large cauliflower to small ulceration w/ hyperkeratosis

24

BCC presentation?

Raised w/ center ulceration, rolled borders

25

Melanoma?

U labia minora and clitoris
Raised, dark pigment

26

Vulvar CA tx?

Staging on FIGO
Surg removal w/ inguinal LN
Radiation if LN involv