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Ch22-Female - Female Reproductive System TOPICS TODAY(Part...

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Female Reproductive System
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TOPICS TODAY (Part I) Vulva Vagina Cervix, uterus Body, uterus Tubes NEXT CLASS (Part II) Ovaries Placenta
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VULVA Synonymous with EXTERNAL genitalia Everything ANTERIOR to the INTROITUS Usual classification of Degen., Inflam., Neopl. Common Diseases: BARTHOLIN Cyst Vulvar Vestibulitis Deg./Inflam. Epithelial: LICHEN diseases BENIGN tumors: Condyloma(ta) MALIGNANT tumors: VIN, SCC
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Result from Inflammation/Obstruction of the Bartholin glands (i.e., greater vestibular glands) Often result in abscesses Surgical removal is curative when local procedures are inadequate or often recurrent NEVER become malignant
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VULVAR VESTIBULITIS, assoc. w. vulvodynia
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“LICHEN” DISORDERS LICHEN Sclerosu(i)s ( atrophic skin) LICHEN Simplex Chronicus ( hypertrophic skin) Common features of FIBROSIS and INFLAMMATION
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Mucosal Atrophy Fibrosis (sclerosis) Inflammation
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LICHEN SIMPLEX CHRONICUS
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The types of lichen lesions which show HYPER -plastic mucosal changes are often regarded as being potentially pre-malignant
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CONDYLOMA(TA)
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VIN, SCC Like condylomas, HIGHLY linked to HPV VIN=changes leading to SCC- in-situ, look like “plaques” BEYOND VIN = INFILTRATION
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VIN
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MALIGNANT MELANOMA
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VAGINA CONGENITAL: Parallel uterus anomalies INFLAMMATORY PRE-menopausal: STD POST-menopausal: ATROPHY BENIGN : Hidradenoma, Condyloma MALIGNANT : VIN, INFILTRATING SCC
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CONGENITAL Imperforate hymen (hematocolpos) Atresia Absence (agenesis) Septate Double vag/uterus (didelphys)
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Atresia, Double vagina, Double uterus.
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VAGINITIS 90% Bacterial Vaginitis is the most common cause of vaginitis, accounting for 50% of vaginitis cases. As previously mentioned, BV is caused by an overgrowth of organisms such as Gardnerella vaginalis (gram-variable coccobacillus), Mobiluncus species, Mycoplasma hominis , and Peptostreptococcus species . Risk factors include pregnancy, intrauterine device (IUD) use, and frequent douching. Candida species ( C albicans, C tropicalis, and C glabrata ) are airborne fungi that are natural inhabitants of the vagina in as many as 50% of women, and vaginal candidiasis is the second most common cause of vaginitis. Risk factors include oral contraceptive use, IUD use, young age at first intercourse, increased frequency of intercourse, receptive cunnilingus, diabetes, HIV or other immunocompromised states, chronic antibiotic use, and pregnancy. T. vaginalis infection, the third most common cause of vaginitis, is caused by trichomonads. These organisms are flagellated protozoans.
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