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# Flashcards

1
Q

<60 Hr and hemodynamic instability
>100 HR and unstable

A

Pacing
Sync cardioversion

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2
Q

Management of vtach

A

Stable - amio
Unstable - scv
No pulse- unsync

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3
Q

Management of afib

A

New (<48hours or unstable - scv
Others - anticoag, bb and ccb (verapamil and diltiazem

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4
Q

Management of wpw

A

Acute - procainamids
Long term- catheter ablation
Unstable - scv

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5
Q

Management of heart blocks

A

1st and 2nd degree type 1 nothing

2nd degree type 2 - pace

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6
Q

TCA toxicity
- pathophysiology
- ekg changes
- treatment

A

Blocks na
Long qrs
NAHCO3

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7
Q

What electrolyte imbalances causes long qt

A

Low ca k mg

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8
Q

Management of Hyperkalemia
(+EKG changes

A

Calcium gluconate
Long qrs

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9
Q

Hypothermia ekg changes

A

J wave or Osborne wave

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10
Q

How does smoking affect ekg (+treatment)

A

Multi focal atrial tachycardium- >=3 different looking waves

Tx: veeapamil, diltiazem

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11
Q

Causes of ATN

Causes of AIN

A

Aminoglycosides, heavy metals. (Lead) , rhabdo , ethylene glycol , radioconstrast dye, irate ( tumor lysis syndrome)

Ain- NSAIDs and antibiotics (penicillin ) diuretics

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12
Q

Differentiate lichen sclerosis from lichen simplex chronicus (+ vulva cancer

A

Sclerosis - fibrosis and thinning of the epidermis of the vulva of a post menopausal women; vulva- paper thin; ** increased risk of vulvar squamous carcinoma

Vulva cancer - HPV related or non HOV related ; HPV: 40s, non HPV: May be due to lichen sclerosis in someone in 70s

Chronicus - hyperplasia of the vulvar epithelium due to chronic scratching creating leathery thick vulva skin

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13
Q

Vaginal carcinoma
- adeno or squamous
- risk factor

A

Squamous lead from VAIN dysplasia due to HPV

DES daughters at risk for clear cell adenocarcinoma

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14
Q

DES MOMS and daughters at risk of

A

Moms- breast cancer
Daygters - adenosis—» clear cell adenocarcinoma of vagina; abnormality of uterus and fallopian tubes therefore increasing miscarriages

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15
Q

Positive histochemical staining for rhabdomyosarcoma/ sarcoma botryoides

A

Desmin and myogenin

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16
Q

Cervical cancer
- risk factor
- squamous or adenocarcinoma
- age
- presentation
- MCCOD

A

HPV related in both squamous and adeno
- vaginal bleeding especially postcoital bleeding and vaginal discharge in 40-50
- MCCOD- invades the bladder and blocks the ureter leading to hydronephrosis and postre al failure (obstructive nephropathy

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17
Q

Acute vs chronic endometritis
- pathophysiology and presentations

A

Acute- bacterial infection of the endometrium due to retained POC; fever, AUB, pelvic pain

Chronic - inflammation due to PID, IUD retained POC , Tb ; same symptoms; inc plasma which is abnormal and lymphocytes which are normally found

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18
Q

What medication predisposed to endometrial polyps

A

Tamoxifen

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19
Q

Endometriosis
- presentation
- MC affected organ
- complication

A

Dysmenorrhea, pelvic pain , uterine ligament affected pelvic pain , Douglas affected (pain with defecation, bladder will afffected ( dysuria) bowel serosa (abdominal pain and adhesions, fallopian tuve (ectopic bc of scarring
- most common : ovaries (increased risk of endometriod ovarian cancer )
- endometrial Endometriod cancer

20
Q

Endometrial carcinoma
- presentation (+age)

A

Endometriod (arising form endometrial hyperplasia; 40s; Looks like normal endometrial )

Sporadic (not formed from a dysplasia ; serous papilloma which the papillary can become calcified therefore psamomma bodies; 70s

21
Q

Differentiate fibroids from Leimyosarcoma

A

Fibroids - white whirled multiple in reproductive age

Sarcoma - single /hemorrhagic / necrotic center in post menopausal; fibroids don’t increase the risk of them

22
Q

Female surface epithelial tumors
- presentation (+age)
- metastasis where
- tumor marker

A

Most common ovaries tumors
- benign (30-40); malignant 60-70
- types : serous/ mutinous cystadenoma, serous/ mucinous cyst adenocarcinoma (malig so older ); benign Endometriod (associated with endometriosis and endometrial Endometriod cancer) and malignant brenner bladder like epithelium

Late onset of symptoms - pain and fullness , urinary frequency increase

Likes. To spread to the omentum
Ca125

23
Q

Brca 1 increase risk of

A

Breast cancer , serous carcinoma of ovary and fallopian (prophylatically salpingo oophorectomy)

24
Q

Female germ cell tumor
- presentation

A

** 15-30 yo reproductive age **

Teratoma (subset is struma ovarii which is primarily thyroid tissue ) - benign but can be malignant if has immature tissue (neural or has a skin with squamous cancer - most common

Dysgerminoma **most commo malignant **; LDH

Endodermal sinus ** most common malignant in children **; afpSchiller Duvall bodies which looks glomerular

Chorioxarcinoma - malignant proliferation. Of trophoblast and not villi; loves to go to blood like placenta does; Bhcg

25
Q

Female sex stromal tumor

A

Granulosa - theca - **malignant **; estrogen- kid (precocious), reproductive age (menorrhagia or metorrhagia; postmeno (endometrial hyperplasia with uterine bleeding

Serotoli- leydig -**androgens ** so virilization and hirsutism; reinke crystals

Fibroma- benign tumor of fibroblast ; presents as meiggs syndrome - ascites, pleural effusion

26
Q

Metastatic tumor with metas to bilateral ovaries -

A

Intestinal gastric adenocarcinoma (krunkenberg) lobular breast cancer and colon cancer

27
Q

Choriocarcinoma can arise from

A

Normal pregnancy , mole, spontaneous abortion, spontaneous germ cell tumor (responds well to chemo)

28
Q

Complication of lymphogranuloma venereum

A

Heals with fibrosis which can affect perianally therefore rectal stricture
-chlamydia L1-l3

29
Q

Complications of orchiditis

A

Infertility , testicular atrophy, increased risk of germinal cell carcinoma (seminoma)

30
Q

Causes of orchitis

A

Mumps- teen
Chlam/ gnorrhea 1 young adult (increased risk of sterility
Pseudomonas or ecoli- old
Autoimmune or Hutus

31
Q

Variocele is associated with

A

Left sided RCC (if it blocks the renal vein , the left spermatic vein which drains into it is affected

32
Q

Male germ cell tumors
- presentation
- risk factors
- diagnosis

A

RF: cryptoorchidism, klinefelter

**ALL are malignant **; don’t biopsy bc can seed

Dysgerminoma (seminoma ) - most common;** bhcg**; responds well to
Treatment

Embryonal - hemorrhagic with necrosis , glands maybe; chemotherapy can change it to mature ; spreads early to blood ; **afp or bhcg **

Yolk sac - _**most common in kids **; afp; Schiller

Chorio- bhcg so hyperthyroidism and gynecomastia possibly because alpha subunit of HCg can bind Lh fsh and tsh; spreads to blood like placenta

Teratoma- malignant unlike in females ; afp or bhcg

33
Q

Male sex cord

A

Mainly benign
- think leydig- precocious puberty or gynecomastia (adult ) ; reinke crystals

34
Q

Testicular tumor in older male
- presentation

A

Lymphoma
- >60 and is bilateral ; similar to diffuse large B cell lymphoma

35
Q

Acute vs chronic prostatis

-presentation

A

Acute - acute inflammation due to bacteria such as gonorrhea or chlamydia in young or pseudomonas/ ecoli in old ——-fever/chills, dysuria, tender boggy prostate on DRE; prostatic secretions show wbc and cx reveals bacteria

Chronic - chronic inflammation —-dysuria with pelvic or low back pain ; prostatic secretions show wbc and cx are negative

36
Q

BPH vs prostate cancer
- location
- PSA
- complications
- treatment

A

BPH- hyperplasia of prostate glands and stroma periurethral zone therefore urethra can become obstructed leading to hydronephrosis , hypertrophy of bladder and infection; urinary symptoms
- since hyperplasia of glands which produce psa ; psa is slightly elevated (5-10 compared to 0-4 )
- Tx: alpha 1 antagonist ( terazosin) good if BP is high , tamsulosin alpha1 a in nórmotensive patients; long term is 5 alpha reductase bc takes months to become effective

Cancer - aligning proliferation of glands; involves peripheral posterior region of the prostate therefore no urinary symptoms until later ; PSA >10 increase bounded PSA ; Gleason based on architecture and not atypia

37
Q

Acute intermittent porphyria
- MOI
- pathophysiology
- presentation
- treatment

A

Porphobilinogen deaminase deficiency (AD)

Neuropsych symptoms, abdominal pain and red urine

Tx: ALAS inhibitor (IV glucose , IV heme , IV hematoma)

38
Q

porphyria cutanea tarda
- MOI
- pathophysiology
- presentation
- treatment

A

Uroporphyringen decarvoxylase deficiency (sporadic)

  • :skin issues, hyperhidrosis (sweating) and red urine
  • Tx: phlebotomy and test for Hep C
39
Q

Tumor marker for ovarian cancer

A

Ca- 125

40
Q

Contraindicated for use of Hrt/estrogen containing contraceptives

A

H/o venous theomembolism disease- mi, pe, h/ o of breast cancer, hepatic adenoma, h/o migraine with aura, female whose 35 and older who smokes , severe HTN

41
Q

Contraindications of use of mirena

A

History of breast cancer
Sti<6 months

42
Q

Candiadiasis management

A

Oral azole

43
Q

Management of urge incontinence

A

Muscarinic antag - oxybutinin, fenacin (darfenacin, solifenacin) tolterodine, trospium

B3 agonist - Mirabegron

44
Q

Management of overflow incontinence

A

Muscarinic agonist - bethanechol, carbachol

Acetylcholisterase inhibitor1 neostimine

If symptomatic (bladder distended and tender- Catherization

45
Q

Management of stress incontinence

A

Kegels (midurethral sling is kegels doesn’t work)

46
Q

Management of POP

A

Kegels and pessaries

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