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Post Test

Hope K. Haefner, MDThe University of Michigan Center for Vulvar Diseases

haefner@umich.edu

ASCCP 2016 Annual Meeting

Disclosure

Hope Haefner, MD was previously on the advisory board of Merck Co., Inc.

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AS PCC

Slides From This Lecture

The pdf from this lecture will be Downloaded to the University ofMichigan Center for Vulvar Diseaseswebsite tomorrow morning

Learning ObjectiveAt the end of this presentation, the participant will:

• Be able to develop an effective differential diagnosis for a variety of vulvovaginal conditions

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Your Diagnosis Is?

A. Complex aphthous ulcerB. Erosive lichen planusC. Herpes simplex virusD. Crohn’s disease

Your Diagnosis Is?

A. Complex aphthous ulcerB. Erosive lichen planusC. Herpes simplex virusD. Crohn’s disease

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Which patient isimmunocompromised?

A. A

B. BC. Both

A.

B.

Which patient isimmunocompromised?

A. A

B. BC. Both

A.

B.

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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

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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

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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

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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

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What is this in patient with hidradenitis suppurativa?

A. Squamous cell carcinomaB. Epithelial inclusion cystC. Pyogenic granuloma D. Paget’s disease

What is this in patient with hidradenitis suppurativa?

A. Squamous cell carcinomaB. Epithelial inclusion cystC. Pyogenic granuloma D. Paget’s disease

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What is the staging system used for Hidradenitis Suppurativa?

A. WHHS (World Health Hidradenitis Staging) B. Clark’s StagingC. 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 StagingC. Breslow’s Staging D. Hurley’s Staging

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Clinical Appearance

Histology

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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

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•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

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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

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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

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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

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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

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See You There!IFCPC/ASCCP

Orlando, Florida | April 4-7, 2017

April 2‐7, 2017

Orlando, Florida

USA

April 4‐7, 2017