504 Obstetrics and Gynecology Board Review •••
❍ What is Novak’s theory regarding endometriosis?
This theory, favored by many, states that tissue derived from the Müllerian system may undergo metaplasia to
become endometrial tissue.
❍ What are the two most common causes of vaginitis?
Candida albicans and Trichomonas vaginalis.
❍ What is the most common cause of bacterial vaginosis?
Gardnerella vaginalis.
❍ What organism is occasionally seen in Pap smears classically in association with use of an intrauterine
device (IUD)?
Actinomyces israelii.
❍ What is the organism that, in association with the use of tampons, is associated with toxic shock syndrome?
Staphylococcus aureus. Specifically, the enterotoxin F and exotoxin C produced by the organism and absorbed by
the patient are the cause of this syndrome.
❍ What is the name of the rare simple vaginal cyst that is typically found in the lateral or anterolateral wall of
the vagina and is lined by a single layer of cuboidal-type cells?
Gartner duct cyst (mesonephric cyst).
❍ What is the most common benign tumor of mesenchyme in the vagina?
Leiomyoma.
❍ What is vaginal adenosis and what is it associated with?
This is a collection of benign mucinous endocervical glands in the vagina and is associated with exposure to
diethylstilbestrol (DES) in utero by the patient’s mother. Specifically, the critical time of exposure is prior to the
18th week of gestation.
❍ What is the more serious complication associated with in utero exposure to DES?
Development of clear cell adenocarcinoma of the vagina and cervix.
❍ What is the most common site in the vagina of adenosis and clear cell adenocarcinoma?
The upper one-third of the vagina on the anterior wall.
❍ What benign polypoid lesion occurs in the vagina and tends to protrude from the introitus and can be
confused with sarcoma botryoides?
Fibroepithelial polyp.
❍ What is the most common malignant vaginal tumor found in children?
Embryonal rhabdomyosarcoma, also known as sarcoma botryoides.