Female and male reproductive, pregnancy, psych Flashcards
(27 cards)
hand biting can be seen in autism. signs pointing away from lesch nyan syndrome include no motor dysfunction (dystonia, spacticity, writhing movements), no nephrolithiasis or gout
symmetric growth restriction causes
asymmetric growth restriction causes
FGR = fetal wieght <10th percentile or birth weight <3rd percentile
symettric = chromosomal abnormalities, congenital infection
assymettric (head sparing) - maternal malnutrition, placental insufficiency!
hypoglycemia, hypocalcemia, hypothermia and what else is a complication of fetal growth restriction?
Polycythemia
management for patient with androgen insensitivity syndrome?
elective gonadectomy!!
increased risk of testicular cancer due to bilateral cyptorchid testes
patient with tourettes.
alpha-2-adrenergic agonist guafenacine has already been tried with no success
what other drug class can be tried?
antidopaminergic medication!!!
eg tetrabenzine!!
4 yo painless coiled right sided scrotal mass that does not transilluminate
persists when supine
next step in management?
abdominal US!! this is a secondary varicocele = investigate for venous thrombus or abdominal mass
contrast primary varicoceal = pubertal onset, left sided, decompresses when supine, managed with observation and reassurance.
direct penile trauma with hematuria
next step in management?
retrograde urethrography
NOT catheterisation as it can worsen the injury
child is age 14
so >/= 13 and no menarche or secondary sexual characteristics.
next step in evaluation?
FSH levels!!!
distinguishes between central causes (low/normal FSH)
and peripheral causes of amenorrhea (high FSH)
but if uterus is absent then workup for amennorhe skips dirrectly to karyotype
NOT gnrh as used for precocious puberty
1 day old transilluminating mass that clinically seems like hydrocele
next step in management?
reasurrance and observation.- self resolve by age 1
NOT scrotal US - can be used to identify inguinal hernia in patient presenting with scrotal mass that does not transilluminate
newborn baby normal penis. only one testes in scrotum, the other not palpable in inguinal region ie undescended
next step in management?
monitor for spontaneous descent!!!
only at 6 months that you do orchiopexy
and if it is BILATERAL undescended testes at birth or one undescended + hypospadias = karyotype, pelvic ultrasound, adrenal gonadal hormones
7 year old charge with vaginal discharge and friable white foreign body in vagina noted
first step in management?
topical anaesthetic and warm fluid irrigation!!!
not notify cps! -> no signs of vaginal trauma, no behaviour changes, foreign body seems to be toilet paper which is common!!!
not speculum exam as should not be performed in a prepubescent girl
a child saying everything will be better when nobody has to take care of me is a red flag for suicidal ideation -> obtain emergency assessment for possible hopitalisation
patchy hair loss and areas of uneven hair growth in child + sparse eyebrows
wears a lot of hats in role in school play
most likely diagnosis
trichotillomania = recurrent hair pulling - irregular patches of hair loss, hair shafts of various lengths
scalp, eyebrows, eyelids affected
having an imaginary friend that a child can hear speak and respond to is normal during school years and is most common between 3-6 years
metabolic complications of infant of diabetic mothers include hypoglycemia, hypocalcemia and hypomagnesemia.
in a jittery baby, particularly if glucose is normal, what do you check next?
serum calcium
what are the 2 common comorbid conditions in tourrettes syndrome?
OCD!! and ADHD!
Wondering about sex is very normal; what questions do you have about sex and your body?
NOT have you thought about how to prevent unintended pregnancy or STIs as this should be explored after thoughts
newborn
watery eye discharge
clear conjuctiva
left eyelid becomes matted shut during sleep
fluroscien dye shows equal distribution on the cornea and conjuctiva
most likely diagnosis?
congenital nasoclacrimal duct obstruction!! blockage of normal tear flow
increased tearing and crusting of eyelashes with normal conjuctiva
management = lacrmial sac massage!!! to open up duct
16 yo, very heavy menstrual bleeding
management?
high dose oral contraceptive therapy
neonatal clavicular fracture management?
reassurance and gentle handling - natural healing or garment sling
NOT figure of 8 splint placement as this is used for older children
alternate routes to school may cause agitation = bag throwing
difficulty navigating social interactions = blurting out answers
these are signs of autism
recurrent cystitis in 4 year old girl. most likely cause?
urinary stasis!!! (due to chronic constipation)
NOT vesicoureteral reflux as as it causes recurrent UPPER tract disease i.e. pyelonephritis
in most common form of congenital adrenal hyperplasia, what is the Karyotype?
46XX
its all about virilization in females = underdeveloped phallus, hypospadias
adolescent new onset psychosis
+ neurological dyfunction = tremor hypertonia, facial expression is diminished facial stiffness (parkinsonism)
most likely pysiological process behind condition?
abnormality in hepatocellular transport
= wilsons disease!!!!
