Gyne Vulva

Question 0

Tx: benign urethral caruncle

Answer 0

1. Oral or topical estrogen
2. Cryosurgery, laser therapy, fulguration, operative incision
   (Place foley catheter to prevent stenosis for 2-3 days)

No tx if small and asymptomatic

Question 1

Dx: benign urethral caruncle

Answer 1

Biopsy with local anesthesia

Question 2

Tx: benign bartholin’s gland cyst

Answer 2

Marsupialization

Excise if 40 y/o above to lessen malignancy

Question 3

Most common large cyst of the vulva

Answer 3

Bartholin’s gland cyst

Benign

Question 4

Tx: skene’s or paraurethral duct cyst

Answer 4

Excision

Question 5

Tx: epidermal inclusion cyst (vulva)

Benign

Answer 5

None

Question 6

Eyatures early malignant melanoma

Answer 6

Assymetry
Border irregularity
Color variegation
Diameter >6mm

Question 7

Tx: benign dysplastic nevus

Answer 7

Excisional biopsy with 5-10mm normal skin around nevus

Question 8

Tx: angiokeratomas

Answer 8

Excisional biopsy

Question 9

Tx: venous malformations and lymphangiomas

Answer 9

Surgical excision

Question 10

Tx: hemangiomas

Answer 10

Initial: subtotal resection

Troublesome bleeding: cryosurgery or argon laser

Question 11

Tx: pyogenic granulomas

Answer 11

Wide and deep excision

Question 12

Most common benign solid tumor of the vulva

Answer 12

Fibroma

Question 13

Tx: fibroma and lipima

Answer 13

Rxcision

Question 14

Tx: hidradenoma

Benign

Answer 14

Biopsy

Question 15

Tx: syringoma

Benign

Answer 15

Excisional biopsy

Cryosurgery

Question 16

Tx: endometriosis

Answer 16

Wide excision

Laser vaporization

Question 17

Aka schwannoma

Answer 17

Granular cell myoblastoma

Question 18

Tx: granular cell myoblastoma

Schwannoma

Answer 18

Wide excision

Question 19

Aka café au lait spots

Generalized neurofibromatous

Answer 19

Von recklinghausen’s disease

Question 20

Tx: von recklinghausen’s dse
Cafe au lait spots
Gen. Neurofibromatous

Answer 20

Excision

Question 21

Tx hematoma

Answer 21

Conservative unless >10cm and rapid or rapidly expanding
Direct pressure
Ice pack

Question 22

Tx: contact dermatitis

Answer 22

Burrow’s soln
Petroleum jelly
Hydrocortisone
Prednisone

Question 23

Tx: psoriasis

Answer 23

Hydrocortisone cream

Question 24

Tx: lichen planus

Answer 24

Topical coticosteroid

Question 25

Dx: lichen planus

Answer 25

Small punch biopsy

Question 26

90% vulvar cancer

Answer 26

Squamous cell ca

Question 27

Prevention: vulvar cancer

Answer 27

Topical steroids

Question 28

Tx: paget’s dse

Answer 28

Radical Vulvectomy with bilateral excision of groin and pelvic nodes (inguinal-femoral lymphadenectomy)
Postop: groin and pelvic radiation therapy

Yes radiotx
No chemotx

Question 29

Screening: paget’s dse

Answer 29

Self-examination

Question 30

Dx: vulvar paget’s dse or atypia

Answer 30

Keyes dermal punch biopsy

Never pap smear or colposcopy

Question 31

Tx: vulvar paget’s dse or atypia

Answer 31

1% hydrocortisone

Question 32

Tx: Lichen sclerosus

Answer 32

Topical testosterone OD BID
Local progesterone
Surgical excision

(SE: clitoral hypertrophy, inc hair growth)

Question 33

Tx: vulvar VIN

Answer 33

Wide local excision
Recurrence: CO2 laser
Post op: local lidocaine gel, analgesics, sitz baths

Question 34

Tx: bartholin’s gland ca

Answer 34

Radical Vulvectomy with bilateral excision of groin and pelvic nodes (inguinal-femoral lymphadenectomy)

Question 35

Tx: basal cell carcinoma

Answer 35

Wide excision

Question 36

Tx: verrucous carcinoma

Answer 36

Wide excision

Question 37

Most frequent non-squamous cell malignancy of vulva

Answer 37

Melanoma