Questions and Verified Answers | Complete Exam
Preparat
Models of sexual response
Biopsychosocial model which is an integrative model of sexual function that evolves over time
reflecting a women's fluctuations in health status, mental health, interpersonal concerns, and
sociocultural beliefs/values
17-b-estradiol vaginal ring
Estring (VVA and urinary urgency)
Estradiol acetate vaginal ring
Femring
- Approved for both VVA and VMS due to high dose of estradiol causing systemic levels of
estrogen
- Need Progesterone if intact uterus
Estrace Vaginal Cream
(17-beta-estradiol cream) - Indicated for VVA and dyspareunia
Premarin Vaginal Cream
(Conjugated Estrogen) - Indicated for VVA and dyspareunia
DHEA vaginal cream
Approved for treatment of moderate-severe dyspareunia s/t VVA
Vulvodynia
Vulvar pain of at least 3 months; a syndrome of unknown cause
- Suspicious lesions should be biopsied to rule out malignancy
, Desquamative inflammatory vaginitis
Menopause syndrome characterized by purulent vaginal discharge, vaginal erythema, and
dyspareunia.
Treat with clindamycin or 10% hydrocortisone cream x 4-6 weeks
Lichen sclerosis
Characterized by thinning of the epidermis and fibrosis (sclerosis) of the dermis; presents as a
white patch (leukoplakia) with parchment-like vulvar skin; treatment includes topical
corticosteroids
Lichen Simplex Chronicus
lichenification --long-term atopic dermatitis -- repetitive scratching/rubbing
well-circulated plaque
tx: stop the itch-scratch cycle by removing irritant; consider topical steroids and antihistamine
VIN Low-grade squamous intraepithelial lesion (LSIL)
Not precancerous
HPV 6 & 11
VIN High grade squamous intraepithelial lesions
Precancerous condition
HPV 16,18, 31
Paget Disease
Typical patient is 60-70, caucasian, with lesion that does not improve with corticosteroid
treatment; often diagnosed as eczema/psoriasis
Consider screening for co-esxisting cancer (20-30% chance of breast, colon, or genitourinary
cancer)
Normal postvoid residual volume
<100mL
>200mL = inadequate bladder emptying
Stress incontinence treatment
- Pelvic Floor PT or Kegel's
- Pessary
- Duloxetine used off-label