Professional Documents
Culture Documents
19. Vulvar mass extending to the anus 28. In the acronym RADAR steps in abuse work the first letter A stands for
a. Stage I a. Ask direct questions only for VAWC suspects
b. Stage II b. Ask direct questions
c. Stage III c. Ask direct questions only for adults
d. Stage IV d. Ask indirect questions to prevent embarrassment
20. Best diagnostic procedure in evaluating vulvar masses 29. A phase in the cycle of violence where the relationship seems to be working, no abuse is taking
a. Pap smear place. This may diminish and disappear altogether as the cycle shortens
b. Toludene blue a. Build up phase
c. Colposcopy b. Explosive phase
d. Biopsy c. Remorse phase
d. Honeymoon phase
21. Vulvar atypia manifests as:
a. Itchiness 30. A phase in the cycle of violence where the relationship seems to be working, but new incidents of
b. Discharge abuse are taking place in increasing frequency
c. Numbness a. Build up phase
d. Mass b. Explosive phase
c. Remorse phase
22. Thinning of the vulvar epithelium, loss of rete edges d. Honeymoon phase
a. Pagets disease
b. CA in situ
c. Verrucous CA
d. Lichen sclerosis
Violence Against Women and Children
23. Lichen sclerosis, changes in the vulvar skin that often appears whitish. Its also described as the - RADAR
following, EXCEPT: o Routine screening for all
a. Markedly thickened epithelium o Ask direct questions
b. Studies show small premalignant potential o Document findings
c. Inflammation is usually present o Assess patient safety and plan
d. Tends to be clitoral in location o Review patient options and referrals
24. Violence Against Women (VAW) is any act of _______________ that results in, or is likely to
result in physical, sexual or psychological harm or suffering to women, including threats of such acts, Pediatric and Adolescent Gynecology
coercion or arbitrary deprivation of liberty, whether occurring in public or private life - Vulvovaginitis
a. Gender based violence o Most common cause of vulvar symptoms
b. Sex based violence o Sign: Pruritus
c. Women based violence - Cervix
d. Female based violence o Only palpable structure during prepubertal stage
- CASE:
25. Marital rape, now recognized under Philippine laws, means o Pinworm
a. A man may be charged with rape if he forces his wife to have sex with him o Itching at night
b. A man may be charged with rape if he forces his live-in girlfriend to have sex with him o Scotch tape swab
c. A man may be charged with rape if he forces his wife to have sex with his friend - Secretions during prepubertal stage
d. A man may be charged with rape if he forces his daughter to have sex with him o Neutral, alkaline
o Absence of lactobacilli
26. Collective term to mean warning signals that need further investigation in VAW e.g. vague
illnesses, serious psychosocial problems, physical injuries that do not match history Vulvar CA
a. Red flags in VAWC - FIGO Staging for Vulvar CA
b. Pathognomonic of VAWC o Stage I - Tumor confined to the vulva or perineum. No nodal metastasis.
c. Red herrings in VAWC o Stage II - Tumor of any seize with extension to adjeacent lower perineal
d. Sign and symptoms of VAWC structures, with negative nodes.
o Stage III - Tumor of any size with or without extension to adjacent perineal
27. In the acronym RADAR steps in abuse work the first letter R stands for structures, with positive inguino-femoral lymph nodes
a. Random screening for some o Stage IV - Tumor invades other regional or distant structures
b. Routine screening for all - Management:
c. Routine counseling for all suspects o Tumor of less than 2cm - Radical local excision with or without unilateral
d. Routine referral to barangay health worker for all groin node dissection
o Tumor of more than 2cm - Radical local excision with inguinofemoral
lymphadenectomy
Vaginal CA
- Usually occur as SCCA in women > 60 years old
- Management:
o Stage I
Less than 0.5 cm
Wide local excision or total vaginectomy or brachytherapy
More than 0.5 cm
Radiotheraphy
Radical hysterectomy with lymphadenectomy
Lower third of the vagina
Radical vaginectomy with inguinal lymphadenectomy
o Stage II
Radiation with chemotherapy
Radical vaginectomy or pelvic exenteration with or without RT
o Stage III - Radiation with chemotherapy
o Stage IVA - Preoperative radiation
o Stage IVB - Radiotherapy with chemotherapy
- Risk of preogression to invasive cancer is higer for those who are older and
immunocompromised
- Management of VIN:
o Surgical excision
o Carbon dioxide laser
o 5FU cream
o Imiquimod 5%
o Therapeutic vaccines