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3p Flashcards

1
Q

episodic headache occurring several times daily for 4-6 weeks with extended relieve for 6-12 months occurs mostly in men

A

cluster headaches

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2
Q

Produced by ovaries & placenta

responsible for enlargement of uterus, breast & genitals

A

estrogen

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3
Q

maintains endometrium for implantation
inhibits uterine contractility, preventing abortion
promotes secretory ducts of breast for lactation

A

progesterone

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4
Q

influences thyroid gland size, activity & increases HR

increases basal metabolic rate by 23% during pregnancy

A

thyroxine (T4)

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5
Q

used in pregnancy test to determine pregnancy state

stimulates progesterone & estrogen by corpus luteum to maintain pregnancy until pregnancy takes over

A

human chorionic gonadotropin (HCG)

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6
Q

produced by placenta

affects glucose & protein metabolism

A

human placental lactogen (hPL)

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7
Q

produced by anterior pituitary gland

causes pigmentation of skin to darken

A

melanocyte stimulating hormone (MSH)

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8
Q

produced by corpus luteum & placenta

inhibits uterine activity

A

relaxin

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9
Q

prepares breast for lactation

A

prolactin

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10
Q

produced by posterior pituitary gland
stimulates uterine contraction
after birth, helps keep uterus contracted
stimulates milk ejection reflex during breast feeding

A

oxytocin

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11
Q

“Patient states,” Amenorrhea, N/V, increased urinary frequency, excessive fatigue, breast tenderness

A

presumptive signs (subjective)

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12
Q

“Provider sees & feels,” softening, darkening of cervix, uterine softening, enlargement, ballottement, positive pregnancy test

A

probable signs (objective)

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13
Q

“Testing reveals”, fetal heart rate detected, fetal outline & movements

A

positive signs (diagnostic)

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14
Q

prompted by hormonal changes
preparation for lactation
estrogen & progesterone cause proliferation in ducts & glandular tissue
12 oz increase in breast weight over term of pregnancy
during pregnancy, breast skin thins & striae develops
alveoli become progressively distended

A

breast changes during pregnancy

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15
Q

solid organ becomes thin- walled & hollow
wall thickens from 10 mm to 25 mm in first 16 weeks
thins to 5-10 mm by term
Hegar’s sign = uterus bends in anterior direction on lower uterine segment
fundus rises out of the pelvis and enlarges 1 cm weekly
uterine souffle’ = maternal arterial blood arriving into the placenta

A

uterine

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16
Q

increased levels of progesterone & relaxin soften pelvic floor ligaments & muscles
further stretched by the gravid uterus & vaginal delivery
contributes to urinary/ fecal incontinence, hemorrhoids, dyspareunia & uterine prolapse

A

pelvic floor changes

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17
Q

increased production of sweat & sebaceous glands
increasing levels of melanocyte- stimulating hormone causes linea nigra
striae gravidarum (stretch marks)

A

skin changes

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18
Q

flatus, constipation diminished bowel sounds from slow peristalsis
decreased intestinal contractility from displacement, fluid reabsorption changes & increased progesterone levels
dyspepsia in pregnancy aggravated by displacement of abdominal organs, increased progesterone alters esophageal sphincter & gastric tone

A

GI changes

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19
Q

heart displaced upward
supine hypotension
cardiac output increases 30-50%
blood volume peaks 30-34 weeks, increases 30-50%, 1110-1600 mL
75% increase is plasma red blood cell volume increases

A

cardiovascular changes

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20
Q

respiratory congestion from increased edema of pharynx & larynx
5% reduce lung capacity from increased chest wall circumference & decreased chest compliance
30% increase in oxygen consumption compromising respiration in those with chronic asthma, obesity or smoking

A

respiratory changes

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21
Q

maintains electrolyte & acid - base balance, regulates increase in blood & extracellular fluid volume, excretes maternal & fetal waste products & conserves essential nutrients
kidneys are displaced & increase in size
effects of progesterone decrease bladder tone

A

renal changes

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22
Q

effects of progesterone, estrogen and relaxin on ligaments & joints. relaxation of pelvic structures
posture shifting center of balance
gait changes, sciatica, discomfort of the symphysis pubis & stretching/ pain of uterosacral & cardinal ligaments

A

muscloskeletal/ neuro changes

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23
Q

thyroid enlargement
pituitary gland increases by factor of 3
basal metabolic rate increase 20-25%
insulin resistance, obesity greater risk for gestational diabetes
increased prolactin & oxytocin
emotional/ irritability hormone shifts
decreased attention span, decreased concentration & memory lapse
sleep alterations
corneal edema, plugged ears, reduced hearing & vertigo

A

endocrine changes

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24
Q

Naegele’s rule

A

1st day of LMP + 7 days - 3 months + 1 year = estimated due date

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25
Rh- mom receives Rhogam when?
@ (7 months) 28 weeks & 72 hours post delivery
26
food to avoid during pregnancy
unpasteurized foods, beverages & raw meats
27
genetic & fetal screening done in 1st trimester
cystic fibrosis, sickle cell, autosomal recessive, down's syndrome abnormal finding warrant further diagnostic testing = aminocentesis
28
cessation of menstruation for at least 12 months
menopause
29
perimenopausal period
2-8 years prior to LMP
30
early postmenopausal period
1st 5 years following menopause
31
late postmenopausal period
6+ years after the LMP
32
anticholinergic antimuscarinic agents oxybutynin (Ditropan), toterodine (Detrol), fesoterdin (Toviaz), darfenacin (Enablex) & solifenacin (Vesicare)
used for urge incontinence
33
tricyclic antidepressants imipramine (Tofranil) and mirabegron (Myrbetriq)
used for urge incontinence
34
alpha - adrenergic agonist (ephedrine & pseudoephedrine (Sudafed) and duloxetine
used for stress incontinence
35
trauma, testicular Ca, enlarged veins in the scrotum, inflammation of the testes (orchitis), swelling due to increased fluid (hydrocele), hernia, infection/ inflammation of epididymis (epididymitis) & CHF cause
scrotal edema
36
common in newborns usually disappears w/o treatment by age 1
hydrocele
37
torsion of spermatic cord = ED
occurs in young males p exercise, Sx required
38
test for torsion of spermatic cord
cremasteric reflex ( gentle stroke of inner thigh) triggers elevation of the ipsilateral testicle
39
lab test for syphilis
RPR
40
painless sore indicates what STI
syphilis
41
tx for syphilis
PCN G 2.4 million units single dose + prednisone x 3 days
42
STD painful sore caused by H ducreyi
chancroid
43
tx for chancroid
azithromycin 1 g single dose or rocephin 250 mg IM single dose
44
what medications for BPH relax the muscles of the prostate & neck of bladder
alpha blockers
45
``` Alfuzosin (Uroxatral) Doxazosin (Cardura) Prazosin (Minipress) Silodosin (Rapaflo) Tamsulosin (Flomax) Terazosin (Hytrin) ```
Alpha blockers
46
meds that shrink the prostate & prevent additional growth
5- alpha reductase inhibitors (5-ARIs)
47
Dutastride (Avodart) | finasteride (Proscar)
5-alpha reductase inhibitors (5-ARIs)
48
meds that improve prostate symptoms by increasing flow rate
Phosphodiesterase 5 inhibitors (PDE5 inhibitors)
49
Sildenafil (Viagra) Vardenafil (Levitra) Tadalafil (Cialis) Avanafil (Stendra)
Phosphodiesterase 5 inhibitors (PDE5 inhibitors)
50
normal pediatric growth percentile range
> 5th % & < 95th %
51
newborn
0-28 days
52
infant
1-12 months
53
newborn average weight
``` 7.5 lbs loses 5-8% of body weight gains back by 10-14 days doubles by 4-6 months triples by 12 months ```
54
newborn reflexes
indicate neurological well being, begin to dissipate in 1st few months except for sucking & Babinski
55
rooting, sucking, moro/ startle, grasping, babinski
newborn reflexes
56
anterior fontanels closes
@ 18 months
57
posterior fontanels closes
@ 2-3 months
58
newborn pulse & resp
``` p = 120-170 r = 30-80 ```
59
6 year pulse/ resp
``` p = 75-115 r = 16-20 ```
60
17 year old pulse/ resp
``` p = 60-100 r = 12-20 ```
61
hemoglobin increase
may indicate dehydration or intravascular hemolysis
62
decreased Hgb
may indicate anemia, sickle cell, thalassemia, hemorrhage or hyperthyroidism
63
Hct increased
may indicate polycythemia, dehydration or erythocytosis
64
Hct decreased
may indicate anemia, hemorrhage, hyperthyroidism, leukemia, cirrhosis
65
MCV increased > 100
macrocytic anemias = folic acid or Vit B12
66
MCV decreased < 80
microcytic anemias = Fe deficiency, thalassemia, lead poisoning & anemia of chronic diseases
67
test for cystic fibrosis
chloride test
68
first trimester screening for Down's or trisomy 18
nuchal translucency and triple screen (AFP-3 test)
69
nuchal translucency
measures the amount of fluid accumulation behind baby's neck
70
Throbbing pain behind one eye photophobia, phonophobia N/V in adults females. aggravated by red wine, aspartame, menstruation and stress
migraine w/o aura
71
Throbbing pain behind one eye photophobia, phonophobia, halos, scotoma, scintillating lights, N/V in adults females. aggravated by tyrosine
migraine w/ aura
72
bilateral "band like" pain, continuous dull pain may last a day, may be accompanied by spasms of trapezius muscles happens in adults aggravated by stress
muscle tension headache
73
intense & very brief, sharp stabbing pain, one cheek in older adults & elderly aggravated by cold food, cold air, talking touch, chewing
trigeminal neuralgia
74
prophylactic tx for headaches
``` propranolol (inderal) tricyclic antidepressants (TCA) = Amitrptyline (Elavil) ```
75
CN I (1)
Olfactory = smell
76
CN II (2)
Optic = visual field (Snellen)
77
CN III, CN IV, CN VI (3,4,6)
Oculomotor = EOM
78
CN V (5)
Trigeminal= sensory nerves to face
79
CN VII (7)
Facial
80
CN VIII (8)
Acoustic = whisper test
81
``` CN IX (9) CN X (10) ```
``` Glossopharyngeal = open mouth yawn Vagus = uvula & gag reflex ```
82
CN XI (11)
Spinal accessory = shoulder shrug
83
CN XII (12)
Hypoglossal = stick out tongue move from side to side

3 p exam (2 decks)

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