OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is atrophic vaginitis. While this may seem a odd practice, it is useful to see multiple examples of how atrophic vaginitis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 56 year old woman comes to the clinic with complaints of vaginal itching, painful urination, and increased urinary frequency. She explains that she has been struggling with these issues for several months, but they have all worsened recently. She has tried to use over the counter water based lubricants, but they have given little relief from the itching. Her last menstrual period was 8 hears ago. She has not been sexually active for the last year (due to her husband passing away). She takes hydrochlorothiazide for hypertension, and also takes pravastatin for hypercholesterolemia. Her physical exam shows reduced elasticity and turgor of the vulvar skin. The vagina is pale, dry, and smooth. The vaginal pH is 6.4. A urinalysis is collected that is normal. What is the most likely diagnosis in this patient?
Question # 2
A 50 year old woman comes to the physician because she is experiencing pain during intercourse, and vaginal irritation. She explains that these symptoms have worsened over the past 3 months. She has tried over the counter lubricants during intercourse, however she still feels pain during penetration. Five years ago, she underwent radiation and chemotherapy for a stage II cervical cancer. While she was receiving chemotherapy, she was found to have recurrent vaginal candidiasis that required suppressive therapy. She has a 25-pack year history of smoking. Her vital signs are within normal limits. A gynecological exam shows vulvar skin with the shrinkage of the clitoral tissues. The vaginal mucousa appears to be pale and thin. What is the likely diagnosis in this patient?
Question # 3
A 62 year old female comes to the clinic because she has the persistent feeling of having to urinate. For the past 3 years she has been experiencing “accidents” that occur multiple times a day, and now she has begun to wear adult diapers. She explains that she has the urgency to void during the night, and often wakes up to find her diaper wet. She has also been experiencing vaginal itching and dryness. Menopause occurred at the age of 52, when a total laparoscopic hysterectomy (with bilateral sloping-oophrectomy) was performed for her diagnosis of endometrial adenocarcinoma. Her past medical history is also significant for recurrent urinary tract infections this pas year. She denies being sexually active, and is not currently taking any medications. Her physical exam shows a smooth vaginal epithelium with patchy erythema. Vulvar skin shows rescued elasticity, and the physician notes lab minor retraction. What is the most likely cause of the patient’s urinary complaints?
Page Updated: 10.09.2016