Term
| Congenital Adrenal Hyperplasia |
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Definition
- ↓ enzyme activity of cortisol producing enz
- ↑ACTH
- ↑ cortisol substrates which are used for androgen production instead
- If severe, virilization occurs in utero
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Term
| Criteria for biopsy of vulvular lesions |
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Definition
- any enlarging lesion or one that has changed color or appearance
- presumed HPV (condyloma) unresponsive to office tx
- lesion with white or thickened areas
- WHITE OR RED LESIONS ON ADULTS (FROM CLASS)
- pigmented lesions that are new, growing, changing, variable colour, irregular borders
- vuvlular dermatosis or dermatitis unresponsive to tx or doubts of diagnosis
- anything that appears malignant
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Term
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Definition
- thin atrophic labia minora adhere if irritated or traumatized
- tx: topical estrogens
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Term
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Definition
- pruritic raised yellowish retention cysts
- often inflamed
- can occur in axilla, mons or labia
- keratin plugged apocrine glands (sweat)
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Term
| epidermal inclusion cysts and sebaceous cysts |
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Definition
- happens with trauma
- located below the epidermis
- mobile, non-tender, spherical and slow growing
- tx: excision if symptomatic
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Term
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Definition
- small fleshy outgrowths of urethral mucosa
- due to poor estrogen support
- in children results in prolapse of the mucosa
- in post-meno women occurs when hypoestrogenic vaginal mucosa contracts away from uretral mucosa
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Term
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Definition
- inflammation of one or more of the minor vestibular glands
- severe introital dysparunia
- 1-4 mm erythematosus dots that are very tender
- some respond to corticosteroids, sometimes surgical excision
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Term
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Definition
- fancy words for freckles and moles, respectively
- may need to be biopsied to exclude melanoma
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Term
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Definition
- benign tumors made of fibrous or connective tissue
- they form in deeper, CT of the vulva
- may require excision
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Term
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Definition
- slow growing tumors composed of adipose tissue
- may require excision
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Term
| hidrademona and neurofibroma |
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Definition
- apocrine gland tumor
- neurofibroma: tumor made up of neurofibres and associated with Von Recklinghausen's disease
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Term
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Definition
| small cherry angioma can appear normally but larger congenital angiomas require more complex investigations and possibly surgery |
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Term
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Definition
- Common
- fluctuant, cystic mass at the postero-lateral aspect of the vulvo-vaginal vestibule
- caused by obstuction of the distal end of the duct through chronic inflammation and fibrosis (if it becomes infected it's a bartholin's abscess)
- biopsy to rule out carcinoma
- tx marsupialisation (cyst removal)
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Term
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Definition
- Macroscopic: Papillary verruciform lesions of skin and mucous membranes. Nearly always multiple and frequently confluent
- Microscopic: Branching papillomatous structure. Koilocytes ("cup shaped") cells with perinuclear halo. They have small nuclei.
- Associated with: vaginitis, pregnancy, DN, OCPs, poor hygiene, immunosuppression, sexual activity with mult part
- may persist, progress to VIN (vulvular intraepithelial neoplasia) or to squamous cell carcinoma
- tx excision
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Term
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Definition
- White lesion
- thickenning of squamous epithelium with hyperkereatosis
- forms white area on vulva as a response to an irritant
- tx; removal of irritant (ex; detergent)
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Term
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Definition
- white lesion, benign (only 3% will develop ca after many years)
- autoimmune?
- epithelium white and thin with fissures (causes pain)
- deferming process (introitus constructed and clitoris inverted)
- epithelial layer THINNED with hyperkeratosis
- tx; steroid cream
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Term
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Definition
- White lesion, pre-malignant
- spectrum of dysplasia and carcinoma in situ
- secondary to HPV in most cases
- VIN 1,2,3 going from somewhat irregular in size and shape and slight delay in maturation to large irregular, hyperchromatic nucleic cells with scanty cytoplasm showing no maturation
- tx; excision
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Term
| Pigmented seborrheic keratosis |
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Definition
- common benign on middle aged and elderly
- dark raised lesion
- hyperkeratosis, papillomatosis, acanthosis (abnormal benign thickening of prickle cell layer of skin)
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Term
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Definition
- a form of adenocarcinoma in situ
- resembles dermatitis clinically
- vulvar skin shows scaling, weeping, discoloration
- remember to always biopsy dermatitis that does not heal
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Term
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Definition
- thick-walled soft cysts resulting from mesonephric remnants (vas deferens, seminal vesicle in the male)
- can vary from 1-5 cm
- usually found on the anterior and lateral walls high in the vagina or laterally lower in the vagina
- tx excision if symptomatic
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Term
| Congenital anomalies of the uterus |
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Definition
- subseptate: inside arch
- arcuate: fundus arch
- bicornate: deep fundus arch
- bicornate with double cervix
- unicornate
- bicornate with rudimentary horn
- uterus didelphys with septate vagina
- cervical atresia
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Term
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Definition
- most common uterine tumor (they are fibroids), malignant leiomyosarcomas are rare
- benign, mostly asymptomatic, histologically myometrium
- ~45% women will have it by 50
- sub-mucosal, sub-serosal or intramural
- mass effect (pain, congestion etc.), uterine bleeding, menorrhagia, may cause infertility, may calclify, degeneration is painful
- tx if symptomatic: hormonal (OCPs, GnRH agonists) surgical (myomectomy, hysterectomy, ablation via hysteroscopy, embolization of uterine arteries)
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Term
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Definition
- localized overgrowth of endometrial glands and stroma
- can cause unpredictable bleeding and menorrhagia
- incidence of resulting carcinoma is very very low
- diagnosis on U/S, curettage, hysteroscopy
- tx; removal, D&C or operative hysteroscopy using electrocautery
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Term
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Definition
- local proliferation of cells
- cause post-coital bleeding or menorrhagia
- no premalignant potential
- diagnosis confirmed on biopsy
- tx; removal in the office (twist them off, eeeew), cautery. All specimens sent for pathology
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Term
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Definition
- result of squamous metaplasia
- layer or superficial squamous cell cover over an invagination of columnar cells under the cervix
- may cause dysparunia
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Term
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Definition
- epithelial condition of uterus and cervix
- can be seen with unopposed estrogen stimulation (PCOS, obesity, estrogen therapy)
- Dx by endometrial biopsy, suspected with inter-menstrual bleeding, dysfunctional uterine bleeding and menorrhagia
- Tx; simple: medroxyprogesterone acetate complex with hyperlasia: fractional D&C, daily progesterone 3 mo
- complec with hyperplasia and atypia: hysterectomy or careful fu after 3 mo of progesterone
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Term
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Definition
- loss of large component of funcitonal endometrial lining
- commonest cause iatrogenic D&C
- prolonged amenorrhea
- this can be a sucessful outcome of endometrial ablation to relieve menorrhagia
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Term
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Definition
- usually result of trauma like endocervical curettage, dilatation or conization
- may be caused by hypoestrogenism
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