Vulva and Vagina

Question 1

What is the genotype of androgen insensitivity patients?

Answer 1

• 46 XY

- it’s X linked

Question 2

how do you treat labial agglutination?

Answer 2

-estrogen cream and massage to separate the labia majora

Question 3

What is vulvar Vestibulitis?

Answer 3

• rare condition in which one or more of the minor vestibular glands becomes infected
• eyrethematous dots
• extremely tender
• severe introital dyspareunia

Question 4

What is the most common benign solid tumor of the vulva?

Answer 4

• Fibroma
• slow growing
• can be really big

Question 5

What is a neurofibroma on the vulva from?

Answer 5

-Von Recklinghausen’s disease

Question 6

Where is a bartholin cyst usually?

Answer 6

-5 or 7 o clock

Question 7

Sebaceous cyst clock thing

Answer 7

-more like 11 or 1

Question 8

What is it when there is a bunch of bumpy stuff around the urethra?

Answer 8

-urethral caruncle

Question 9

What can a vulvar hematoma commonly result from?

Answer 9

straddle injury

Question 10

What does atrophic vaginitis result from?

Answer 10

• menopause
• minora regresses and majora shringks
• from loss of estrogen

Question 11

What does squamous cell hyperplasia come from?

Answer 11

• prolonged itch- scratch cycle

- biopsy will have elongated rete ridges

Question 12

What is Lichen Sclerosis?

Answer 12

• the parchment paper thing
• menopause
• intesnse pruritus, dyspareunia, burning pain
• loss of rete ridges and inflammatory cells lining the basement membrane
• treat with moderate strength steroid ointments

Question 13

Tx for lichen sclerosis?

Answer 13

-clobetasol

Question 14

What was that main difference between lichen simplex chronicus and lichen sclerosis?

Answer 14

• the presence of rete ridges

- lichen slcerosis does not have them, chronicus does

Question 15

What is the most striking feature of lichen sclerosis?

Answer 15

-the presence of a hyaline zone in the superficial dermis

Question 16

If there is acanthosis nigricans, what do we think of?

Answer 16

-insulin resistance

Question 17

What syndrome has vaginal agenesis?

Answer 17

• Rokintansky-Kuster-Hauser Syndrome

- mullerian agenesis (paramesonephros)

Question 18

What is a Gartner’s duct cyst a remant of?

Answer 18

• wolffian duct

- mesonephros

Question 19

Where are bartholin gland abscesses again?

Answer 19

-5 and 7 o clock

Question 20

Most common cause of vaginal trauma?

Answer 20

-sexual assault

Question 21

What is the most common symptom with VIN?

Answer 21

-pruritus

Question 22

managing VIN III?

Answer 22

-local superficial surgical excisioin

Question 23

What are the histologic features associated with Paget’s disease?

Answer 23

• Paget’s cells

- large and pale

Question 24

What are most vulvar cancers?

Answer 24

-SCC’s

Question 25

In which rare vulvar carcinoma is radiation contraindicated?

Answer 25

• Verrucous carcinoma

- radiation may induce anaplastic transformation

Question 26

If there is VAIN, how do we manage it?

Answer 26

• with laser therapy
• or topical 5-FU
• if unsuccessful, may require vaginectomy

Question 27

What kind of epithelium lines the vagina?

Answer 27

-nonkeratinized stratified squamous epithelium

Question 28

What do the bacteria in the vagina produce?

Answer 28

• lactic acid and H202

- keeps pH 3.8-4.2

Question 29

What organism do we think of if there is a more basic vagina?

Answer 29

-G. Vaginalis

Question 30

What is the most common cause of Vaginitis?

Answer 30

• Bacterial vaginosis

- Gardnerella

Question 31

Tx of Vaginitis?

Answer 31

• Metronidazole

- not a STI so do not have to treat partner

Question 32

What is the hallmark for G. Vaginalis?

Answer 32

-clue cells

Question 33

What is the second most common cause of vaginal infections?

Answer 33

• Candida

- the pH will be low

Question 34

Tx of Candidiasis?

Answer 34

-Diflucan

Question 35

Buzz word for Trichomonas?

Answer 35

-strawberry cervix

Question 36

Tx of Trichomonas?

Answer 36

Metronidazole again