Vulval Diseases

Question 1

Ttt lf bartholin cyst

Answer 1

Asym: expectant
Symp: warm compression 10-15 mins many times for 3-4 d and painkillers

Question 2

Ttt of bartholin abscess

Answer 2

1. Antibiotics if infected and later drained
2. Ballon catheter insertion (fistulisation)
3. Marsupialisation under GA

Question 3

Normal urethral length

Answer 3

4-5 cm

Question 4

Most common benign tumor of female urethra

Answer 4

Urethral caruncles

90% of urethral masses in post MP

Question 5

Main predisposing risk factor for urethrL caruncle

Answer 5

Post menoapuse

Question 6

Percent of women seen in vulval clinic with lichen sclerosis

Answer 6

25%

Question 7

What is lichen sclerosis

Answer 7

Inflammatory dermatosis affects anogenital are

Question 8

Percent of lichen sclerosis cases associated with autoimmune diseases

Answer 8

40%

Question 9

The hallmark sign of lichen sclerosis

Answer 9

Porcelain white atrophic plaques on vulva and perineum

Question 10

TTT of lichen sclerosis

Answer 10

1st: topical potent steroids (0.05% clobetasol propionate) ointment better than cream

2nd: topical tacrolimus (not more than 2 y)

3rd: surgery and CO2 laser vaporization

Question 11

Age group of lichen planus and lichen sclerosus

Answer 11

Both postmenopausal

Question 12

What vulval disease that may develop around the wrist

Answer 12

Lichen planus

Question 13

Malignancy taht can develop due to lichen planus

Answer 13

SCC up to 3%

Question 14

Wickham striae is remarkable for

Answer 14

Erosive lichen planus

Plaques and papules with fine white reticular pattern

Question 15

Ttt of lichen planus

Answer 15

Ultrapotent steroids
(Clobetasol propionate)

Question 16

HPV types responsible for VIN

Answer 16

16,33

Question 17

Mean age of HPV dependent and independent VIN

Answer 17

Dep: 49
Ind: 70

Question 18

RF of HPV dependent and independent VIN

Answer 18

Dep: sexual intercourse- hpv16,33- poor immunity
Ind: age - lichen sclerosus

Question 20

Diagnosis of VIN

Answer 20

1. Incisional biopsies or cold knife biopsies (4mm width- 5mm depth)
2. Colposcopic evaluation
3. Anoscopy and digital rectal exam

Question 21

Management of vHSIL

Answer 21

1. Imiquimode 5% 16 weeks
2. Cidofovir
3. 5 flurouracil
4. Sinecatechins

Question 22

Surgical management of vHSIL

Answer 22

1. Laser ablation or excision
2. Photdynamic therapy
3. Wide local excision
4. Skinning vulvectomy

Question 23

What is behcet disease

Answer 23

Chronic multisyatem dis characterized by recurrent painful oral and genital ulcers-> usually leave scarring

Question 25

Life time risk of developing cancer with lichen scleross

Answer 25

3-5%

Question 26

Pathways of vulval carcinogensis

Answer 26

1. HPV infection 2. Vulvar dystrophy or autoimmune disease: lichen sclerosis 3. Paget disease

Question 27

Erythematous plaques over vulva and scalp + nail pitting

Answer 27

Psoriasis

Question 28

The most appropriate diagnostic method to distinguish between VIN and invasive vulval cancer

Answer 28

Incisional or punch biopsy

Question 29

Which Vulval me condition has the highest long-term risk of progression to invasive squamous cell carcinoma

Answer 29

Differentiated vulval intraepithelial neoplasia (dVIN) 50%

Question 30

What is the most likely site for positive Q-tip test for vulvodyina

Answer 30

Posterior introitus

Question 31

A patient allergic to latex needs drainage of a recurrent cyst. What to use

Answer 31

Jacobi ring

Question 32

Spasm of which muscle of the pelvic floor is most commonly implicated in vaginismus

Answer 32

Puboccocygeus

Question 33

What is the most common cause of hypoactive sexual desire disorder

Answer 33

Paychosexual