DAY6 Flashcards
what supplements decrease the risk of neural tube defects… ex. Spina Bifida
Vit B9, folic acid.. planning preganancy 400mg, with history 4g
what is preterm delivery
20 to 37 weeks
classes of teratogens (an agent that can disturb the development of an embryo or fetus)
radiation, maternal infections, chemicals, and drugs..
ex. Abdominal CT
FDA drug classification… Class D
- no risk in human study
- no risk in animal study
- high risk but benefits outweigh the risk
- Fetal abnormal
- indeterminate risk, benefits may outweigh rsik
class D is risky but benefits outweight the risk..
Class A is 1
Class B is 2
CLass E is 4
class C is 5
pregnant woman with persistent headache or visual disturbances, persistent epigastric pain and hyperreactive reflexes
pre-eclampsia.. classified by BP
mild 140/90
severe 160/110
eclampsia includes seizure
treatment for eclampsia
delivery
4 weeks postpartum, breast pain and redness along with high fever, chills and flu like symptoms. focal breast erythema, swelling and tenderness
mastitis. . severe pain… cellutis of glandular tissue in the breast
tx: antibiotics and continue breast feeding to release the pressure
most common medical complication of pregnancy
Diabetes Mellitus.
diagnosed before pregnancy - pregestational
during pregnancy at 26 weeks - gestation.
can result in very large babies
mild depressive symptoms that develop within a few days of delivery and resolve within 2 weeks
- postpartum blues
- postpartum depression
- postpartum psychosis
- postpartum delusions
postpartum blues..common.. tx is zoloft, celexa.. (avoid prozac and paxil during pregnancy)
postpartum depression is a year after
RhoGAM shot
used to prevent an immune response to Rh+ blood in people with an Rh- blood type..
ex. mother and baby…mother is rh- and husband is type O, baby is rh +
bacterial vaginosis vs trichomoniasis vs candida vulvovaginitis
fishy odor vs malodorous odor vs no odor
bacteria vs protozoa (STI) vs fungus
grayish white discharge vs yellow green vs white
female with thin white discharge for 10 day, fishy odor, worse after intercourse, no prior STD, clue cels seen under microscope
bacterial vaginosis
female with yellowish green discharge with malodorous odor, pH - 6, flagellated organism under microscope
treat patient and sexual partners.. this is a STD trichomoniasis
cervical cancer screening…
start at 21 or 3 years after sexual activity starts
ovulation is represented by
surge of FSH and LH hormones..
FSH get a follicule ready for ovulation
LH trigger ovulation, makes the egg release from ovary
LH is produced in the…
anterior pituitary gland
ovulatary phase includes …
- mature egg is released from the ovary
- LH surge
- FSH surge
- progesteron surge
all except progesterone surge this happens with the follicle ruptures
major risk factors for cervical cancer
HPV infection, tobacco use
types of HPV that account for majority of cervical cancer
HPV16 and 18
HPV6 and 11 are for warts
complications of hyperparathyroidism… increase amount OF PTH.. (decreased calcium in bones)
OSTEOPOROSIS…
also neophrolithiasis, nephrocalcinosis, osteopenia, pancreatitis, cardiac valve calcification
51 yo female with hot flashes, atrophy of the vagina, osteoporosis, coronary artery disease, sleep disturbances, high levels of FSH..
menopause..
Hot flash Atrophy Vagina Osteoporosis CAD Sleep disturbances
Increase FSH, LH..derease estrogen, avg age is 51, earlier in smokers
loss of urine after increase intra abdominal pressure ex coughing, sneezing, lifting, laughing
- total incontinence
- stress inconitinence
- urge incontinence
- overflow incontinence
stress incontinence
urge incontinence happens when there is an involuntary loss of urine at inappropriate times , overactive bladder
total incontinence is all times all positions
overflow is from chronic urinary retention
I-PAD
meninges… inner.. pia arachnoid dura
headache started hour agao, vomiting, worst headache of my life, stiff neck
- epidural hematoma
- subdural hematoma
- subarachnoid hemorrhage
- intracerebral hemorrhage
subarachnoid hemorrhage….
epidural.. trauma, lucid intervals, biconvex lens shape
subdural - elderly, crescent shape
subaracnoid - trauma, berry aneyrysims, abrupt onset, worst headache,
central nervous system
brain and spinal cord..
PNS sensory pathways, motor pathways
motor pathways somatic and autonomic
Autonomic sympathetic, parasympathetic
spinal nerves: Cervical Thoracic Lumbar Sacral Coccyx
8 12 5 5 1
characteristics of parasympathetic system..
- pupils dilate
- increased heart rate
- bronchi dilate
- emission of bile
parasymathetic is rest and digest…
4. emission of bile
sympathetic is parasympathetic is
muscle breakdown muscle building
urination blocked urination
ejaculation erection
reflexes are graded on a scale of 1 to 5 0 to 4 1 - 1+ -2 to 2+
0 to 4+
DTR grading.. 4+ very brisk, heperactive brisker than averge, slightly hyperactive normal low normal 0 no response
biceps reflex tests ….
C5, C6
biceps C5 brachioradials C6 triceps C7 patellar L4 achilles S1
pupillary reactions... CN I and II CN II and III CN V and VII CN VII and IX
CN II and III
CN II optic is information going in..
CN III oculomotor is information going out..
characterized by UMN and LMN signs.. spacticity, weakness, +babinski’s sign, muscle atrophy, asciculations
Amyotrophic Lateral Sclerosis.. ALS (death of neurons)
Brachial plexus…. Randy Travis Drinks COld Beer
Root trunks divisions cords branches
which CN is involved in taste.. CNIII CNV CNIX CNXI
CN IX is glossopharyngeal..posterior 1/3 of tongue
also CNVII - facial anterior 2/3 of tongue
CN10 vagus epiglottis
big toe dorsiflexes and the toes fan out..
big toe flexes up.. this is a postiive babinski sign and indicates UMN problem..
inner ear problem, sound waves not processed, sensorinueral hearing loss..
- cerumen impaction
- foreign bodies
- otitis externa
- presbycusis
presbycusis.. difficulty distinguishing voices in a crowd, elderly, inner ear problem
blood is made up of…
45% cells and 55% plasma
characteristics of blood cells…
45% of blood, supply of oxygen (via RBC), circulation of WBC, clotting at sites of injuries
responsible for maintaing electrolytes and fluid balance
plasma (55% of blood)
protein reserve of the body, aids in clotting
plasma (clotting is assisted by fibrinogen protein)
life span of RBC
4 months (120 days)
wbc 3 to 4 days
platelets 5 to 10 days
sickle cell anemia RBC life span
shorter than normal… 12 to 15 days
life span of platelets
5 to 10 days
Never Let Monkeys Eat Bananas
Neutrophil 50 to 70% eat granules Lueokocytes 25 to 35% specific immune response Monocytes 4 to 6% eat no granules Eosinophil 1 to 3 % allergy parasistes Basophil 0.4 to 1% inflammatory
engulfing WBC (phagocytosis)
neutrophils, monocytes
eosionphils are responsible for…
- phagocytosis
- allergic reactions
- inflammatory reactions
- humoral and cellular immunity
allergic reactions
phagocytosis.. neutrophils and monocytes
inflammatory reactions basophils
defends against helminthic infection
eosinophil.. causes of eosinophila.. neoplasia, asthma, allergy, connective tissue disease, parasites
functions of blood cells…45 % of blood (plasma 55%)
RBC
WBC
Platelets
RBC carry oxygen
WBC protect body from germs
Platelets form sticky blood clots
A antigen of RBC surface and Anti B antibody in plasma
blood group A
universal recipients of RBC
blood group AB (no antibodies in plasma)
universal donor of plasma
universal donor of RBC
blood group O (no antigens on RBC surface)
universal recepient of plasma
Rh- mother in 2nd pregancy has increased risk of…
transplacental transmission of maternal antibodies that will reject a fetus of Rh+…treatment is Rho(D) immune globulin…
type of antibody that can cross he placenta in a pregnant woman.
IgG…
IgA.. local protection of mucous membranes
IgM - first type of antibody made in response to an infection
IgE - involved in immediate hypersensitivity response (eosinophils)
what is the measurement for anemia types.. corpuscular volume or mean cell volume
MCV..
microsytic anemia <80
normocytic anemia 80 to 100
macrocytic anemia >100
microcytic anemia..
- iron deficiency
- B12 deficiency
- folate deficiency
- drug toxicity
iron deficincy..
b12 and folate is macrocytic
megaloblastic anemia.. (macrocytic
B9 and B12 deficincy..
B9 homcystein increase.. methymalonic acid normal
B12 homocystein increase .. methymalonic acid increase
pernicious anemia… B12 deficiency
a result of..
loss of gastric parietal cells which product intrinsic factor that help absorb B12,
vit B12 deficincy
decreased intake crohns pernicious anemia celiac tapeworm
leading cause of cancer death in men and women
Lung
metastases from Breast colon prostate bladder
metastases to adrenals, brain, bone liver
most common leukemia in children ALL acut lymphocytic AML acute myelogenous 20 to 40 CML chronic myelogenous 40 to 60 CLL chronic lymphocytic >65
ALL
30 year old leukemia, previous chemo,
Acute Myelogenous
risk factor for bladder cancer..
smoking, aniline dyes, schistosomiasis.. Dx; cystoscopy
dx for prostate cancer..
DRE, PSA test, transrectal biopsy
cancer staging notation system for malignant tumors
T size
N nearby lymph nodes
M metastasis
macronutrients vs micronutrients
carbohydrates, protein, fat.. vs.. macrominerals
enzyme release for carbohydrate digestion
mouth and small intestine (amylase comes from pancreas)
protein digestion…
pepsin from stomach, trypsin from pancreas, peptid (SI)
fat digestion..
lipase (SI)
small intestine consists of
duodenum jejunum ileum (crohns)
external hemorrhoid..
below the pectinate line, painful
above the pectinate line and not painful
internal hemorrhoid
dividing point for the upper and lower gastrointestinal tract..
ligament of treitz
division between duodenum and jejunum
hematochezia comes from…
lower GI tract.. bright red blood
melena comes from…
upper GI tract.. dark tarry stool
inflammatory bowel disease is…
crohn’s and ulcerative colitis
crohns vs ulcerative colitis
skip lesions vs continuous
ileum involved vs rectum involved (entire tract)
oral ulcers, terminal ileum, colon, skip lesions, abdominal pain, non-bloody diarrhea, perirectal abscess
crohn’s disease
involves rectum, continuous lesions, abdominal pain with bloody diarrhea
ulcerative colitis..
malabsorption with chronic diarrhea, steatorrhea, weight loss, dermatitis, biopsy reveals loss of villi..
celiac disease.
nausea, vomiting, hardness in the lower right side of the abdomens…
mcburney’s sign with show appendicitis
AST:ALT 2:1 or greater…
alcoholic liver disease
iron overload.. more in men than women..
hemochromatosis.. women do not because of menstural cycle.. tx is phlebotomy
copper overload..
wilson’s disease
copper overload,, brownish yellow ring visible around the corneo scleral junction (kayser fleischer rings)
wilson’s disease (copper overload)
