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reproduction and sexual health > vaginal and vulval disorders > Flashcards

vaginal and vulval disorders Flashcards

(70 cards)

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1
Q

what is pagets disease of the vulva

A

intraepithelial adenocarcinoma

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2
Q

who does pagets disease of the vulva affect

A

postmenopausal women
60-80 most commonly

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3
Q

what is the most common presentation for pagets disease of the vulva

A

chronic pruritus

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4
Q

what can pagets disease of the vulva look like

A

red/pink scaly plaque on the vulva, commonly on the labia majora

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5
Q

what is needed for a diagnosis of pagets disease of the vulva

A

biopsy

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6
Q

surgical management of pagets disease of the vulva

A

wide local excision and mohs micrographic surgery

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7
Q

name some non-surgical options for treatment of pagets disease of the vulva

A

imiquimod, 5-fluorouracil, radiotherapy

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8
Q

name some risk factors for vulval carcinoma

A

increasing age, lichen sclerosus, HPV infection, pagets disease of the vulva

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9
Q

what is the most common type of vulval cancer

A

squamous cell carcinoma

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10
Q

what is vulval intraepithelial neoplasia

A

precursor to HPV-driven squamous cell carcinoma

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11
Q

management of vulval intraepithelial neoplasia

A

biopsy and resection

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12
Q

where is vulval cancer usually found

A

on the labia

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13
Q

how can vulval carcinoma present

A

lump (+/- lymphadenopathy)
itching
non-healing ulcer
pain
skin changes
bleeding or discharge unrelated to the menstrual cycle

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14
Q

investigation of vulval carcinoma

A

examination + biopsy

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15
Q

management of vulval carcinoma

A

wide local incision
+/- adjuvant chemoradiotherapy

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16
Q

what is a complication of a bartholins gland becoming blocked

A

cyst becomes an infected abscess

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17
Q

who usually presents with a bartholins cyst

A

20-30

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18
Q

how does the presentation of a bartholins cyst differ to an abscess

A

both present with a palpable swelling
abscess: pain, lymphadenopathy, erythema

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19
Q

conservative management of a bartholins cyst

A

warm salt water baths

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20
Q

management of a bartholins abscess

A

word catheter - allows fluid to drain continuously

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21
Q

what is bacterial vaginosis

A

overgrowth of anaerobic bacteria in the vagina

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22
Q

is BV an STI

A

no but can be precipitated by sex

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23
Q

what is the most commonly associated bacteria with BV

A

gardnerella vaginalis

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24
Q

name some risk factors for BV

A

multiple sexual partners
excessive vaginal cleaning
recent antibiotics
smoking
copper coil

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25
classic presentation of BV
fishy smelling watery grey/white discharge
26
investigations for BV and positive result
pH above 4.5 charcoal vaginal swab - clue cells on microscopy
27
clue cells on microscopy
BV !!
28
what criteria can be used to diagnose BV
amsel criteria
29
management of BV
metronidazole
30
what is the common name for vaginal candidiasis
thrush
31
what is the most common organism associated with vaginal candidiasis and describe it
candida albicans - gram positive fungi
32
name some risk factors for vaginal candidiasis
increased oestrogen poorly controlled diabetes immunusoppression
33
clinical presentation of vaginal candidiasis
thick white discharge - no smell vulval and vaginal itching
34
management of vaginal candidiasis
clotrimazole
35
what should we consider testing for in patients with recurrent vaginal candidiasis
HIV
36
what are the 2 main causes of stress incontinence
urethral hypermobility - impaired pelvic floor intrinsic sphincter deficiency
37
what is the most common causative factor for stress incontinence
childbirth
38
what might stress incontinence be associated with
prolapse
39
what causes urge incontinence
overactivity of the detrusor muscle
40
what is overactive bladder syndrome
chronic condition that results from hyperactivity of the detrusor muscle
41
name some risk factors for overactive bladder syndrome
increasing age, female, pregnancy + childbirth, DM
42
classic presentation of overactive bladder syndrome
frequency and nocturia
43
what investigation can be done to evaluate bladder muscle functoin
urodynamics
44
conservative management of overactive bladder syndrome
reduce oral intake, avoid caffeine and alcohol, bladder retraining
45
medical management of overactive bladder syndrome
solifenacin
46
surgical management of overactive bladder syndrome
botox, percutaneous tibial nerve stimulation
47
conservative management of stress incontinence
weight management, pelvic floor training, incontinence ring
48
medical management (or help to manage) stress incontinence
vaginal oestrogen
49
surgical management of stress incontinence
bulking agents, fascial slings, colposuspension
50
name some risk factors for prolapse
female, increasing age, obesity, smoking (chronic cough), prior pelvic surgery, constipation, heavy lifting
51
what is urethrocele
prolapse of the urethra into the vagina
52
what is cystocele
prolapse of the bladder into the vagina
53
what is cystourethrocele
prolapse of both urethra and bladder into the vagina
54
what is uterine prolapse
descent of the uterus into the vagina
55
what is vaginal vault prolapse and who can get them
post-hysterectomy descent of the vaginal vault
56
what is rectocele
prolapse of the rectum into the vagina
57
what is a 1st degree prolapse
descent but still in the upper half of the vagina
58
2nd degree prolapse
descended to the introitus
59
3rd degree prolapse
protrudes out of the vagina
60
procidentia
prolapse entirely outside of the vagina
61
symptoms of a uterine prolapse
sensation of heaviness or pulling in the pelvis urinary problems - incontinence or retention
62
how do symptoms of prolapse differ throughout the day
worsen as the day goes on
63
what can be use to stage prolapse
POP-Q - measures the site of prolapse in relation to the hymenal ring
64
conservative management of prolapse
avoid heavy lifting, lose wright, stop smoking, reduce constipation pelvic floor for minimum of 3 months
65
what can be given to patients for management of prolapse when surgery is contraindicated
vaginal pessary
66
what is lichen sclerosus
chronic inflammatory skin disease of the anogenital region
67
how does lichen sclerosus present
white patches on skin, may progress to scarring itchiness and pain - exacerbated by urination or sex
68
management of lichen sclerosus
topical steroid e.g. dermovate
69
what does having lichen sclerosus give you an increased risk of
squamous cell carcinoma
70
what should be recommended during childbirth for a women who has had FGM
anterior episiotomy

reproduction and sexual health (18 decks)

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