Vulva Dx Flashcards by Katya Angoua

Inflammatory disease of the vulva

Vulval condylomata
herpes Simplex
candidiasis

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Pathogen causing condyloma acuminatum

HPV

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Gross morphology of condyloma acuminatum

Exophytic benign papillomatous lesion on skin or mucous membrane

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Main part of the reproductive system affected by condyloma acuminatum

Vulva
Perianal region perineum
vagina
cervix

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Different presentation of condylomata

Papules 
Plaques 
 nodules
 spiked or 
cauliflower like excrescences

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Microscopic findings in condylomata

Striking papillomatous proliferation of squamous epithelium
Koilocyte- Epithelial cell with Perry nuclear hello and wrinkled nucleus containing HPV particles
Extensive Cytoplasmic destruct leading to koilocyte

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Thank you Bashan period of herpes simplex

1-3 weeks

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gross morphology of herpes simplex

Small vesicles and vulva which erode and become painful ulcers

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Ganglia affected by genital herpes

Sacral ganglia

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Can a newborn acquire fetal herpes infection through the birth canal from mother

Yes

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If a mother has herpes virus what is an indication of C-section

Active herpetic lesions in the vagina at time of delivery

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Percentage of women with asymptomatic fungi in vulva or vagina

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Most common offender of candidiasis

Candida Albicans

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Percentage of women that actually present with clinical apparent candidal vulvovaginitis

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Risk factors to candidiasis

Pregnancy
diabetes mellitus
oral contraceptives

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Meaning presentation of infection candidiasis

Itching vulva

white discharge

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Chris morphology of candidiasis

Firmly adherent Small white plaque on mucous membrane

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Microscopy of candidiasis

Submucosal edema

chronic inflammation

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What is the main diagnostic criteria of candidiasis

Characteristics spores and pseudohyphae in the wet mount preparation

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Leukoplakia meaning

White pathches

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Leukoplakia common areas

Vulva

Perineum

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Types of leukoplakia

Squamous hyperplasia

Lischen sclerosis

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Condylomata acuminata due tot which HPV strain

2
6
11

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In coNdylomata acuminata , this phenomenon prominent in superficial keratinocytes

Koilocytosis

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Name of sweat gland tumors presenting as local lump

Hidradenomas

Hudradenomas Micro morphology

Interlacing papillae lined with epithelium

Granular cell tumor morphology

Well circumscribed vulval lump | Uniform large cells , pink granular cytoplasm

Type of tumor seen on bartholins glands

Cysts abscess Adenomas Adenocarcinoma

Main population affected by carcinoma of vulva

6-7th decade

Main type of carcinoma of the vulva

squamous cell carcinoma

Lymph nodes to which carcinoma of the vulva spreads

Inguinal lymph node

Disease that leads to HPV related carcinoma

Vulval intraepithelial neoplasia Or Bowens disease

What can you compare extra memory Paget’s disease to in terms of manifestation

Paget’s disease of breast

Morphology of extra memory Paget’s disease

Prurituc red crusted sharply demarcated map like area on labia majora Palpable submucosal thickening or tumor

Disease related to vagina discharge

Chronic cervicitis

Type of discharge in gonococcal infections

Frothy the vagina discharge

Population of women affected by squamous cell carcinoma

Older woman

Parts of the reproductive system at risk of fistula formation because of squamous cell carcinoma

Vagina bladder and rectum

Which cancer is found in adolescent girls and is associated with administration of stillboestrol to the mothers in early pregnancy

Clear cell adencarcinoma

Second name of embryonal rhabdomyosarcoma

Sarcoma botryoids

Population at risk of embryonal rhabdomyosarcoma

Infants and children under five years old

Morphology of embryonal rhabdomyosarcoma

Malignant Rhabdomyoblast polypoid rounded bulky messages sometimes fill and project out of vagina Grape clusters - botyroides

Elements causing death in embryonal rhabdomyosarcoma

Penetration of peritoneal cavity p | Obstruction of urinary tract

Type of epithelium in ecto cervix

None keratinized stratified squamous epithelium

Type of epithelium in endo cervix

Mucus secreting columnar epithelium with glands

Noninfectious inflammatory disease of the cervix causes

Chemicals tampons pessaries

Infectious causes of inflammatory disease of cervix

Bacteria -n. Gonorrhaea , strep, gardnerella vaginalis ,actinomyces Israeliii , tuberculosis virus - HPV HSV fungi- candida ,aspergillus protozoa -T vaginalis she still small spaces

What is cervicitis

Mild clinic information of cervix

Structure that can undergo squamous metaplasia in chronic cervicitis

Endocervical glands

Can you see dysplasia Of the squamous epitheliumin cervicitis

Yes

Second name of cervical erosion

Cervical ectopy

What is cervical erosion

Overgrowth of columnar epithelium replacing squamous epithelium around the cervical os

Etiology of cervical erosion

Parturition contraceptive pills persistent condition normal in infancy association with cervicitis

What is cervical dysplasia

Disorderly but not neoplastic proliferation of cell with less in uniformity of individual cell and less of architectural orientation may end up in Franck malignancy if not treated

Different grades of cervical dysplasia

Mild moderate severe

What are the stages of dysplasia in the three forms of cervical intraepithelial neoplasia and invasive carcinoma

CIN1- Mild dysplasia Less ,than 1/3 CIN2-Moderate dysplasia ,lower than 1/2 to 2/3 CIN3- Cynthia dysplasia -more than 90%

symptoms of CIN

None

What do you see in ascetic acid painting of cervix in the dysplastic epithelium

Aceto-whiteness

What is carcinoma in situ of cervix

Complete loss of stratification in polarity variation in nuclear sizes of cells Mitotic figures at all levels

Main area of carcinoma in situ development in cervix

squamocolumnar Junction

Main age of carcinoma in situ of cervix

4th decade or earlier

Is a screening test diagnostic for cervical cancer

Which test is used to big dysplastic cells of cervic before they become malignant

Papaniculaou

What is the Bethesda system

Adequacy of smear presence or absence of dysplastic or malignant cells background of smear

Most common malignant tumor of the female genital tract

Carcinoma of the cervix

Main type of carcinoma of the cervix

Squamous cell carcinoma

High incidence Risk factors of carcinoma of cervix

Prostitute early age of first coitus multiple sexual partner lifetime partners with previous multiple sex partner

Low incidence risk factors in carcinoma of cervix

``` Oral contraceptive cigarette smoking family history Genital infection lack of circumcision in male sexual partner ```

Strains of HPV associated with squamous papilloma

1 2 4 7

HPv associated with condylomata and cervical intra epithelial neoplasia 1 and 2

6 | 11

HPV associated with cervical intraepithelial neoplasia 3 and invasive carcinoma

16, 18, 33

If a cervical cancer is not associated with HPV which other risk factor might be associated to

HIV and cigarette smoking

How do carcinoma of the cervix spread

Downward to the os and vagina laterally to parametrium and ureters Anteriorly and posteriorly to bladder the rectum and sacral nerveto the pelvic lymph nodes

Percentage of endocervical adenocarcinoma in malignant cervical tumors

Main morphology of invasive adénocarcinoma

Fungated or polyploid or papillary mass If exophytic-> would have papillary pattern if endophytic -> would have Glandular or tubular pattern

Better survival for scc or invasive Adenocarcinoma

Scc

How many stages in cervical carcinoma

5 from 0 to 4

What is stage 0 cervical carcinoma

Carcinoma in situ at cervical intraepithelial neoplasia stage 3

What is stage 1 cervical carcinoma

Carcinoma confined to cervix

What is stage 2 cervical carcinoma

Carcinoma extending beyond cervix but not into pelvic wall | involves vagina not lower third

What is stage 3 cervical carcinoma

Carcinoma extending into pelvic wall which involves lower third of vagina no carcinoma free space between tumor and pelvic wall

What is stage 4 cervical carcinoma

Carcinoma extend beyond true pelvis can involved mucosa of bladder wall or rectum distant metastasis

5 yearSurvival rates for stage one cervical cancer

80 to 90%

5 yearSurvival rates for stage 2 cervical cancer

75%

5 yearSurvival rates for stage 3 cervical cancer

35 %

5 yearSurvival rates for stage one cervical cancer

10 to 15%

Main cause of death in stage 4 cervical cancer

Ureteral obstruction Pyelonephritis uremia

Prevention of cervical carcinoma

Vaccination against HPV for girls and boys less than 15 years old 2 doses with 6 to 12 months interval Gerdasil 9 vaccine to 27 to 45 years old Gerdasil 3 vaccine for 11 and 12 yo Cervical cancer screening Pap smear Visual inspection using acetic acid

Vulva Dx Flashcards

(88 cards)