Question | Answer |
small firm whitish nodule w/ black dot or punctum (most common tumor found on the vulva) | epidermoid cysts |
blocked sweat glands | apocrine sweat gland cysts |
blockage of a Bartholin gland located bilaterally to the vaginal orifice | Bartholin's Duct cyst (and abscess) |
if a Bartholin's cyst appears for the 1st time in a women over _____, get biopsy to rule out rare Bartholin's gland ______ | 40, carcinoma |
caused by blockage of an endocervical gland | cervical cyst |
usually small, white, and firm. also called nabothian or retention cysts | cervical cyst |
tx of cervical cyst? | nothing required! reassurance |
benign growths of the endocervical canal | cervical polyps |
painful burning vesicles that evolve into ulcers | genital herpes |
____ can be both above and below the waist, _____ only occurs below the waist | HSV-1, HSV-2 |
gold standard for dx of genital herpes | viral culture! |
tx of genital herpes | no tx! but Acyclovir helps |
flat-surfaced, rough, fleshy, lesions that may or may not be pedunculated | genital warts/condyloma acuminata |
genital warts caused by _____. warts are usually serotypes ____&____ and cervical cancers are usually ____&____ | 6&11, 16&18 |
dx and tx of genital warts? | dx: PE, tx: excision, cryotherapy, topical acid, etc w/ weekly follow-up |
an overgrowth of normal vaginal bacteria | bacterial vaginosis |
dominant species of bacterial vaginosis | Gardnerella vaginalis |
presentation of bacterial vaginosis? | discharge that often appears grayish, watery or thin, and profuse but nonirritating. MALODOROUS |
dx tests for bacterial vaginosis? | Whiff test, wet mount, pH eval (>4.5) |
clue cells found in what? | bacterial vaginosis |
tx of bacterial vaginosis? | Metronidazole |
PRURITIS, burning, dysuria, dyspareunia, vulvar edema, erythema, discharge that is thick/white/curd-like | Candidiasis |
if a women presents w/ dysuria, but UA is normal, think about ______ | yeast |
KOH prep of candidiasis will show what? | branching hyphae and spores |
tx of candidiasis? | OTC topicals, Rx topicals, Fluconazole |
discharge is that thin or watery, yellow to green to gray, possibly frothy, sometimes malodorous, pruritis. STRAWBERRY CERVIX | Trichomonas Vaginalis |
dx for trich? | wet prep w/ saline shows protozoan. future is most sensitive and specific (GOLD STANDARD) |
tx of trich? | Metronidazole |
N. gonorrhoeae or C. trachomatis. mucopurulent discharge from cervix with possible CMT, w/o other sxs of PID | cervical infection (cervicitis) |
dx for gonorrhea and chlamydia? | nucleic acid amp test (NAAT) |
tx of gonorrhea? | Ceftriaxone IM w/ either azithromycin or Doxy. also tx partner and education |
most frequently reported STD in US w/ highest incidence in 15-19yo | Chlamydia |
tx of chlamydia? | azithromycin OR doxy (tx for gonorrhea also, unless r/o). tx parter, education. RETEST IN 3 MONTHS |
VIN is related to HPV ____&____ | 16 & 18 |
_____ _____ has velvety red lesions and can be associated w/ a malignant epithelial cell CA | Paget dz |
vulvar cancer is usually a ______ cell _____ | squamous cell carcinoma |
vaginal cancer is very rare and often ____ | asymptomatic |
Cervical intraepithelial neoplasia (CIN) refers to ______ changes in the cervical epithelium | premalignant |
3 degrees of CIN? | CIN 1: lower 1/3 of epithelium
CIN 2: lower 2/3
CIN 3: more than 2/3 |
primary cause of CIN is _____; serotypes ___&___ | HPV; 16 & 18 |
RF for CIN? | mult or early exposure to HPV, smoking, immunodeficiency |
screening for CIN | 1st step: Pap
2nd step: colposcopy indicates I, II, or III |
cervical CA should being at age ___ and repeated ever ____ yrs as long as results are negative | 21, 3 |
screening b/n 21 and 30yo should be ______ only and not include ____ | cytology, HPV |
women >_____yo can be screened every 5 yrs if both cytology and HPV are negative | 30yo |
screening can be d/c at age _____ if low risk | 65 |
women who have had CIN 2 or 3 or cervical CA should have annual screening for at least _____ yrs after tx | 20 |
what does ASC-US indicate? | do HPV testing. if -, repeat pap in 1yr. if +, refer for colposcopy and biopsy |
preferred surgical excision methods of cervical CA (CIN II and III) | LEEP |
first sx of cervical CA | postcoital bleeding |
tx of cervical CA? | hysterectomy, radiation, or chemo-radiation therapy. prognosis depends on the stage |
prevention of cervical CA? | Gardasil (protects against 6, 11, 16, 18) approved for ages 9-26 for both men and women |