risk factors

Question 1

alzhimers disease risk fators

Answer 1

APP GENE TRISOMY 21 EARLY ONSET DEMENTIA
PSEN1 EARLY ONSENT AD
PSEN2
APO E GENE USUALLY causes late onset dementia

other risk facctors of alzhimers disease
inreasing age
family history of alzhimers/ dementia
low socioeconomic status
downs, DM, dyslepidemia
hypertension, peripheral vascular disease
traumati brain injuries
environmental factors including seound hand smoke

Question 2

ampullary canccer

Answer 2

obstructive cancer and heme positive stool
the only lesion with obstructive jaundice and bleeding in lumen of
intestine is ampillary cancer

Question 3

beningn essential tremors

Answer 3

risk factors family history
autosomal dominant pattern
head tremor

improves with alcohol consumption

Question 4

birth trauma

Answer 4

macrosomnia
premature infants
abnormal fetal pesentation
sholder dystocia
forcep or vacuum assited delivery
prilonged or rapid labor

Question 5

brest cancer

Answer 5

brest cancer increased estrogen state
early menarche, late menopouse
nulliparity
first full term pregnancy after 35
harmone replacement therapy after menopouse
braca
obesity
positive history of celular atypia
lifraumeni syndrome(brest, leukemia,soft tissue tumors, adrenal gland tumors) mutationin p53
peutz jeghers( hamartomatus polyps through out git, associated tumors of brest, ovaries, pancreas

Question 6

brest self examinationt

Answer 6

there is poor evidence to support the hypothesis that brest self examination decreases the mortality, infact it may give false positive and need for unnecessary biopy. so brest self examination should not be recommended at any age

Question 7

cervical canceri

Answer 7

increase risk with hpv 16,18
e6 inhibition of p53-> inhibition of apoptic pathway and inhibition of p21
e7 inhibition of rb protein
inhibits p21 and 27 cdk inhibitors.
risk|: early onset of sexual activity]multiple sexual partners
high parity
immunosupperation
cigerrete smoking
inutero des

Question 8

cervical cancer screening in immunocompromised,sle,organ transplant and pt on immmunosuppresants

Answer 8

do pap on onset of sexual activity

every 6 months times 2 if negative annually

Question 9

ccomplications of post term

Answer 9

oligohydromnios
macrosomia
convulsions
still birth
meuconium aspiration

Question 10

Contraindications to OCP

Answer 10

mirgeane with aura
previous dvt/ stroke, mi
smoker who smokes>15 ciggs age is >35
brest ca, hepatic camcer
b.p>160/100

Question 11

ectopic pregnacy

Answer 11

hx of PID
previous ectopic
past surgeries involving the fallopian tybes
endometriosis
NON ANATOMICAL RISK 
history of infertility

Question 12

emergency contraception

Answer 12

urliprital is the most effective can be given up to 5 days next is levenogestril then ocp

Question 13

endometrial cancer

Answer 13

estrogen dependent risk factors 
nulliparity\early menarch late menopouse
PCOS
hx of brest cancer, tamoxifen use
obesity
HNPCC

protective factors
multiparity
combine OCP

Question 14

evisceration vs dehiscence

Answer 14

in evisceration the organ starts produding exposed to air increased risk of infection its a surgecal emergency but before do wet sterile dressing

in dehiscence the skin is intact but fasccia frails you see serosangious drainage acutely and hernia chronically skin is intcat and there is sterile barrier
management abdominal binders and return to or electivley

Question 15

hypertensive pregnancy disorder

Answer 15

general:
thrombophillia
african american
age<20 and >40
DM,GDM.chronic htn
SLE, CRD

PREGNANCY RELATED RIDK
nulliparity
previous pre eclamsia
multiple gestation
hydatiform moles

Question 16

leiomyoma

Answer 16

nulliparity
early menarch
obesity 
increase incidence in afro
influenced by harmones eg estrogen, growth ahrmone, progrgestrone

Question 17

lesibians higher risk of which infection

Answer 17

bacterial vagionosis

Question 18

lobular ductal carcinoma insutu

Answer 18

if dx on needle then do exictional biopsy. no need of sentinel lymph node biopsy because lcis is a no invasive carcinoma

Question 19

multiple gestation

Answer 19

advanced maternal age>35

previous multiple pregnancy

Question 20

ovarian torsion risk factors

Answer 20

ovarian mass >5cm
women of reproductive age
pregnancy
infertility treatment with ovolution induction

Question 21

overian cancer

Answer 21

genetic
brca1/2
hnpcc syndrome
HARNMONAL INBALANCE( high estrogen situations)
increase number of life time ovulutions
infertility/ low number of pregnancy
early menarch low menopouse
PCOS

Question 22

pessary tratment for utrine prolapse

Answer 22

only used in pt who are poor candidates for surgery, surgery is the main stay of treatment

Question 23

placenta previa

Answer 23

maternal age > 35
mulltiparity
short interval between preganacy
previous placenta previa

Question 24

post term pregnancy

Answer 24

proir post term
nulliparity
obesity
age >35
fetal anamolies

Question 25

PRE MENSTURAL PAIN SUNDROME

Answer 25

1ST LINE SSRI, NOT RESPONDING GIVE ANOTHER SSRI. | GNRH LEUPROLIDE CAN ALSO WORK BUT HAVE MORE SIDE EFFECT PROFIE AND IS COSTLY

Question 26

pre term labor

Answer 26

``` high risk:- history of pre term birth cervical insufficiency multiple gestation low risk:- lifestyle and envi factors smoking substance use maternal age<18 and>40 ```

Question 27

prognostic factors for MYLTIOLE MYELOMA

Answer 27

negative prognostic factors include beta 2 microglobulin, low albumin, increase crp increase LDH

Question 28

raloxifene

Answer 28

raloxifene is not used in post menouposal increase risk of endometrial carcenoma

Question 29

risk factors for ca of penis

Answer 29

phymosis smoking multiple sexual hx i.e HPV

Question 30

RISK FACTORS FOR FETAL MACROSOMIA <4KG

Answer 30

``` MATERNAL advance age multiparity diabetes excessive weight gain durinh pregnancy FETAL: postterm pregnancy male sex african amererican/hispanics ```

Question 31

risk factors for post partum endometritis

Answer 31

cessarian section prolonged labour multiple cervicle exam retained product of conception

Question 32

risk factors for septic arthritis

Answer 32

``` abnormal joint (OA,RA,GOUT,PROSTHETIC JOINT) AGE .80 DIABETES IV DRUG ABUSE ALCOHOLISM INTRA ARTICULAR STEROID INFECTION GONOCOCCIMIA ```

Question 33

risk factors for spinal epidural abcess

Answer 33

its more coomon than intracranial abcess spread of bacteria from distant source contigous tissue infection vertebral body osteomyelitis, or direct inoculation spina; proccedures. iv drug abuse,dm , imune compramised,hiv, alcoholism. staph aures accounts for 60percent of cases

Question 34

risk factors of colon cancer

Answer 34

``` IST DEGREE FAMILY HISTORY, FAP,IBD,LYNCH SYNDROME OTHERS INCLUDE ALCOHOL INTAKE SMOKING OBESITY AFRICAN AMERICAN RACE ``` PROTECTIVE FACTORS INCLUDE HIGH FIBRE DIET OCP,NSAIDS REGULAR EXERCISE

Question 35

rta VS other non anion gap

Answer 35

to differentiate between the two do urine anion gap | i.e (urine na + urine k)- urinary chloride

Question 36

short term complication of LEEP

Answer 36

BLEEDING,BLEEDING

Question 37

spontaneous abortions

Answer 37

MaternalAbnormalities of the reproductive organs Septate uterus,Uterine leiomyomas,Uterine adhesions,Cervical incompetence Systemic diseases diabetes mellitus, hyperthyroidism, hypothyroidism, genetic disorders, infections, hypercoagulability (e.g., antiphospholipid syndromeFetoplacentalChromosomal abnormalities account for up to half of all spontaneous abortionsCongenital anomaliesMiscellaneousTraumaIatrogenicEnvironmentalUnknown

Question 38

sub arcchinoid aneurysm

Answer 38

first degree relatives with sub archinoid hemorrage screen for aneurysm

Question 39

syphillis sero conversion

Answer 39

folllowing medications of syphilis its important to follow sero conversion to know that the treatment is efffective and there is no Reinfection. following treatment of priamry syphylis serocconversion should occcur withn a year secondary in 18 months tereitory syphillis in 4-5 years if the titers are increasing think of reinfection treatment failure its is imporatant to check csf for syphilis

Question 40

Tocolytics contrindication i.e. stopping preterm labor is dangerous to mom or fetus

Answer 40

obstetric complication: abrutio placenta, ruptured memranes,chorioamniotis. fetal conditions: lethal anmoly, anencephlay, renal agenesis, featl demise or jeoperady maternal conditions: severe pre eclamsia. eclamsia.advance cervical dilatation.

Question 41

transverse myelitis vs GBS

Answer 41

flacid paralysis and hyporeflexia with hx of URTI or gi infection d/d transverse myelitis or gbs LOOK for SENSORY LEVEL and BOWEL AND BLADDER DYSFUNCTION PRESENCE OF SENSORY AND BOWEL/ BLADDER DYSFUNCTION MAKES TRANSVERSE MYELITS MORE LIKELY DO MRI OF SPINE AS NEXT STEP SHOWS ENHANCEMENT WITH GODOLINIUM. RULE OUT TUMOR, HERNIATION,EPIDURAL ABCESS. ONCE TM IS DIAGNOSED DTART TREATMENT WITH HIGH DOSE STEROIDS

Question 42

uterine atony

Answer 42

``` responsible for 80% of pph risk multiparity multiple gestation post term pregnancy large for gestation age>4kg poor myometrial contraction following prolonged labor ```

Question 43

utrine rupture

Answer 43

classic uterine scar myomectomy traomatic rupture

Question 44

utrune inversion

Answer 44

``` utrine fundus collapse into endometrium risk: nullipariity cord traction difficult removal of placemta previous utrine inversion ```

Question 45

vasa previa

Answer 45

placental abnormalities eg bilobed, succenturriate placenta, velamentous umbilical cord indertion multiparity

Question 46

vulvar cancer

Answer 46

``` infection with hpv 16,18,31,33 immunosupression vulvular dystrophy and vulvar or cervical intraepithelial neoplasia smoking precancerous lesion ```

Question 47

placental abruption

Answer 47

``` Predisposing factors Vascular changes Hypertension (most common cause) Preeclampsia/eclampsia (Abdominal) trauma; car accidents Previous abruption Alcohol and cigarette consumption, cocaine use ``` ``` Intrauterine fetal death Maternal DIC and hypovolemic shock Couvelaire uterus Retroplacental hemorrhage may extend through the uterus into the peritoneum uterine rupture ```