ASCCP 2016 Annual Meeting. Post Test. Hope K. Haefner, MD The University of Michigan Center for Vulvar Diseases

Transcription

1 ASCCP 2016 Annual Meeting Post Test Hope K. Haefner, MD The University of Michigan Center for Vulvar Diseases Disclosure Hope Haefner, MD was previously on the advisory board of Merck Co., Inc. 1

2 Slides From This Lecture The pdf from this lecture will be Downloaded to the University of Michigan Center for Vulvar Diseases website tomorrow morning AS C P Learning Objective At the end of this presentation, the participant will: Be able to develop an effective differential diagnosis for a variety of vulvovaginal conditions 2

3 Your Diagnosis Is? A. Complex aphthous ulcer B. Erosive lichen planus C. Herpes simplex virus D. Crohn s disease Your Diagnosis Is? A. Complex aphthous ulcer B. Erosive lichen planus C. Herpes simplex virus D. Crohn s disease 3

4 Which patient is immunocompromised? A. A B. B C. Both A. B. Which patient is immunocompromised? A. A B. B C. Both A. B. 4

5 Which Statement is Incorrect about Diagnostic Studies used to evaluate an Ulcer? A. DFA, PCR, and culture studies for herpes simplex virus carry similar sensitivities (ability to detect a true infection when present) B. A DIF (direct immunofluorescence) study is performed on a biopsy of a specific patient s skin to look for the present of auto antibodies C. A tissue biopsy-based wound culture on an open wound is better than a swab-based wound culture for detecting an infectious ulcer Which Statement is Incorrect about Diagnostic Studies used to evaluate an Ulcer? A. DFA, PCR, and culture studies for herpes simplex virus carry similar sensitivities (ability to detect a true infection when present) B. A DIF (direct immunofluorescence) study is performed on a biopsy of a specific patient s skin to look for the present of auto antibodies C. A tissue biopsy-based wound culture on an open wound is better than a swab-based wound culture for detecting an infectious ulcer 5

6 Which Statement is Correct about Aphthae? A. Aphthae almost always heal with scarring B. A large portion of patients with aphthae have Behçet s disease C. Oral medications that target neutrophils can treat aphthae D. Topical steroids are often ineffective for aphthae Which Statement is Correct about Aphthae? A. Aphthae almost always heal with scarring B. A large portion of patients with aphthae have Behçet s disease C. Oral medications that target neutrophils can treat aphthae D. Topical steroids are often ineffective for aphthae 6

7 An important condition to rule out when considering DIV is: 1. Gonorrhea 2. Syphilis 3. Mobiluncus 4. Trichomonas An important condition to rule out when considering DIV is: 1. Gonorrhea 2. Syphilis 3. Mobiluncus 4. Trichomonas 7

8 Silicone lubricants feel smoother and are more resistant to drying out than water based lubricants A. True B. False Silicone lubricants feel smoother and are more resistant to drying out than water based lubricants A. True B. False 8

9 What is this in patient with hidradenitis suppurativa? A. Squamous cell carcinoma B. Epithelial inclusion cyst C. Pyogenic granuloma D. Paget s disease What is this in patient with hidradenitis suppurativa? A. Squamous cell carcinoma B. Epithelial inclusion cyst C. Pyogenic granuloma D. Paget s disease 9

10 What is the staging system used for Hidradenitis Suppurativa? A. WHHS (World Health Hidradenitis Staging) B. Clark s Staging C. Breslow s Staging D. Hurley s Staging What is the staging system used for Hidradenitis Suppurativa? A. WHHS (World Health Hidradenitis Staging) B. Clark s Staging C. Breslow s Staging D. Hurley s Staging 10

11 Clinical Appearance Histology 11

12 Your Diagnosis Is: A. Squamous cell cancer B. Erosive lichen planus C. Plasma cell vulvitis D. Basal cell cancer Your Diagnosis Is: A. Squamous cell cancer B. Erosive lichen planus C. Plasma cell vulvitis D. Basal cell cancer 12

13 Breast cancer survivors should not be given local vaginal or vulvar estrogens True False Breast cancer survivors should not be given local vaginal or vulvar estrogens True False 13

14 Ospemifene is safer to use in breast cancer survivors than Bazedoxifene True False Ospemifene is safer to use in breast cancer survivors than Bazedoxifene True False 14

15 19 y.o. GO developed vulvovaginal itching February 2014 for which she sought treatment She denied having any ulcers at that time Vulvar lesions appeared in March of 2014 and initially started as 3 to 4, small, moon shaped, lesions on her vulva, not particularly painful She finds this interfering with her day to day routine, but is not bedridden 15

16 She has seen multiple healthcare providers and obtained an extensive workup, which to this point has been negative She was most recently seen at the at a major referral center due to suspected Behcet's disease; however, this has since been ruled out Numerous tests all negative, including extensive STD workup 16

17 Your Diagnosis Is? What is her main problem? A. Self inflicted tissue damage B. Aphthous ulcers C. Pyoderma gangrenosum D. Decubitus ulcers Your Diagnosis Is? What is her main problem? A. Self inflicted tissue damage B. Aphthous ulcers C. Pyoderma gangrenosum D. Decubitus ulcers 17

18 See You There! IFCPC/ASCCP Orlando, Florida April 4-7, 2017 April 2 7, 2017 Orlando, Florida USA April 4 7,