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Womens Health Cards > Vulvovaginal > Flashcards

Vulvovaginal Flashcards

1
Q

What tissue makes up vulvar and vaginal tissue

A

Squamous epithelial cells

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2
Q

What hormone helps thicken the vaginal mucosa

A

Estrogen

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3
Q

What produces lactic Acid and is a natural barrier

A

Lactobacilli

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4
Q

What is caused by an alteration in normal vaginal flora

A

Bacterial vaginosis

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5
Q

What bacteria causes bacterial vaginosis

A

Gardenerella vaginalis

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6
Q

What does BV do to the ph of the vagina?

A

Increases the PH

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7
Q

Name the dx.

Fishy malodorous, thin Grey white milky discharge

A

Bacterial vaginosis

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8
Q

What is needed for dx of BV

A

3/4 Amsels criteria

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9
Q

What is the 4 parts of Amsel’s criteria

A

Homogeneous thin Grey white discharge
+ whiff test
+ clue cells
Vaginal PH >4.5

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10
Q

What is added in order to determine the whiff test

A

Koh

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11
Q

Treatment for bacterial vaginosis

A

Metronidazole (Flagyl) 500 mg BID for 7 days

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12
Q

Do you need to treat sexual partners for BV

A

No

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13
Q

What bacteria causes candidiasis

A

Candida albicans

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14
Q 
The following can cause what vaginal dz? 
Antibiotics 
Douching 
Increased estrogen levels 
Increased blood sugar 
Decreased immune system
A

Candidiasis

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15
Q

Name the dx.

Intense itching and redness near the vagina with a thick white vaginal discharge

A

Candidiasis

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16
Q

What is the gold standard to diagnosis candidiasis

A

Vaginal culture

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17
Q

What will you see on wet prep of candidiasis

A

Branching pseudohyphae and budding spores

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18
Q

What is the treatment of candidiasis

A

Antifungals : azoles
Topical: for vulvar sx
Systemic: Fluconazole (Diflucan) 150mg once

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19
Q

When is candidiasis considered recurrent

A

More than 4 cases a year

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20
Q

What is the most prevalent non-viral STI

A

Trichomoniasis

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21
Q

What bacteria causes trichomoniasis

A

Trichomonas vaginalis

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22
Q

Name the dx.

Frothy, thin yellow-green, malodorous discharge with a strawberry cervix

A

Trichomoniasis

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23
Q

What does the discharge look like in trichomoniasis

A

Frothy, thin yellow-green, malodorous discharge

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24
Q

What does the wet prep show in trichomoniasis

A

Motile flagellates and increased number of PMNs

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25
Q

Treatment of trichomoniasis

A

Metronidazole (Flagyl) 2g one dose

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26
Q

Does the partner of a pt with trichomoniasis need treated?

A

Yes

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27
Q

If you want to retest for trichomoniasis when is it suggested

A

3 months

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28
Q

What are you at risk for with trichomoniasis

A

Increased risk of PID and infertility
Hiv
Preterm delivery and premature rupture of membranes in pregnancy

29
Q

What is due to topical irritants that causes discharge, itching, and burning

A

Chemical vaginitis

30
Q

Treatment for chemical vaginitis

A

Stop the offending agent

31
Q

What causes atrophic vaginitis

A

Decreased estrogen levels

32
Q

What is the treatment of atrophic vaginitis

A

Vaginal moisturizers and lubricants

33
Q

What is a complication of a FB in the vagina

A

TSS

34
Q

What causes Toxic shock syndrome

A

Endotoxins of s. Aureus

35
Q

Name the dx.

A patient comes to you with a high fever, sore throat, malaise, and a macular rash of palms and soles

A

Toxic shock syndrome

36
Q

How do you diagnosis TSS

A

Positive wound or mucosal culture

37
Q

What is the treatment of TSS

A

Empiric antibiotics

Clindamycin IV + vancomycin IV

38
Q

What is the most common benign epithelial vulvar disorder

A

Lichen sclerosis

39
Q

What are patients at risk of if they have lichen sclerosis

A

Squamous cell carcinoma

40
Q

Name the dx.

White lesions that form plaques, intense itching, if scratched can cause telangiectasia, fissures and ulcers

A

Lichen sclerosis

41
Q

How do you diagnosis lichen sclerosis

A

Biopsy

42
Q

Treatment of lichen sclerosis

A

High potency steroid: Clobetasole 0.05%

43
Q

What glands help lubricate during sexual arousal

A

Bartholin gland

44
Q

Name the dx.

Patient comes to you with a pain near her vagina. States that she noticed a bump down there that is painful and swollen

A

Bartholin cyst

45
Q

Treatment of bartholin cyst

A

Infected: I&D
Or Word catheter: leave in 4-6 weeks
Recurrent abscess: marsupialization

46
Q

When can you not preform marsupialization on a bartholin cyst

A

When acutely infected

47
Q

What 2 premalignant lesions are associated with HPV

A

Vulvar intraepithelial neoplasia (VIN) and vaginal intraepithelial neoplasia (VAIN)

48
Q

What are risk factors for developing VIN and VAIN

A

Smoking and immunocompromised

49
Q

Patients may present with vulvar itching or pain. This is often associated with candidiasis but they get no relief from treatment. Lesions may be white, brown, red, or black

A

Vulvar intraepithelial neoplasia

50
Q

How do you diagnosis vulvar intraepithelial neoplasia

A

Biopsy

51
Q

What is follow up for vulvar intraepithelial neoplasia

A

Every 6 months for 5 years after last treatment and then annually

52
Q

This is often diagnosed by abnormal Pap smear, but no cervical lesions are found

A

Vaginal intraepithelial neoplasia

53
Q

How do you diagnosis vaginal intraepithelial neoplasia

A

Biopsy

54
Q

What is the follow-up plan for vaginal intraepithelial neoplasia

A

Cytology smears every 6 months for 1–2 years then annually

55
Q

What is the treatment for vaginal intraepithelial neoplasia and vulvar intraepithelial neoplasia

A

Wide excision
Laser ablation: for multiple small lesions
For young pts can use topical Imiquimob

56
Q

What decreases your risk of developing vulvar intraepithelial neoplasia or vaginal intraepithelial neoplasia

A

HPV vaccine

57
Q

What is the most common type of vulvar cancer

A

Squamous cell carcinoma

58
Q

What are the 2 pathways for development of vulvar cancer

A
  1. Relation to HPV infection-younger women

2. Chronic inflammation and vulvar dystrophy-older women

59
Q

Name the dx.

Long history of itching with a vulvar lump/mass that is normally raised

A

Vulvar cancer

60
Q

Where does squamous cell carcinoma in vulvar cancer normally arise

A

Labia

61
Q

How do you treat vulvar cancer

A

Wide local excision with lymph node dissection

62
Q

What is the most important prognostic factor when diagnosing vulvar cancer

A

Lymph node involvement

63
Q

What cancer is vaginal cancer normally associated with

A

Squamous cell carcinoma

64
Q

What type of cancer is most common with vaginal cancer

A

Squamous cell carcinoma

65
Q

Name the dx.

Abnormal Pap smear. On the posterior 1/3 of vagina is a mass

A

Vaginal cancer

66
Q

Where is the most common site for vaginal cancer

A

Posterior upper 1/3 of vagina

67
Q

What is the treatment for vaginal cancer

A

Hysterectomy + vaginectomy + lymphadenectomy if stage 1

Chemo and XRT for advanced stages

68
Q

What was prescribed to pregnant women to prevent miscarriage in 1938-1971

A

Diethylstilbestrol (DES)

69
Q

What is DES linked to

A

Clear cell carcinoma of vagina in women

Womens Health Cards (17 decks)

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