Term
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Definition
High dose oral contraceptives
Diaphragm use with spermicide
Diabetes mellitus
Antibiotic use
Pregnancy
Immunosuppression
HIV/AIDS
Transplantation
Alcoholism
Tight fitting clothing |
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Term
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Definition
| Diflucan 150 mg po once or topical antifungal agent (both safe during pregnancy) |
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Term
| Trichomonas vaginalis is usually ___, but may cause severe itching. Typically associated with __ __ __ discharge with fowl odor. |
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Definition
- asymptomatic
- yellow-green frothy d/c |
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Term
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Definition
Metronidazole 2 gm single oral dose
(remember metronidazole has disulfuram like effect so don't drink with this) |
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Term
| Bacterial Vaginosis dx criteria: |
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Definition
Must have 3 of the following:
- Vaginal ph > 4.5
- Clue cells
- Thin homogenous d/c
- Fishy odor after addition of 10% KOH |
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Term
| With trichomonas or BV partner should be treated? |
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Definition
| Trichomonas- should have partner treated, not with BV |
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Term
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Definition
| Metronidazole 500 mg bid po x 7days |
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Term
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Definition
- aka crabs
- constant itching secondary to sensitization
- initial sensitization takes several weeks to develop
- incubation period 30 days |
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Term
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Definition
Permethrin (Nix Creme)
Lindone (Kwell)
anyone that has had contact with the patient or their bed should be treated |
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Term
| Scabies (not an STI) is caused by the parasite Sarcoptes scabies. Unlike pediculosis pubis, scabies does NOT have a predilection for hairy areas. Itching is worse at night. Treatment is: |
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Definition
| Permethrin 5% cream applied to whole body, left on for 8-14 hours and then washed off |
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Term
| HPV __ and __ cause condyloma accuminatum. |
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Definition
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Term
| Condyloma accuminatum treatment: |
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Definition
- Trichloroacetic Acid
- Surgical removal
- Laser therapy
- Electrosurgery
- Cryosurgery
- Intralesional interferon |
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Term
| 10% of HPV infections persist. 90% of HPV infections resolve on their own. |
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Definition
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Term
| HPV at high risk for causing cervical CA: |
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Definition
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Term
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Definition
for girls ages 11-26, but can be given as early as age 9 y/o
3 IM injections over a 6 month time (0 month, 2 months, 6 months) |
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Term
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Definition
- clinical presentation
- viral culture- positive w/in 2-4 days of inoculation |
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Term
Primary syphilis chancre is a painless button – like lesion with a central shallow ulceration.
Multiple lesions can occur especially in immunocompromised patients
Serologic tests become positive 4-6 weeks after exposure
1 - 2 weeks after development of the chancre
Secondary syphilis is the result of hematogenous dissemination of the spirochetes and is a systemic disease.
Develops in 50% of untreated cases between 6 weeks and 6 months (average 9 weeks)
Attack will last 2 – 6 weeks, if untreated
Systemic symptoms include
Red macules and papules over the palms of the hands and the soles of the feet.
Vulvar lesions include mucous patches and condyloma lata associated with painless lymphadenapathy. The vulvar lesions of condyloma lata are large raised, flattened, grayish-white areas
Latent stage of syphilis follows the secondary stage and varies in duration for 2 – 20 years.
During the latency period, a woman has a positive serology without symptoms or signs of her disease.
Destructive effects in
Central nervous system
Cardiovascular system
Musculoskeletal system
Tertiary syphilis develops in approximately 33% of patients who are not appropriately treated during the primary, secondary, or latent phase of the disease.
Manifestations of tertiary syphilis includes optic atrophy, tabes dorsalis, generalized paresis, aortic aneurysm and gummas (cold abscess with a necrotic center) of the skin and bones. |
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Definition
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Term
| Non-neoplastic epithelial d/o of the vulva: |
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Definition
- Lichen sclerosis
- Squamous cell hyperplasia aka hyperplastic dystrophy
- Other dermatoses |
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Term
| Lichen sclerosis of the vulva is characterized by __ __ of the vulvar surfaces. Symptoms include __ __ and ___. |
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Definition
- smoothing out
- intense pruritis
- dyspareunia |
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Term
| Lichen sclerosis of vulva treatment: |
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Definition
- Acute tmt: Clobetasol proprionate 0.05% daily
- Chronic tmt: Testosterone proprionate 2% |
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Term
| Presentation of squamous cell hyperplasia of the vuvla: |
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Definition
- ithcing is main symptom
- elevated localiazed lesions with white and red plaques
- weeping or crust formation |
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Term
| Tmt of squamous cell hyperplasia of the vulva: |
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Definition
| Clobetasol proprionate 0.05% twice daily until symptoms resolve, then a less potent steroid ointment |
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Term
| Staining the vulva with 1% solution of ___ ___ or __ __may help to identify ___. |
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Definition
- toluidine blue
- acetic acid
- VIN |
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Term
| mean age of occurence for VIN: |
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Definition
45-50 y/o
increased incidence in young white patients less than 35 y/o
incidence of invasive vulvar ca has not changed |
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Term
| VIN is more likely to become invasive in __ patients and/or ___ patients. |
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Definition
- older
- immunosuppressed |
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Term
| VIN with __ lesions and ___ patterns are more likely to become invasive. |
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Definition
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Term
| What kind of vulvar biopsies should be done if suspect VIN? |
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Definition
| Keyes dermatologic punch 4-6 mm |
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Term
|
Definition
- surgical excision with disease free border of at least 5 mm
- if extensive> skinning vulvectomy with split thickness skin graft
- Laser therapy for multiple lesions, 1mm destruction of non-hair baring area, 2.5-3mm required if appendages involved |
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Term
| MC presenting symptoms of invasive CA of the vulva: |
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Definition
- Pruritis 45%
- Mass 45%
- Pain 23% |
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Term
| Invasive cancer of the vulva method of mets: |
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Definition
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Term
| Invasive CA of the vulva treatment: |
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Definition
Treatment
Unilateral Lesions
Wide radical resection of primary lesion plus
Ipsilateral superficial inguinal node dissection
If superficial inguinal nodes positive
Remove deep inguinal node
Remove contralateral superficial and deep inguinal nodes
If nodes are positive use post-operative radiotherapy to affected areas
Bilateral Lesions
Radical Vulvectomy and
Bilateral superficial inguinal node dissections through separate incisions
Midline Lesions
Wide radical resection and
Bilateral superficial lymph node dissection done through separate incisions |
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