pp clues obgyn ped Flashcards
(257 cards)
1
Q
What does the Seminal Vesicle give to sperm?
A
Food (fructose) and clothes (semen)
2
Q
What do the Bulbourethral = Cowper’s glands secrete?
A
Bicarbonate (neutralize lactobacilli)
3
Q
What does the Prostate secrete?
A
“The prostate HAZ it”
Hyaluronidase Acid phosphatase
4
Q
What is the Capacitation reaction?
A
Zn used to peel semen off
5
Q
What is the Acrosomal reaction?
A
Sperm release enzymes to eat corona radiata
6
Q
What is the Crystalization reaction?
A
Wall formed after 1 sperm enters (to prevent polyspermy) the egg
7
Q
Where does Testosterone come from?
A
Adrenal gland and testicles
8
Q
Where does DHT come from?
A
Testicles (at puberty)
9
Q
What is a Pseudohermaphrodite?
A
External genitalia problem; does not match genotype
10
Q
What is a True Hermaphrodite?
A
internal genitalia problem => has both sexes’ genitalia
11
Q
What is a Female Hermaphrodite?
A
Impossible b/c the default is female
12
Q
What is a Female Pseudohermaphrodite?
A
XX with low 21-OHase
=> high testosterone
13
Q
What is a Male Hermaphrodite?
A
XY with no MIF
14
Q
What is a Male Pseudohermaphrodite?
A
XY that has low 17-OHase => low testosterone
15
Q
What is Hirsuitism?
A
Hairy
Hi testoterone
16
Q
What is Virilization?
A
female child with male sexual charcateristic
17
Q
What is Testicular Feminization = Androgen Insensitivity
A
Bad DHT receptor w/ blind pouch vagina
18
Q
What is McCune-Albright?
A
Precocious sexual development, polyostotic fibrous dysplasia “whorls of CT”, “Coast of Maine” pigmented skin macules
19
Q
What is Cryptochordism?
A
Testes never descended => sterility after 15mo, seminomas
20
Q
Which stage of the menstrual cycle has the highest estrogen levels?
A
Follicular stage (has
proliferative endothelium)
21
Q
What stage of the menstrual cycle has the highest temperature?
A
Ovulatory stage
22
Q
What stage of the menstrual cycle has the highest progesterone levels?
A
Luteal stage (has secretory endothelium)
23
Q
What form of estrogen is highest at menopause?
A
E1: Estrone (made by fat)
24
Q
What form of estrogen is highest in middle-age females?
A
E2: Estradiol (made by ovaries)
25
What form of estrogen is highest at pregnancy?
E3: Estriol (made by placenta)
26
What states have increased estrogen?
Pregnancy, liver failure, p450 inhibition, obesity
27
What is Adenomyosis?
Growth of endometrium myometrium, enlarged "boggy" uterus w/ cystic areas
28
What does DES taken by Mom cause in her daughter?
Adenomyosis-->menorrhagia
->Clear Cell CA of the vagina
-> Recurrent abortions from cervical
incompetence
29
What is Kallman's syndrome?
No GnRH, anosmia (can't smell)
30
What is Polycystic Ovarian Syndrome?
^Cysts: no ovulation-> progesterone
(^ endometrial CA) ->can't inhibit LH, obese, hairy, acne
31
What is Savage's syndrome?
Ovarian resistance to FSH/LH
32
What is Turner's syndrome (XO)?
High FSH, low estrodiol( E2), ovarian dysgenesis
33
What does the Progesterone challenge test tell you?
Bleeds => she has estrogen
Not bleed => she has no E2 or ovaries
^FSH->Ovary problem
low FSH->pituitary problem
34
What is Sheehan syndrome?
Post-partum hemorrhage->pituitary, hyperplasia infarcts ->no lactation
35
What is Asherman's syndrome?
Previous D&C ->uterine scars
36
What is Oligomenorrhea?
Too few periods
37
What is Polymenorrhea?
Too many periods
38
mcc of post- coital vaginal bleeding?
Cervical cancer
39
What is the most common cause of post- coital vaginal bleeding in pregnant women?
Placenta previa
40
mcc of vaginal bleeding in post-
menopause women?
Endometrial cancer
41
What is Dysmenorrhea?
| mcc of teenage seeing a doctor
PG-F causes painful menstrual cramps (teenagers miss school/work)
42
What is Endometriosis?
Painful cyclical heavy menstrual bleeding
=> "powder burns, chocolate cysts" due to ectopic endometrial tissue
43
What is Kleine regnung?
Scant bleeding at ovulation
44
What is Menorrhagia?
Heavy menstrual bleeding
45
What is Fibroids = Leiomyoma?
Benign uterus SM tumor
-> Submucosal type => bleeding
-> Subserosal type => pain
46
What is Metrorrhagia?
Bleeding or spotting in between periods
47
What is Mittelschmerz?
Pain at ovulation
48
What causes Syphilis?
Treponema pallidum (spirochete)
49
What is Herpes?
ds DNA virus
50
What is HPV?
ds DNA virus
51
What is Chlamydia?
Obligate intracellular parasite
52
What causes Gonorrhea?
Gram – diplococcus
Facultitive intracellular
53
What causes Chancroid?
H. ducreyi
54
What causes
Lymphogranuloma Venereum?
Chlamydia trachomatis
55
What causes Granuloma Inguinale?
C. granulomatosis
56
What causes Epididymitis?
Chlamydia or GC
57
What is Condyloma Lata?
Flat fleshy warts, ulcerate, 2° Syphilis
58
What is Condyloma Accuminata?
Verrucous "cauliflower" warts, koilocytes, HPV 6,11
59
How does Herpes present?
1°: Painful grouped vesicles on red base 2°: Painful solitary lesion
60
How does Syphilis present?
1°: Painless chancre (1-6 wks)
2°: Rash, condyloma lata (6 wks)
3°: Neuro, cardio, bone (6yrs)
61
How does Chancroid present?
Painful w/ necrotic center, Gram –rod, "school of fish" pattern
62
How does Lymphogranuloma Venereum present?
Painless ulcers→abscessed nodes→
genital elephantiasis
63
How does Granuloma Inguinale present?
Spreading ulcer, Donovan
bodies, granulation test
64
How does Chlamydia present?
| in females
Cervicitis (yellow pus), conjunctivitis, PID
65
How does Gonorrhea present?
purulent urethral discharge
(yellow-green)
dysuria
arthritis,
cervicitis
PID
Palmer rash
| purulent yellow malodor discharge
perihepatitis
66
What is Epididymitis?
Unilateral scrotal pain decreased by support
67
What causes Congenital blindness?
CMV
| HHV-5-owl eye
ganciclovir
68
What causes Neonatal blindness?
Chlamydia
| azithromycin
69
What is Lichen simplex chronicus?
Raised white lesions, chronic scratching in vulva
70
What is Lichen sclerosis?
Paper-like vulva, itching, cancer risk
71
What is Hidradenoma?
Sweat gland cysts
72
# T(ToRCHes)
What causes non-bacterial fetal infections?
| T (TORCHes)
"TORCHeS"
=>Toxoplasma: multiple ring-enhancing lesions,
cat
urine,
parietal lobe Others
73
# R
ToRCHeS
=>Rubella: cataracts,
hearing loss,
persistant PDA,
meningoencephalitis,
pneumonia,
"blueberry muffin" rash
74
# C
ToRCHeS
| DS dna virus
=>CMV: spastic diplegia of legs,
hepatosplenomegaly, blindness, central calcifications
75
# H
ToRCHeS
=>HSV-2: temporal lobe hemorrhagic
encephalitis,
76
# S
ToRCHeS
=>Syphilis: Rhagade's (lip fissure), saber, shin legs, Hutchison's razor teeth, mulberry molars, saddle nose
77
What is Paget's disease of the breast?
Rash and ulcer around nipple, breast cancer
78
What is Lobular carcinoma?
Cells line up single file, contralateral primary
79
What is a Comedocarcinoma?
Multiple focal areas of necrosis, “blackheads”
80
What is Inflammatory carcinoma?
Infiltrates lymphatics, pulls on Cooper's ligaments,“peau d’orange”
81
What is Cystosarcoma phylloides?
"Exploding mushroom", firm, rubbery, moveable,good prognosis
82
What is Intraductal papilloma?
Nipple bleeding
83
What is Ductal carcinoma?
Worst prognosis breast cancer
84
What is Sarcoma Botyroides?
Vagina cancer, ball of grapes appearance
85
What is a Sister Mary Joseph Nodule?
Ovarian CA spread to umbilicus
86
What is Meig’s syndrome?
Pleural effusion, ovarian fibroma, ascites
87
What are the side effects of estrogen?
Weight gain, breast tenderness, nausea,
| relaxation
88
What are the side effects of progesterone?
Acne, depression, HTN
| increase apetite, aggressive, polycythemia
89
Why do pregnant women get anemia?
Dilutional effect; RBC rises 30% but volume rises 50%
90
What are the degrees of vaginal lacerations?
1st Degree: Skin
2nd Degree: Muscle
3rd Degree: Anus
4th Degree: Rectum
91
What is Vernix?
Cheesy baby skin
92
What is Meconium?
Green baby poop
93
What is Lochia?
Endometrial slough
94
What is normal blood loss
during a vaginal delivery?
500mL
95
What is normal blood loss during a C- section?
1L
96
How do you treat A1 Gestational DM?
Diet
97
How do you treat A2 Gestational DM?
Insulin
98
What are identical twins?
Egg split into perfect halves "monochorionic"
99
What are fraternal twins?
Multiple eggs fertilized by different sperm
100
What is Ovarian
Hyperstimulation Syndrome?
Weight gain and enlarged ovaries after clomiphene use
101
Who makes the Trophoblast?
Baby
102
Who makes the Cytotrophoblast?
Mom => GnRH, CRH, TRH, Inhibin
103
Who makes the Syncitotrophoblast?
Mom and baby => HCG, HPL
104
When does implantation occur?
1 week after fertilization
105
When is β-HCG found in urine?
2 weeks after fertilization
106
What is the function of Estrogen?
Muscle relaxant,
constipation
↑protein production
irritability
varicose veins
107
What is the function of Progesterone?
↑appetite,
↑acne,
dilutional anemia,
quiescent uterus,
pica,
hypoTN,
melasma
108
What makes progesterone <10wk gestation?
Corpus luteum
109
What makes progesterone >10wk gestation?
Placenta
110
What is the function of β-HCG?
Maintains corpus luteum,
sensitizes TSHr
=> act hyperthyroid (to ↑BMR)
111
What makes β-HCG?
Placenta
112
How fast should β-HCG rise?
Doubles every 2 days until 10 wks (when placenta is fully formed)
113
What is the function of AFP?
Regulates fetal intravascular volume
114
What is the function of HPL?
Blocks insulin receptors => sugar stays high (baby's stocking up on stuff needed for the journey)
| insulin resistance gestational diabetes
115
What is the function of Inhibin?
Inhibits FSH => no menstruation
116
What is the function of Oxytocin?
Milk ejection, baby ejection
117
What is the function of Cortisol in pregnancy?
Decreases immune rejection of baby, lung maturation
118
What are the thyroid hormone levels during pregnancy?
↑TBG => ↑bound T4, normal free T4 levels
↑Total T4
119
When can you first detect fetal heart tones?
Week 20
120
When can you tell the sex of a fetus
by US?
Week 16
121
What does an AFI <5 indicate?
Oligohydramnios (cord compression)
122
What does an AFI >20 indicate?
Polyhydramnios (DM)
123
How fast should fundal height change?
Uterus grows 1cm/wk
124
What is the Pool Test?
Fluid in vagina
125
What is Ferning?
Estrogen crystallizes on slide
126
What is Nitrazine?
Shows presence of amniotic fluid
127
What is the risk of chorionic
villus sampling?
Fetal limb defects
128
What is the risk of amniocentesis?
Abortion (2% risk)
129
What is a normal biophysical profile?
| ultrasound
8-10
130
What is a biophysical profile?
"Test the Baby, MAN!"
Tones of the heart
Breathing
Movement: BPD, HC, AC, FL
AFI
Non-stress test (normal = "reactive")
131
What pelvis types are better for vaginal delivery?
Gynecoid, anthropoid
132
What pelvis types will need C/S?
Platypelloid, android
133
How do you predict a due date with Nägele’s Rule?
9 months from last menses →add 1 wk
134
Why is Nägele’s Rule inaccurate?
B/c it does not start from ovulation date
135
How do you correct Nägele’s Rule for cycles >28 days?
Add x days if cycle is x longer
136
How much weight should a pregnant woman gain?
1lb/wk
137
When should intercourse be avoided during pregnancy?
3rd trimester b/c PG-F in semen may cause uterine contractions
138
What are the Leopold maneuvers?
1) Feel fundus
2) Feel baby's back
3) Feel pelvic inlet
4) Feel baby's head
139
What is Stage I of labor?
Up to full dilation
1) Latent Phase (<20h): Contractions →4 cm cervical dilation
Active Phase (<12h): 4-10 cm cervical dilation (1cm/ hr)
140
What is Stage II of labor?
Full dilation →delivery
Station 0: Baby above pelvic rim (most uteri are anteverted)
1. Engage
2. Descend
3. Flex head
4. Internal rotation
5. Extend head
6. Externally rotate
7. Expulsion: LOA most common
presentation
141
What is Stage III of labor?
Delivery of placenta (due to PG-F) Bloodgush→cordlengthens→fundus firms
142
How do you monitor baby's HR?
Doppler, scalp electrode
143
How do you monitor uterus?
Tocodynamics, uterine pressure catheter
144
What Bishop's score predicts delivery will be soon?
>8
145
What are Braxton-Hicks contractions?
Irregular contractions w/ closed cervix
146
What is a Vertex presentation?
Posterior fontanel (triangle shape) presents first, normal
147
What is a Sinciput presentation?
Anterior fontanel (diamond shape) presents first
148
What is a Face presentation?
Mentum anterior →forceps delivery
149
What is a Compound presentation?
Arm or hand on head →vaginal delivery
150
What is a Complete breech?
Butt down, thighs and legs flexed
151
What is a Frank breech?
Butt down, thigh flexed, legs extended (~pancake)
152
What is a Footling breech?
Butt down, thigh flexed, one toe is sticking out of cervical os
153
What is a Double Footling breech?
Two feet sticking out of cervical os
154
What is a Transverse Lie?
Head is on one side, butt on the other
155
What is Shoulder Dystocia?
Head out, shoulder stuck
156
Can you try vaginal delivery on a woman who has had a Classic Horizontal C/S previously?
No, must have C/S for all future pregnancies
157
Can you try vaginal delivery on a woman who has had a Low Transverse C/S previously?
Yes
158
What is early deceleration?
Normal, due to head compression
159
What is late deceleration?
Uteroplacental insufficiency b/c placenta can't provide O2/nutrients
160
What is variable deceleration?
Cord compression
161
What is increased beat-to- beat variability?
Fetal hypoxemia
162
What is decreased beat-to- beat variability?
Acidemia
163
What is Pre-eclampsia?
Ischemia to placenta => HTN (>140/90)
164
What is the treatment for Pre- eclampsia?
Delivery
165
What is HELLP syndrome?
Hepatic injury causing:
* Hemolysis
* Elevated Liver enzymes
* Low Platelets
166
What is Eclampsia?
HTN + seizures
167
What are the symptoms of eclampsia?
H/A, changes in vision, epigastric pain
168
What is the treatment for eclampsia?
4mg Mg sulfate as seizure prophylaxis
169
What is Chorioamnionitis?
Fever, uterine tenderness, ↓fetal HR
170
What are the symptoms of
Amniotic Fluid Emboli?
Mom just delivered baby and has SOB → PE, death (amniotic fluid →lungs)
171
What is Endometritis?
Post-partum uterine tenderness
172
What is an incomplete
molar pregnancy?
2 sperm + 1 egg (69, XXY), has embryo parts
173
What is a complete molar pregnancy?
2 sperm + no egg (46, XX – both paternal), no embryo
174
What is Pseudocyesis?
Fake pregnancy w/ all the signs and symptoms
175
What is the most common cause of 1st trimester maternal death?
Ectopic pregnancy
176
What is the most common cause of 1st trimester spontaneous abortions?
Chromosomal abnormalities
177
What are the most common causes of 3rd trimester spontaneous abortions?
Anti-cardiolipin Ab, placenta problems, infection, incompetent cervix
178
What is a threatened abortion?
Cervix closed, baby intact (Tx: bed rest)
179
What is an inevitable abortion?
Cervix open, baby intact (Tx: cerclage = sew cervix shut until term)
180
What is an incomplete abortion?
Cervix open, fetal remnants (Tx: D&C to prevent placenta infection)
181
What is a complete abortion?
Cervix open, no fetal remnants (Test: β- HCG)
182
What is a missed abortion?
Cervix closed, no fetal remnants (Tx: D&C)
183
What is a septic abortion?
Fever >100°F, malodorous discharge
184
What is Placenta Previa?
Post-coital bleeding, placenta covers cervical os; ruptures placental arteries
185
What is Vasa Previa?
Placenta aa. hang out of cervix
186
What is Placenta Accreta?
Placenta attached to superficial lining
187
What is Placenta Increta?
Placenta invades into myometrium
188
What is Placenta Percreta?
Placenta perforates through myometrium
189
What is Placenta Abruptio?
Severe pain, premature separation
of placenta
190
What is Velamentous Cord Insertion?
Fetal vessels insert between chorion and amnion
191
What is a Uterus Rupture?
Tearing sensation, halt of delivery
192
What is an Apt test?
Detects HbF in vagina
193
What is Wright's stain?
Detects nucleated fetal RBC in Mom's vagina
194
What is a Kleihauer-Betke test?
Detects percentage of fetal blood in maternal circulation (dilution test)
195
What is maternity blues?
Post-partum crying, irritability
196
What is post-partum depression?
Depression >2wks
197
What is post-partum psychosis?
Hallucinations, suicidal, infanticidal
198
What are the newborn screening tests?
"Please Check BBefore Going HHome"*
PKU
Congenital adrenal hyperplasia
Biotinidase,
β-thalassemia
Galactosemia
Hypothyroidism
Homocystinuria
199
What is VATER syndrome?
Vertebral abnormality Anal
TE fistula
Renal
200
What is an average IQ?
85-100
201
What are the most common causes of mental retardation in the US?
EtOH, Fragile X, Down's
202
calculate IQ
(mental age/chronological age)100
203
What is Rubeola also known as?
Measles
Complication: pneumonia
| SSPE:Subacute sclerosing panencephalitis
204
What is Rubella also known as?
German measles
3day measles
| R in ToRCHeS infection
205
What is the APGAR test?
Test at 1 and 5min (normal>7)
Appearance (color)
Pulse
Grimace
Activity
Respiration
206
What is the most common eye infection the first day of life?
Clear discharge due to silver nitrate
207
What is the most common eye infection the first week of life?
Gonorrhea => purulent discharge
208
What is the most common eye infection the second week of life?
Chlamydia
209
What is the most common eye infection the third week of life?
Herpes
210
What are the causes of Hyperbilirubinemia?
Sepsis, ABO incompatibility, hypothyroidism, breastfeeding
211
What is the cause of symmetrically small babies?
Chromosomal abnormality or TORCHS
212
What is the cause of asymmetrically small babies?
Poor blood supply spares brain => small body, normal head
213
What is the cause of large babies?
DM or twin-twin transfusions
214
What is Milia?
Neonatal whiteheads on malar area
215
What is Nevus Flammeus?
"Stork bites" on back of neck, look like flames
216
What is Seborrheic Dermatitis?
Red rash w/oily skin and dry flaky hairline
217
What are Hemangiomas?
mc benign bld vessel tumor
Flat blood vessels
218
What are Mongolian spots?
Melanocytes on lower back
219
What is Erythema Toxicum?
White vesicle on red area, has eosinophils
220
What is Subgaleal Hemorrhage?
Prolonged jaundice in newborns due
to birthing trauma
221
What is Caput Succedaneum?
Bleeding under scalp (edema crosses suture lines)
222
What is Cephalohematoma?
Bleeding under bone (blood not cross suture lines)
223
What is an Epstein's pearl?
White pearls on hard palate
224
What is persistent eye drainage
since birth usually due to?
Blocked duct
225
What are wide sutures due to?
Hypothyroidism, Down's
226
What causes a Cleft Lip?
Medial nasal prominence did not fuse
227
What causes a Cleft Palate?
Maxillary shelves did not fuse
228
What is the most common cause of
no red reflex?
Cataracts
229
What is the most common cause
of a white reflex?
Retinoblastoma
| look for osteosarcoma
230
What is the sign of a Clavicle Fracture?
| newborn
Asymmetric Moro reflex
231
What is an Omphalocele?
intestines protrude out of the umbilicus covered by the peritoneum
232
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually
due to anovulation
233
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
234
What is Gastrochesis?
Abdominal wall defect, off-center
235
What is a Nephroblastoma?
Kidney "Wilm's" tumor, hemihypertrophy, aniridia
236
What is a Neuroblastoma?
Adrenal medulla tumor, hypsarrthymia, opsoclonus, ↑VMA
237
What is Polyhydramnios?
Too much amniotic fluid, baby can't swallow
238
What are the most common causes of Polyhydramnios?
NM problem: Werdnig-Hoffman
GI problem: Duodenal atresia
239
What is Oligohydramnios?
Too little amniotic fluid, baby can't pee
240
What are the most common causes of Oligohydramnios?
Abd muscle problem: Prune Belly Renal agenesis: Potter’s syndrome
241
What is Fifth disease?
Erythema infectiosum "slapped cheeks", arthritis in mom, aplastic anemia
| B19, hydrop fetalis,
infect stem cell: proerythrocyte
242
What is Sixth disease?
| HHV 6/7
Roseola, exanthema subitum (fever disappears, then rash appears)
| complication: Febrile siezure and encephalitis
243
What is Hand-Foot-Mouth disease?
Mouth ulcers => won't eat or drink, palm/sole rash, Coxsackie A virus
244
What is Measles = Rubeola?
1) Cough, Coryza, Conjunctivitis
2) Koplik spot
3) Morbilliform blotchy rash
| SSPE
245
What is Molloscum Contagiosum?
Flesh-colored papules w/ central dimple
| DNA Poxvirus
246
What is Mumps?
| linear envelope ssRNA nonsegmented virus
Parotiditis => red Stenson’s duct
| double transmission paramyxovirus
247
What is Otitis Media?
Middle ear infection
| S. pneumoniae [4]
Haemophilus influenzae [7]
Moraxella catarrhalis
248
What is Pityriasis Rosea?
Herald patch → migrates along skin lines “C-mass tree” appearance
249
What is Rubella = German 3- day measles?
| togavirus- env +ssRNA
Trunk rash, lymphadenopathy behind ears, don't look sick
250
How is Smallpox different from Chickenpox?
Smallpox is on face, same stage of development, fever
251
What is Varicella = Chickenpox?
1) Red macule
2) Clear vesicle on red dot
3) Pustule
4) Scab
252
What is Zellweger syndrome
| cerebrohepatorenal syndrome
Neonatal seizures
| PEX gene: impaired peroxisome synthesis
253
What is the most common cause of delayed speech development?
Hearing loss
254
What are the signs of child abuse?
*Multiple ecchymoses
* Retinal hemorrhage
* Epidural/Subdural hemorrhage
* Spiral fractures (twisted)
* Multiple fractures in different healing
stages
255
What should you rule out when child abuse is suspected?
* Osteogenesis imperfecta
* Bleeding disorders
* Fifth disease
* Mongolian spots
256
Treatment for hypertension before pregnancy n 12 weeks postpartum
Lebetalol: B-blocker
Nifedipine: Ca++ blocker
Methyldopa: alpha2 agonist
Hydralazine: incr cGMP
257
pregnant HTN treatment with dihydropyridines causes
Skin flush, swelling of low extremity, constipation….ca+ blocking effect.
