4/17 Flashcards
Most common cause precocious puberty males
CAH
Folicular phase
begins 1st day of menses
FSH stimulated ovarion follicle which in turn secretes estradiol
What does estradiol do
induces endometrial proliferation, further increasing FSH and LH
What causes ovulation in Luteal phase
LH surge
Progesterone effect on FSH and LH
decreases
what does hCG do
Maintains corpus lutteur and progesterone secretion
Amenorrhea first test
B-hcg
first question primary amenorrhea
is there secondary sex traits?
Secondary sex traits primary amenorrhea final tests
US and genetic analysis to determine anatomy and kayitypes
No secondary sex traits primary amenorrhea next test
FSH LH
No secondary sex traits primary amenorrhea low FSH and LH next test and results.
check prolactin to see if it’s Prolactinoma or HPA dysfunction(GnRH, etc.)
No secondary sex traits primary amenorrhea high FSH and LH dx
Gonadal Agenesis or ovarian failure
Secondary Amenorrhea first test
thyroid
2nd amenorrhea normal thyroid next test
prolactin
2nd amenorrhea normal thyroid, normal prolactin next test
progestin challenge
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, next step
Estrogen-progesterone challenge
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, - Estrogen-progesterone challenge dx
Ashermans
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, +Estrogen-progesterone challenge next test
FSH, LH
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, +Estrogen-progesterone challenge, High FSH and LH dx
Ovarian failure
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, +Estrogen-progesterone challenge, Low FSH and LH dx
HPA dysfuntion
2nd amenorrhea normal thyroid, normal prolactin, + progesterone challenge, next step
Is there hirsutism
2nd amenorrhea normal thyroid, normal prolactin, + progesterone challenge, Hirsutism dx
PCOS, Adrenal tumor, Cushing’s syndrome
2nd amenorrhea normal thyroid, normal prolactin, + progesterone challenge, NO Hirsutism dx
anorexia,HPA dysfunction
most common cause of female infertility
endometriosis
when is endometriosis pain worst
1 to 2 weeks before menses
symmetric uterine enlargement AUB, 40+
adenomyosis
What is increased PCOS LH or FSH
LH
Testosterone PCOS
increased
Which genital ulcers are painless
syphylis and lymphogranularum (lymph nodes are painful for this one also buboes)
Which genital ulcers are painful
Chancroid, herpes
Folicular cyst Origin, characteristics,tx
Ovarian folicle
granulose cell, may regress over menses period
Observation
Corpus luteum cyst Origin, characteristics,tx
Corpus luteum
Theca cells large and firm, more common late weeks of cycle
Observation
Mucinous or serous cystadenoma Origin, characteristics,tx
Epithelial cells
Psammoma bodies(calcification), may be extremely large
unilateral sapling-oophorectomy
endometrioma Origin, characteristics,tx
Endometrium
generalized symptoms
OCP, GnRH agonist, cystectomy, oophorectomy
teratoma/ dermoid cystOrigin, characteristics,tx
germ cells
multiple dermal tissues
cystectomy maybe unilateral sapling-oophorectomy
stromal Origin, characteristics,tx
Granulosa, theca, ledig
Precocious puberty
unilateral sapling-oophorectomy
Ductal Carcinoma insitu characteristics and h&p
ducts only, no stromal involvement, usually asymptomatic
lobular insitu characteristics and h&p
lobules only, increased risk of contralateral malignancy
asymptomatic
invasive ductal characteristics and h&p
micro calcification, fibrotic response ,most common invasive kind. skin dimple, orange, nipple discharger
invasive lobular characteristics and h&p
less fibrous response, bilateral or multifocal, associated with hormone replacement same as invasive ductal signs and sx skin dimple, orange, nipple discharger
pagets characteristics and h&p
adenocarcinoma, scaly eczematous or ulcer on nipple, pain, itching, burning
inflammatory characteristics and h&p
angioinvasive, poor prognosis, pain, erythema, warmth, orange, lymphadenopathy
medullary characteristics and h&p
well circumscribed, rapid growth, soft
mucinous characteristics and h&p
well circumscribed, slow growth, gelatinous
tubular characteristics and h&p
tubular, asymptomatic
okay meds for htn pregnancy
labetalol
nifedipine
a-methaldopa
hydralazine- fro crisis
where is mg excreted
kidney
placental abruption clinical presentation
sudden onset painful vaginal bleeding.
High frequency low intensity contractions
hypertonic, tender uterus
Most common complication chronic hypertension pregnancy
preterm labor
when to avoid NSAIDS in pregnancy
1st and 3rd trimester, acetaminophen is okay
what is Leggier Calve Perthes dz
osteonecrosis of femoral epiphysis- 7 year old
besides sickle shaped what other abnormal rbc sickle cell dz
Howell- Jolly- bodies
3 aortic stenosis auscultation findings
- delayed, weak, slow rising carotid pulse(pulses parvus and trades.
2.single and soft S2
#. Mid to late peaking systolic murmur
why are klinefelters infertile
dysgenesis of seminiferous tubules
strep bovis association
colon cancer