Answer: There is no universally accepted definition for HG, but most clinicians consider this diagnosis in the setting of compromised fluid, electrolyte, and nutritional status. Some use a maternal weight loss of 5% and persistent significant ketonuria to make the diagnosis. A wide range of laboratory abnormalities may be seen, but a patient with moderate [...]

Answer: In multiple surveys, 60-70% of women experience symptoms of NVP. In one large comprehensive study, investigators found that symptoms began between the 4th and 7th menstrual week in 70% of patients with NVP, but that 7% had symptoms prior to their first missed period. Resolution of symptoms varied: in 30% symptoms disappeared by 10 [...]

Answer: Imperforate hymen: Usually recognized after puberty when retention of menses leads to hematocolpos. Accumulation of retained secretions may also lead to hematometra and hematosalpinx. Inspection of the introitus reveals an imperforate hymen with a bulging fluid mass in the vagina.▪ Treatment-cruciate incision of the imperforate hymen. Septate vagina: May be complete or incomplete, with [...]

Answer: Vestibulitis is defined as a constellation of symptoms and signs, including entry dyspareunia, vestibular erythema, and vestibular tenderness in the absence of an active dermatosis or disorder that would otherwise explain the findings. Management includes symptomatic relief with 5% lidocaine ointment; tricyclic antidepressants may be helpful. Surgical treatment should only be considered in severe [...]

Answer: Vulvadynia is defined as diffuse vulvar pain that occurs with or without provocation and is usually constant and unremitting. Pain is described as dull and burning. On exam, the vulvar skin and architecture are normal, and there are usually no architectural abnormalities. Management includes tricyclic antidepressants, anticonvulsants, and pain management programs. Reference: Tovell HMM, [...]

Answer: Melanocytic nevi: Vary in color and size (from 1-2 mm to 1-2 cm). Typically are asymptomatic. Diagnosis confirmed histologically usually with simple excision. Acanthosis nigricans: Cutaneous disorder affecting the axillae, nipples, umbilical area, and crural region. Appears as a poorly defined, velvety hyperpigmentation. Only symptomatic treatment is available. Vitiligo: Characterized by complete depigmentation of [...]

Answer: Lichen sclerosis: Most common in prepubertal and postmenopausal patients. Characterized by epithelial thinning with edema and fibrosis of the dermis and associated shrinkage and agglutination of the labia and introital stenosis. The edematous skin has a white, thin, and paperlike appearance. The labia minora is usually lost. Patients often experience pruritis. Sexually active women [...]