vulvar/vaginal disease Flashcards Preview

Ob Gyn > vulvar/vaginal disease > Flashcards

Flashcards in vulvar/vaginal disease Deck (59)
1

musty, fishy odor with incr thin gray-white to yellow discharge; mild vulvar irritation, pH >4.5

BV

2

incr in WBC, loss of normal lactobacilli, clue cells " ground glass"

BV

3

gold standard for BV

gram stain

4

clinical dx of BV made with 3/4 of what criteria

1. abnormal gray discharge
2. pH >4.5
3. + whiff test
4. + clue cells

5

BV tx (2)

1. oral or topical metronidazole
2. topical clindamycin

6

itching, burning, external dysuria, dyspareunia, thick odorless cottage cheese, pH 4-5

candida

7

dx of candida

visualization of blastospores or pseudohyphae on saline or KOH microscopy

8

tx of candida

vaginal application of imidazole, miconazole, clotrimazole, terconazole

9

what sort of azole to use in pregnancy for tx of candida infxn

oral fluconazole

10

if recurrence of candida within 1 month of tx

oral fluconazole x 6 mon

11

tx of T glabrata

intravaginal boric acid capsules or gentian violet

12

where does trich live?

vagina, skene ducts, urethra

13

transmission of trich

sexual, pools, hot tubes

14

trich pH

>4.5

15

appearance of vulva with trich

edema or erythema

16

strawberry cervix

trich

17

dx of trich

1. microscopic exam
2. nucleic acid probe test

18

trich tx

oral metronidazole or tinidazole

19

tx of trich in pregnancy

oral metronidazole or tinidazole

20

atrophy of vaginal epithelium due to decr estrogen levels

atrophic vaginitis

21

expected pH in atrophic vaginitis

>4.7

22

decr vaginal discharge, dryness, ithcing, burning, dyspareunia, urinary urgency, recurrent UTI

atrophic vaginitis

23

tx of atrophic vaginitis (2)

1. local water-based moisterizers
2. topical or oral estrogen tx

24

pruritis that can interfere with sleep, pruritis ani, inflammatory process

lichen sclerosis

25

tx of lichen sclerosis

1. improve general care
2. superpotent steroid ointment (clobetasol)

26

an itch that rashes

lichen simplex chronicus

27

develops secondary to an irritant dermatitis

lichen simplex chronicus

28

labia majora/minora and perineal body can be diffusely reddened with occ hyperplastic plaques of red-brown

lichen simplex chronicus

29

tx of lichen simplex chronicus

1. d/c irritant
2. antipruritic: diphenhydramine or hydroxyzine + mod strength steroid cream
3. antidepressant

30

presents as a desquamative lesion of the vagina on the inner labia minora and vuvlar vestibule

lichen planus

31

whitish lacy bands or keratosis (wickham striae)

lichen planus

32

presents with chronic vulvar burning, insertional dyspareunia, profuse vaginal discharge

lichen planus

33

does biopsy of lichen planus show any atypia?

no

34

tx of lichen planus

topical steroids

35

between lichen simplex chronicus and lichen planus, which requires a shorter course of tx?

lichen planus

36

between lichen simplex chronicus and lichen planus, which is more likely to recur?

lichen planus

37

tx of psoriasis

1. coal tar + UV light
2. topical steroids

38

inflammatino of sebaceous glands with lesions that are pale red to yellow-pink; may be covered by oil appearing scaly crust

seborrheic dermatitis

39

tx of vulvar dermatitis

1. remove offending agent
2. 5% soln Al acetate
3. topical corticosteroids

40

small smooth nodular material on vulva that may be excised

sebaceous (inclusion) cysts

41

collection of peritoneal fluid within round ligament insertion into labia majora

cyst of the canal of nuck

42

when to tx bartholin's gland cyst with Abx

+ N. gonorrhea OR cellulits

43

premalignant conditions of the vulva

1. paget's disease
2. Vulvar intraepithelial neoplasia (VIN)

44

chronic pruritis, velvety-red lesions that become eczematous & scar into white plaques, age >60

paget's disease

45

tx of paget's disease

wide local excision

46

dx of VIN

colposcopy + biopsy

47

tx of VIN

wide local excision or laser excision

48

f/u of VIN: colposcopy every____ until

every 6 months until disease free x 2 years

49

most common type of vulvar cancer

squamous cell carcinoma

50

where is vulvar cancer usus found?

labia majora

51

dx of vulvar cancer

need to have annual exam & do a biopsy if indicated

52

tx of vulvar cancer

wide local excision with inguinal lymph node dissection

53

how to dx premalginant disease of vagina

1. PAP
2. colposcopy
3. biopsy

54

tx of VaIN

local resection, laser ablation or 5FU

55

in utero exposure to DES assc'd with

clear cell adenocarcinoma

56

peak incidence for vaginal cancer

age 60

57

watery, blood tinged vaginal discharge, postmenopausal bleeding, vaginal pruritis

vaginal cancer

58

tx of stage I, II vaginal cancer

surgical resection

59

tx of stage III, IV vaginal cancer

radiation