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Flashcards in GYN- Lower GU Deck (20)
1

cause of labial fusion

excess androgens (Tx is d/c andogrens)
can be due to 21-hydroxylase def (Tx is cortisol in this condition)

** can get reconstructive surgery

2

How to diagnose imperforate hymen vs transverse vaginal septum

imperforate hymen = presents as primary amenorrhea + cyclical abd pain with mucocolpos/hematocolpos

TVS = presents as primary amenorrhea + cyclical abd pain + short vagina that ends in blind pouch
**presence of hymenal ring indicates TVS

3

vaginal atresia vs vaginal agenesis

atresia = failure of lower vaginal to develop

agenesis = absence of vagina w/partial uterus and tubes (aka MRKH syndrome)

4

vaginal thinning and atrophy in postmenopausal women + Tx?

lichen sclerosis = topical steroids

**10% assc with cancer

5

chronic vulvar/vaginal irritation --> puritis --> hyperkeratotic changes + Tx?

atopic eczema = topical steroids

6

chronic vulvar/vaginal irritation --> puritis --> reactive changes + Tx?

lichen simplex chronicus = topical steroids

7

shiny purple papules +/- vaginal adhesions + Tx?

lichen planus = steroid suppository + surgery for adhesions

8

silver scaly plaques + auspitz sign (bleeding when plaqes are removed) + Tx

vulvar psoriasis = topical steroids + UV light

9

red spots/patches in upper 1/3 vagina due to DES exposure in utero + Tx

vaginal adenosis = close f/u bc is precursor to clear cell adenocarcinoma

10

vaginal dryness +/- bleeding in postmenopausal women + Tx?

atrophic vaginitis = topical estrogen

11

MC vulvar cyst

epidermal inclusion cyst = 2/2 to blocked hair follicle | Tx = I&D or excsion if infected

12

multiple asymptomatic vuvlar cysts is most likely

sebacous cyst

13

cysts that are only found in the groin and axillary region

apocrine cysts

14

cyst that appears at 12 o'clock position in vulva

skene cyst

15

cyst that appears at 4 and 8 o'clock position in vulva + management

bartholin cyst/abcess

usually self resolve but if > 40 need to Bx to r/o cancer
**if large or symptomatic, Bx to r/o cancer**

16

cysts located in the anterolateral wall of the proximal (superior) portion of the vagina

Gartner duct cyst which are remnants of mesonephric (Wolffian ducts)

Tx is excision

17

DES associated anomalies

vaginal adenosis
clear cell carcinoma
other cervival and uterine anomalies(?)

18

occurs when ectocervix (SSC) overgrows endocervix (SCC)

Nabothian cyst (benign)

19

treatment for cervical polyps

remove if symptomatic

20

treatment for cervical fibroids

remove is symptomatic