Family Nurse Practitioner Exam

What is the most likely diagnosis for a tender and warm cystic mass on the left labia majora noted during a pelvic exam?

1. Skene's gland cyst

2. Cystocele

3. Lymphogranuloma venereum

4. Bartholin's gland abscess

The correct answer is: Bartholin's gland abscess

The presence of a tender and warm cystic mass on the left labia majora during a pelvic exam strongly suggests a Bartholin's gland abscess. This condition occurs when the Bartholin's glands, which are located bilaterally at the posterior portion of the vaginal opening, become blocked or infected. When such blockage occurs, fluid can accumulate, leading to the formation of a cyst. If the cyst becomes infected, it results in an abscess, characterized by tenderness, warmth, and often swelling, which aligns with the symptoms observed in this scenario. Other conditions listed may present with cystic masses, but they do not typically manifest the same level of tenderness or warmth associated with an acute infection as seen in Bartholin's gland abscess. For example, a Skene's gland cyst generally does not become tender or warm unless infected; it is usually asymptomatic. A cystocele, which is a bulge of the bladder into the anterior wall of the vagina, presents as pressure or protrusion rather than a localized tender cystic mass. Lymphogranuloma venereum may present with genital ulcers and lymphadenopathy but not typically as a tender cystic mass in the labial area. Therefore, the clinical presentation described most accurately