Diseases Of The Vagina

Front 1

Here is the overview of development

Back 1

learn it, live it, love it

Front 2

Here is the overview of development

Back 2

learn it, live it, love it

Front 3

Congenital absence of the vagina. It is caused by RKH aka Rokitansky-Kuster Hauser syndrome

Back 3

What is this is?
What disease caused this?

Front 4

What is this patient infected with?

Back 4

Trichomonas

Front 5

What organism is this patient infected with

Back 5

She is infected with Candida

Front 6

You lowered her sheet to get a clue. You went on her, up her, and down her for a tagallant, royal time.

What kind of cells are these?

Back 6

Clue Cells

That was the mnemonic for rail of the fore mast & main mast on USCGC Barque Eagle

Front 7

What does this pap smear indicate?

Back 7

HPV condyloma

Front 8

What is this?

Back 8

HPV Condyloma

Front 9

Toxic Shock syndrome

Back 9

What disease is this slide associated with

Front 10

What disease is this slide associated with?

Back 10

Atrophic vaginitis

Front 11

What is this?

Back 11

EID

Front 12

Endometriosis

Back 12

What is this?

Front 13

What is this?

Back 13

Endometriosis

Front 14

What is this?

Back 14

Benign mixed tumor of the vagina.

Front 15

ERMS

Back 15

What is this? (besides nasty looking)

Front 16

What is this?

Back 16

ERMS

Front 17

ERMS
Thank you Dr. Netter

Back 17

What is this?
Who made this image.

Front 18

What is this?

Back 18

Vaginal adenosis. Mucosa of the exocervix and adjacent vagina contains
mucinous glands in place of normal squamous epithelium. Mucus is PAS-positive
(red).

Front 19

What does this patient have?

Back 19

Clear cell
adenocarcinoma

Front 20

What is this?

Back 20

Trichomonas vaginalis

Front 21

What is this?

Back 21

HSV
Herpes Simplex Virus

Front 22

What does this shift of flora suggest?

Back 22

Bacterial vaginosis

Front 23

This cartoon should help explain the transformation zone

Back 23

It is clear like mud right?

Front 24

What is this image?

Back 24

Squamous metaplasia

Front 25

What is this image?

Back 25

LGSIL or Condyloma

Front 26

What is this image?

Back 26

ASCUS

Front 27

What are these cells?

Back 27

HGSIL

Front 28

What are these cells?

Back 28

SCC Nonkeratizing

Front 29

What are these cells (red) ?

Back 29

SCC Keratinizing

Front 30

What is this image?

Back 30

Endocervical adenocarcinoma in situ (AIS) /HSIL

Front 31

What is this image?

Back 31

Carcinoma in situ (CIS or CIN III)

Front 32

What is this image?

Back 32

Microinvasive carcinoma (Stage la)

Front 33

What is this image?

Back 33

Keratinzing squamous
cell carcinoma of
cervix

Front 34

What is this image?

Back 34

Keratinzing squamous
cell carcinoma of
cervix

Front 35

What is this image?

Back 35

Squamous Cell Carcinoma of the cervix (SCC)

Front 36

What is this image?

Back 36

Squamous Cell Carcinoma of Cervix (SCC)

Front 37

What is this image?

Back 37

Squamous Cell Carcinoma of the cervix (SCC)

Front 38

What is this image

Back 38

Cervix smear: small cell ca

Front 39

What is this image?

Back 39

Adenocarcinoma

Front 40

What is this image

Back 40

Pap smear squamous cell carcinoma

Front 41

This is a test

Back 41

Do you know do you know do you know...

Front 42

Name vaginal anomalies

Back 42

vaginal agenesis,
obstruction, duplication, and fusion

Front 43

What are the features of urogenital sinus anomalies?

Back 43

urinary and genital tracts open into
a common channel.

Front 44

What is the feature of cloacal anomalies?

Back 44

urinary, genital, and anorectal tracts open into a common
channel.

Front 45

How often do imperforate hymens occur?

Back 45

1 in 1000 births

Front 46

When can imperforate hymen, atresia of the vagina or transverse vaginal septum present?

Back 46

In the newborn or at puberty

Front 47

What is duplication due to?

Back 47

Incomplete fusion of Mullerian tracts.

Front 48

How does one diagnose congenital anomalies?

Back 48

Physical examination,
ultrasonography,
&
retrograde contrast studies.

Front 49

Do duplication & fusions anomalies require treatment?

Back 49

They may not.

Front 50

What is the second most common cause of primary amenorrhea?

Back 50

Rokitansky-Kuster-Hauser syndrome (RKH)

Front 51

What is Rokitansky-Kuster-Hauser (RKH)?

Back 51

Absence of the upper vagina & uterus. The mullerian duct system stops developing at gestational days 44-48.

Front 52

What is chromosomal analysis to exclude?

Back 52

It is essential to exclude karyotypic abnormalites of the X chromosome (e.g. Turner syndrome, the most common cause of primary amenorrhea).

Front 53

What are the acquired vaginal disorders?

Back 53

Infections/inflammations
Cysts
Endometriosis
Neoplasms
In Utero DES Exposure
Pelvic Relaxation

Front 54

What are common infections and/or disorders inflammation of the vagina?

Back 54

Trichomonas vaginalis
Candida albicans
Garnerella vaginalis
Condyloma acuminatum (HPV)
Toxic Shock Syndrome (Staph Aureus)
Atrophic vaginitis

Front 55

What are the most common type of vaginal cysts?

Back 55

Vaginal inclusion cysts are the most common. These can form as a result of trauma or following an obgyn procedure.

Front 56

What is relatively common type of cyst?

Back 56

Gartner's duct cysts.
A portion of the Wolffian duct remains in the lateral vaginal wall. This duct is active during fetal development but ordinarily disappears after birth in the female of the homo sapiens species.

Front 57

Where has endometriosis been found (commonly)?

Back 57

Endometriosis is commonly found in episiotomy sites.

Front 58

How long has there been a controversy over the origin of endometriosis? (and this is relevant clinically how?)

Back 58

There has been a 100-year controversy over the origin of this lesion; developmental or acquired.

Front 59

What has been observed regarding traumatically removed endometrium?

Back 59

It appears that traumatically removed endometrium can implant in scars.

Front 60

When can menstrual endometrium implant in the peritoneum?

Back 60

Retrograde expulsion

Front 61

Does endometriosis respond to the cycle? How do they respond to it?

Back 61

Yes, it responds to the cycle & but not like a 12 yo girl to 90s boy band in sync, it is often out of phase with the endometrial cavity.

Front 62

How will an endometriosis lesion respond to pregnancy or hormonal manipulations?

Back 62

The lesion will involute.

Front 63

Why is the risk of Toxic Shock syndrome greater in young people?

Back 63

Older people are more likely to have the necesary antibodies to the toxin that causes TSS.

Front 64

What are more than half the reported cases of TSS associated with?

Back 64

Women using tampons.

Front 65

What do the other half result from?

Back 65

Localized infections following burns, boils, insect bites, or surgeries.

Front 66

What is significant about a benign mixed tumor of the vagina?

Back 66

It is a rare tumor that may be confused with sarcoma.

Front 67

What is the median age of occurance of benign mixed tumor?

Back 67

young women (median age 30 yrs)

Front 68

Where does the benign mixed tumor typically occur?

Back 68

In or just above the hymenal ring.

Front 69

Histologically what size & composition of the benign mixed tumor?

Back 69

Small (1 to 5 cm in diameter)
Composed of bland spindle-shaped stromal elements admixed with epithelial origin.

Front 70

What is the origin of spindle-shaped cells & epithelial cells?

Back 70

Epithelial origin (so says Zaman)

Front 71

What is the most common type of malignant tumors in the vulva disorders.

Back 71

Squamous cell carcinoma from cervix with local extenstion. Other sites include vulva, bladder, & rectum.

Front 72

What are the risk factors for squamous cell carcinoma?

Back 72

- HPV type 16
- Smoking cigarettes
-Immunodeficiency

Front 73

Where do squamous cell carcinoma first metastasize to?

Back 73

Inguinal nodes.

Front 74

What is sarcoma botryoides (embryonal rhabdomyosarcoma)?

Back 74

It is a tumor of children, usually younger than 6-years-old, it gets its name from the grape-like clusters it froms.

Front 75

What is synonym of squamous cell?

Back 75

epidermoid (Zaman might use the term)

Front 76

What else is sarcoma botryoides?

Back 76

submucous rhabdomyosarcoma.

Front 77

Can a similar tumor to sarcoma botryoides be found in the oral cavity?

Back 77

Yes.

Front 78

Adenosis (benign & common)
Adenocarcinoma (clear cell adenocarcinoma) - fortanately rare. What is implicated

Back 78

Diethylstilbestrol (DES) exposure.

Front 79

When were diethylstilbestrol (DES) and related drugs (dienestrol & hexestirenol) given ?

Back 79

To prevent threatened abortions or women with histories of obstetrical difficulties in the mid 1940s.

Front 80

How many women were exposed to diethylstilbestrol (DES) and related drugs (dienestrol & hexestirenol) ?

Back 80

It is estimated that over 2 million women were exposed to these drugs.

Front 81

How much of the exposure can be verified?

Back 81

Only about 50%.

Front 82

What happened in the early 1970s?

Back 82

Vaginal & cervical abnormalities including the rather rare vaginal clear cell adenocarcinoma. This was more frequent in the offspring of mothers who had taken DES during pregnancy.

Front 83

When is the critical interval of intrauterine DES exposure?

Back 83

The first eighteen weeks of pregnancy.

Front 84

What does DES inhibit?

Back 84

DES inhibits mullerian differentiation of the tubes, uterus, & cervix

Front 85

What are the most common changes of in utero DES exposure?

Back 85

vaginal adenosis, cervical &/or vaginal ridges such as vaginal nood, pseudopolypoid/incompetent cervix, and cervical erosion.

Front 86

What frequency of the common changes due to in utero DES exposure has reported to occur?

Back 86

40 - 90 % of exposed women

Front 87

Have upper genital tract changes been documented?

Back 87

Yes upper genital tract changes (uterus) have been documented by hysterosalpingograms)

Front 88

Menstrual _________ are more common in DES exposed women.

Back 88

irregularites

Front 89

What is the most ominous & least common change in DES exposed women?

Back 89

The development of clear cell carcinoma.

Front 90

What is the most common changes of DES exposure called?

Back 90

Adenosis

Front 91

What is adenosis defined as?

Back 91

It is defined as the presence of columnar mucin-secreting epithelium in the vagina. It is often contiguous with glands lying in the lamina propria of the vagina.

Front 92

With advancing age is metaplasia involved with the involution of vaginal adenosis?

Back 92

Yes.

Front 93

Have DES-changes in males been discovered?

Back 93

Yes, DES-related changes are now being discovered.

Front 94

What are the DES-changes?

Back 94

Epididymal cyst, hypotrophic testes, examples of microphallus, sperm abnormalities are more common in DES-exposed males than in controls.

Front 95

What is pelvic relaxation associated with?

Back 95

A Number of conditions associated with traumatic childbirth, poor obstectrical care, & large number of births.

Front 96

What are the results of pelvic relaxation?

Back 96

Weakening of pelvic musculature & prolapse of various structures.

Front 97

What are the structures that prolapse as a result of pelvic relaxation.

Back 97

Uterine prolapse
cystocele
urethacele
enterocele, &
rectocele

Front 98

How do pelvic relaxation conditions present?

Back 98

Urinary incontinence. Detected on pelvic exam during a valsava manuever.