EBCOG P1 – 3 Month – General gynecology – Day 2

EBCOG P1 – 3 Month – General gynecology – Day 2 Q1

Options Q1-3

A.Chronic vulvovaginal candidiasis

B.Eczema

C.Idiopathic

D.Lichen planus

E.Lichen sclerosus

F.Lichen simplex

G.Paget’s disease

H.Psoriasis

I.Recurrent herpes infection

J.Systemic lupus erythematosus

K.Vestibulodynia

L.Vulval intraepithelial neoplasia (VIN)

M.Vulvodynia

For each of the following clinical descriptions, what is the most likely diagnosis from the option list above? Each option may be used once, more than once or not at all.

Q1. A 58-year-old woman presents with dyspareunia, vulval itching and soreness. A biopsy is taken from atrophic areas on the vulva. The histology report states: ‘There is epidermal atrophy, hyperkeratosis with subepidermal hyalinisation of collagen and lichenoid infiltrate.’

EBCOG P1 – 3 Month – General gynecology – Day 2 Q2

Q2. A 23-year-old woman with schizophrenia presents with vaginal itch and soreness. On examination, there are marked excoriations and lichenification. Most of her pubic hair is absent.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q3

Q3. A 40-year-old woman presents with vaginal soreness, discharge and dyspareunia. On examination, the mucosal surfaces of the vagina are eroded. At the edges of the erosions, the epithelium is mauve/grey, and Wickham’s striae are noted.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q4

Options

A Skin patch testing

B Clobetasol

C Immunomodulators

D Topical anti-fungal cream

E CO2 laser vaporisation

F Local excision

G Simple vulvectomy

H Radical vulvectomy

I General measures

J Laser therapy

K HPV vaccination

L Immunosuppressants

M Interferon therapy

N Photodynamic therapy

Match the most appropriate management to each scenario:

Q4. A 53-year-old woman presents with severe pruritus and thinning of the vulval skin, which bleeds on scratching. There is pain, discomfort and dyspareunia and adhesion of the labial margins on examination. She also suffers from diabetes.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q5

Q5. A 33-year-old woman presents with recent onset of irritation and soreness of the vulva but with a long-standing history of vaginal discharge. There is also evidence of an inflamed area on the inner side of the thigh.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q6

Q6. A 42-year-old woman presents with recurrent oral and genital ulcers, which are quite painful. There is extensive evidence of scarring from previous lesions.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q7

Q7. Significant pruritus in a 52-year-old smoker with red plaques and some warty lesions.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q8

Q8. A 32-year-old woman presents with vulval lesions that are smooth and discrete, red in colour, but not affecting the vaginal mucosa. The patient also complains of discrete lesions in the flexural areas of the body.

EBCOG P1 – 3 Month – General gynecology – Day 2 Q9

Q9. A 44-year-old woman complains of a long-standing history of inflammatory bowel disease and complains of recent onset swelling and ulceration of the vulva and occasionally something draining out of these swollen areas.