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Conditions Flashcards

1
Q

Endometriosis: definition

A

Endometrial cells grow outside uterus

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2
Q

Hypospadias: definition

A

Urethral opening not located at tip of penis

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3
Q

Secondary amenorrhea: definition

A

Absence of periods for 3+ months in women who previously menstruated

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4
Q

Infertility: definition

A

Inability to conceive in 12 months for women <35

Begin evaluation at 6 mo for women >35

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5
Q

5-alpha reductase deficiency: presentation

A

Male internal genitalia, female external genitalia at birth Male external genitalia develop at puberty

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6
Q

Factor V Leiden: pathophysiology

A

Factor V Leiden is a mutant form of Factor V that Protein C (anticoagulatory factor) cannot bind to

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7
Q

Threatened spontaneous abortion

A

Cervical os closed, viable intrauterine pregnancy visible on ultrasound

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8
Q

Inevitable spontaneous abortion

A

Cervical os open, products of conception about to pass through

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9
Q

Incomplete spontaneous abortion

A

Cervical os open, products of conception partially passed through

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10
Q

Complete spontaneous abortion

A

Cervical os closed, products of conception fully expelled

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11
Q

Missed spontaneous abortion

A

Cervical os closed, nonviable intrauterine pregnancy visible on ultrasound

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12
Q

Ectopic pregnancy: risk factors

A 
Prior ectopic pregnancy
Hx of STI's
Pelvic inflammatory disease
Smoking
Young age <18
IUD
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13
Q

Superficial thrombophlebitis: presentation? concerning?

A

Presentation: redness, tenderness, palpable veins

Usually does NOT lead to embolization but most common thrombotic disorder in pregnancy

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14
Q

Pulmonary embolism: presentation

A

Acute onset dyspnea
Tachypnea
Tachycardia
Pleuritic chest pain

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15
Q

Pulmonary embolism in pregnancy: diagnosis

A

Spiral CT is safe in pregnancy

Compression ultrasound: assess for DVT with PE

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16
Q

Diabetes: complications during pregnancy

A

Macrosomia
+Shoulder dystocia
+Brachial plexus palsy

Increased risk of spontaneous abortion

Infection

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17
Q

Pregestational diabetes: complications

A

Congenital cardiac anomalies

Sacral agenesis

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18
Q

Gestational diabetes: risk factors

A

Obesity
Maternal age
Gestational weight gain
Family history

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19
Q

Chronic hypertension in pregnancy: complications

A

Increased risk of preeclampsia (superimposed), placental abruption

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20
Q

Preeclampsia: risk factors

A

Things that lead to more placental mass:
- multiple gestation

Things that lead to abnormal vasculature:
- chronic HTN, diabetes, obesity

Extremes of age
Nulliparity

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21
Q

Preeclampsia: presentation

A

Neuro: severe headache, scotomata

Renal: oliguria

Pulm: pulmonary edema

GI: epigastric pain secondary to hepatic edema

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22
Q

HELLP: stands for?

A

Hemolytic anemia
Elevated Liver enzymes
Low Platelets

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23
Q

Eclampsia: presentation, PE warning signs

A

Seizures + preeclampsia, mostly occurring postpartum

Hyperreflexia, clonus = warning signs that seizures may be imminent

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24
Q

Caesarean section: indications

A

Malpresentation (breech)

Maternal HIV, HSV (if active lesions) infection

First or second stage arrest

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25
Caesarean section: complications
Hemorrhage, infection Neonatal microbome alteration (babies get gut flora from passing through birth canal) Transient tachypnea of newborn (maternal hormones support fetal lung reabsorption; babies with C-section have extra fluid in lungs) Maternal intra-abdominal adhesions
26
Neonatal resuscitation: indications
No crying, breathing | Poor tone
27
Neonatal resuscitation: steps
Position and clear airway Warm, dry, stimulate for 30s If HR<100, start positive pressure ventilation for 30s If HR<100 continue PPV If HR<60, begin chest compressions
28
Preeclampsia: pathophysiology
Not well understood | Vasospasm --> ischemia
29
Pyelonephritis in pregnancy: most common bugs
E. coli (75%) | Klebsiella, Enterobacter, Proteus
30
Meconium Aspiration Syndrome: pathophysiology
Meconium (fetal intestinal debris) can obstruct airways, cause pneumonitis, inactivate surfactant In utero: Fetal distress --> decreased anal sphincter tone --> meconium released into amniotic fluid and inhaled by fetus After delivery: Poor oxygenation --> pulmonary vasoconstriction --> pulmonary respiratory distress, possibly persistent pulmonary hypertension
31
Meconium Aspiration Syndrome: presentation
Meconium-stained fingernails and skin Respiratory distress: tachypnea, use of accessory muscles, decreased O2 sat
32
Meconium Aspiration Syndrome: imaging
Hyperinflated lungs
33
Breast milk jaundice vs breastfeeding jaundice
Breast milk jaundice: - BM itself may have beta-glucuronidase or . UDPGT inhibitors (unknown) Breastfeeding jaundice: - baby not feeding well, can't produce enough output to excrete adequate bilirubin
34
Conjugated hyperbilirubinemia in neonates: definition?
>10% direct (conjugated)
35
Prematurity: complications
PULM Neonatal Respiratory Distress Syndrome CARDIO Patent ductus arteriosus, heart failure GI Necrotizing enterocolitis HEENT Retinopathy of prematurity HEME Anemia ENDOCRINE Hypoglycemia NEURO/PSYCH Developmental delays Intraventricular bleeding
36
Neonatal respiratory distress syndrome: prevention
Give betamethasone 48hrs (and up to 7 days) prior to delivery
37
Neonatal respiratory distress syndrome: pathophysiology
Absence/lack of surfactant keeps pulmonary vasculature resistance high - cannot get oxygenated blood
38
Neonatal respiratory distress syndrome: imaging
Ground glass appearance due to microatelectasis (alveolar collapse) Air bronchograms due to air unable to enter alveoli Hypoinflation
39
Necrotizing enterocolitis: pathophysiology
Neonates don't have normal gut flora + have weaker intestinal walls - certain bacteria can overgrow, increases risk of infection
40
Hypoglycemia in premature babies: pathophysiology
Decreased fat = fewer glucose stores; liver hasn't yet started gluconeogenesis
41
Retinopathy of prematurity: pathophysiology
Newly developed blood vessels grow out and then regress - | in premature babies, vessels haven't regressed and are still friable --> risk of rupture
42
Interventricular hemorrhage in prematurity: pathophysiology
Friable vessels can rupture
43
Small for gestational age (SGA): definition
<10th percentile for birth weight
44
Small for gestational age: pathophysiology
Either IUGR or constitutionally small
45
Small for gestational age: complications
Increased risk of hypoglycemia, hypothermia (decreased glycogen stores, impaired gluconeogenesis)
46
Large for gestational age: definition
>90th percentile for birth weight
47
Short stature: definition
>= 2 SD's below mean, or <3rd percentile for height OR growth line crosses 2+ major percentile lines
48
Failure to thrive: definition
>= 2 SD's below mean, or 3rd percentile for weight OR growth line crosses 2+ major percentile lines
49
GH deficiency: presentation
Initially presents as failure to thrive, then decreased height velocity
50
Developmental delay: patterns of onset
Inborn errors of metabolism: good health followed by decline in developmental milestones (metabolites take time to build up, or child recently added new foods into diet) Prenatal/perinatal causes: present early in life
51
Delayed puberty: definition
No breast development by 13 No testicular development by 14
52
Kallman Syndrome: pathophysiology
Defective migration of GnRH-releasing neurons from olfactory placode to hypothalamus
53
Kallman Syndrome: presentation
Hyposmia/anomsia (reduced or lack of smell)
54
McCune-Albright Syndrome: pathophysiology
Increased hormone levels (estrogen, GH, thyroid, etc)
55
McCune-Albright Syndrome: presentation
Cafe-au-lait macules | Polyostotic fibrous dysplasia (affecting more than one bone)
56
Primary ovarian insufficiency: definition
Cessation of ovarian function before age 40
57
Asherman Syndrome: definition
Endometrial scarring due to surgery (e.g. curettage) or infection
58
Benign prostatic hyperplasia: presentation
Increased urinary frequency, nocturia Difficulty initiating stream, fully emptying bladder
59
Fibroadenoma: presentation
Palpable, smooth, mobile mass, often in a young and otherwise healthy woman
60
Ductal carcinoma in situ: presentation
Most women with mammography findings were asymptomatic (no palpable masses)
61
Adenomyosis: presentation
Enlarged, rounded uterus OR asymptomatic
62
Acute endometritis: presentation
Soft uterus Uterine tenderness +systemic signs of infection
63
Fibroids/leiomyomas: presentation by type
Submucosa: heavy bleeding, can be intermenstrual bleeding if endometrial lining is unstable Intramural: heavy bleeding Subserosal: NO bleeding! Bulk symptoms +dyspareunia (pain during intercourse)
64
Leiomyosarcoma: gross presentation
Single lesion with areas of necrosis and hemorrhage Does NOT arise from leiomyoma
65
Endometrial cancer: presentation
Post-menopausal bleeding
66
Ovarian cancers: presentation
Super non-specific, vague symptoms: abdominal distension/bloating, abd pain, urinary frequency, constipation, nausea Presents late clinically b/c masses have so much space to grow within peritoneal cavity
67
Types of ovarian cancers
Serous (most common), mucinous, endometroid, Brenner (bladder-like epithelium)
68
Stages of ovarian cancers
Benign, BORDERLINE, malignant
69
Difference between Type I and Type II ovarian cancers
Type I: - low grade, likely progressed from benign cystadenoma --> borderline serous carcinoma --> low grade serous carcinoma - associated with KRAS and BRAF mutations Type II: - higher grade, NOT derived from low grade tumors - likely of fallopian tube origin (serous tubal intraepithelial carcinoma) - associated with p53 mutations and BRCA1 carriers
70
Endometriosis: presentation
Usually asymptomatic but 3 D's: - Dysmenorrhea: cyclic pelvic pain around time of period - Dyschemiza: pain w/ bowel movements - endometrial implants near bowel - Dyspareunia: pain w/ intercourse - implants near uterosacral ligaments or vagina
71
Urge urinary incontinence: presentation
Involuntary leakage accompanied by or preceded by urgency, due to overactive bladder
72
Stress incontinence: presentation
Involuntary leakage on effort or exertion, or on sneezing or coughing, due to underactive outlet
73
PCOS: diagnostic criteria
Rotterdam Criteria (2 out of 3): 1. Clinical or biochemical hyperandrogenism 2. Oligoamenorrhea (<8 menses/year) 3. Polycystic-appearing ovaries on ultrasound Need to exclude: - Cushing's (24 hr urine cortisol) - Testosterone producing tumor (testosterone, DHEA) - Nonclassical (late-onset) adrenal hyperplasia (21-hydroxylase deficiency)
74
Virchow's Triad
Prothrombic states: - Hypercoagulability - Venous stasis - Endothelial damage
75
Preeclampsia: diagnosis
BP: 2 measurements of >140/90 four hours apart AND one of the following: - proteinuria (24 hr urine >300mg or spot protein/creatinine ratio >0.3) - thrombocytopenia <100K - impaired liver function: LFT's 2x normal - renal insufficiency (creatinine >= 1.1) - pulmonary edema - cerebral disturbances (severe headache) - visual impairment (blurry vision)
76
Delirium: diagnosis
Acute onset AND inattention that fluctuates AND EITHER: Disorganized thinking OR altered level of consciousness (reduced awareness of environment)
77
Conductive hearing loss: definition
Hearing loss due to conducting sound waves anywhere along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles)
78
Sensorineural hearing loss (SNHL): definition
Hearing loss due to issues with - inner ear or sensory organ (cochlea and associated structures) OR - vestibulocochlear nerve (cranial nerve VIII) [90% of hearing loss reported]

Life Stages (10 decks)

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