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Life Stages > Conditions > Flashcards

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
Q

Caesarean section: complications

A

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

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26
Q

Neonatal resuscitation: indications

A

No crying, breathing

Poor tone

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27
Q

Neonatal resuscitation: steps

A

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

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28
Q

Preeclampsia: pathophysiology

A

Not well understood

Vasospasm –> ischemia

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29
Q

Pyelonephritis in pregnancy: most common bugs

A

E. coli (75%)

Klebsiella, Enterobacter, Proteus

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30
Q

Meconium Aspiration Syndrome: pathophysiology

A

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

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31
Q

Meconium Aspiration Syndrome: presentation

A

Meconium-stained fingernails and skin

Respiratory distress: tachypnea, use of accessory muscles, decreased O2 sat

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32
Q

Meconium Aspiration Syndrome: imaging

A

Hyperinflated lungs

33
Q

Breast milk jaundice vs breastfeeding jaundice

A

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
Q

Conjugated hyperbilirubinemia in neonates: definition?

A

> 10% direct (conjugated)

35
Q

Prematurity: complications

A

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
Q

Neonatal respiratory distress syndrome: prevention

A

Give betamethasone 48hrs (and up to 7 days) prior to delivery

37
Q

Neonatal respiratory distress syndrome: pathophysiology

A

Absence/lack of surfactant keeps pulmonary vasculature resistance high - cannot get oxygenated blood

38
Q

Neonatal respiratory distress syndrome: imaging

A

Ground glass appearance due to microatelectasis (alveolar collapse)

Air bronchograms due to air unable to enter alveoli

Hypoinflation

39
Q

Necrotizing enterocolitis: pathophysiology

A

Neonates don’t have normal gut flora + have weaker intestinal walls - certain bacteria can overgrow, increases risk of infection

40
Q

Hypoglycemia in premature babies: pathophysiology

A

Decreased fat = fewer glucose stores; liver hasn’t yet started gluconeogenesis

41
Q

Retinopathy of prematurity: pathophysiology

A

Newly developed blood vessels grow out and then regress -

in premature babies, vessels haven’t regressed and are still friable –> risk of rupture

42
Q

Interventricular hemorrhage in prematurity: pathophysiology

A

Friable vessels can rupture

43
Q

Small for gestational age (SGA): definition

A

<10th percentile for birth weight

44
Q

Small for gestational age: pathophysiology

A

Either IUGR or constitutionally small

45
Q

Small for gestational age: complications

A

Increased risk of hypoglycemia, hypothermia (decreased glycogen stores, impaired gluconeogenesis)

46
Q

Large for gestational age: definition

A

> 90th percentile for birth weight

47
Q

Short stature: definition

A

> = 2 SD’s below mean, or <3rd percentile for height

OR growth line crosses 2+ major percentile lines

48
Q

Failure to thrive: definition

A

> = 2 SD’s below mean, or 3rd percentile for weight

OR growth line crosses 2+ major percentile lines

49
Q

GH deficiency: presentation

A

Initially presents as failure to thrive, then decreased height velocity

50
Q

Developmental delay: patterns of onset

A

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
Q

Delayed puberty: definition

A

No breast development by 13

No testicular development by 14

52
Q

Kallman Syndrome: pathophysiology

A

Defective migration of GnRH-releasing neurons from olfactory placode to hypothalamus

53
Q

Kallman Syndrome: presentation

A

Hyposmia/anomsia (reduced or lack of smell)

54
Q

McCune-Albright Syndrome: pathophysiology

A

Increased hormone levels (estrogen, GH, thyroid, etc)

55
Q

McCune-Albright Syndrome: presentation

A

Cafe-au-lait macules

Polyostotic fibrous dysplasia (affecting more than one bone)

56
Q

Primary ovarian insufficiency: definition

A

Cessation of ovarian function before age 40

57
Q

Asherman Syndrome: definition

A

Endometrial scarring due to surgery (e.g. curettage) or infection

58
Q

Benign prostatic hyperplasia: presentation

A

Increased urinary frequency, nocturia

Difficulty initiating stream, fully emptying bladder

59
Q

Fibroadenoma: presentation

A

Palpable, smooth, mobile mass, often in a young and otherwise healthy woman

60
Q

Ductal carcinoma in situ: presentation

A

Most women with mammography findings were asymptomatic (no palpable masses)

61
Q

Adenomyosis: presentation

A

Enlarged, rounded uterus OR asymptomatic

62
Q

Acute endometritis: presentation

A

Soft uterus
Uterine tenderness
+systemic signs of infection

63
Q

Fibroids/leiomyomas: presentation by type

A

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
Q

Leiomyosarcoma: gross presentation

A

Single lesion with areas of necrosis and hemorrhage

Does NOT arise from leiomyoma

65
Q

Endometrial cancer: presentation

A

Post-menopausal bleeding

66
Q

Ovarian cancers: presentation

A

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
Q

Types of ovarian cancers

A

Serous (most common), mucinous, endometroid, Brenner (bladder-like epithelium)

68
Q

Stages of ovarian cancers

A

Benign, BORDERLINE, malignant

69
Q

Difference between Type I and Type II ovarian cancers

A

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
Q

Endometriosis: presentation

A

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
Q

Urge urinary incontinence: presentation

A

Involuntary leakage accompanied by or preceded by urgency, due to overactive bladder

72
Q

Stress incontinence: presentation

A

Involuntary leakage on effort or exertion, or on sneezing or coughing, due to underactive outlet

73
Q

PCOS: diagnostic criteria

A

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
Q

Virchow’s Triad

A

Prothrombic states:

  • Hypercoagulability
  • Venous stasis
  • Endothelial damage
75
Q

Preeclampsia: diagnosis

A

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
Q

Delirium: diagnosis

A

Acute onset
AND inattention that fluctuates

AND EITHER:
Disorganized thinking OR altered level of consciousness (reduced awareness of environment)

77
Q

Conductive hearing loss: definition

A

Hearing loss due to conducting sound waves anywhere along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles)

78
Q

Sensorineural hearing loss (SNHL): definition

A

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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