Female Dz@ Flashcards
“Central scar” on CT liver mass
FNH
Should OCPs be d/c’ed in pts with FNH?
No, inc risk of getting it but no need to dc
What s/s of intraheptic cholestasis of preg?
Elevated LFTs, severe pruritis, normal GGT
How to confirm ICP?
Bile acid levels
When to dc infliximab in preg?
8-10 weeks before deliveru
How to treat endometriosis pain?
OCPs
MC demographic to get serous cystadenoma?
Female > 60 yo
“Central scar” in panc lesion
serous cystadenoma
Describe differences in sampling of MCN and serous Cystad?
MCN - mucin secreting cuboidal epithelium
SCA - glycogen containing cuboidal epith
CEA in SCA vs MCN?
MCN usu >200, SCA low
SEs of linaclotide vs lubiprostone?
Linac - HA
Lubi - N, edema, chest dc, SOB
Both - Diarrhea, abd pain/dist, incontinence
What class is linaclotide and lubiprostone?
Linac (Linzess) - GC2C agonist - stims Cl, HCO3, H2O into colon
Lubi (Amitiza) - activates ClC-2 chloride chanels and inc secretion
Rates of fertility of UC pts before and after IPAA?
Before - gen pop (15%)
After - 1/2 of gen pop
IHCP tx
Urosdiol
What risk to baby in IHCP?
Prematurity, stillbirth, meconium staining
What ABs to check if considering scleroderma?
Anti topoisomerase I, anticentromere, ANA, ANti-RNA Poly III
Anti CCP in what dz?
RA
Diff in anti TopoIso and centromere?
TI - Scleroderma
CM - CREST
Which progression should be made when treating GERD in pregnancy?
Start with lifestyle modification and Ca carb, can then add H2B, then PPI if needed
T/F: Sodium bicarb is a safe antacid during pregnancy.
False, can lead to metab alk and fluid overload
Pt with fecal urge incontinence likely have defect in what?
EAS
Pt with incontinence without urge likely have defect with what?
IAS
What is best mgmt of urge incontinence?
Biofeedback therapy + PFR > PFR alone
T/F: Biofeedback is effective for IAS defect leading to incontinence.
False
What criteria need to be met to dx PBC?
2/3 - elevated alk phos, + AMA, bx with nonsuppurative destruction of intralobular bile ducts
T/F: FNH, which has a typical pattern of central scar on imaging, should be treated by d/c contraceptives if on them
False, all is true but tx is reassurance, no need to d/c OCPs in most cases
Which type of liver mass should be resected prior to pregnancy due to risk of rupture by hormone induced growth?
Hepatic adenoma - usu in pts with long term OCP use
How to confirm Intrahepatic cholestasis of pregnancy?
Check bile acid levels - should be very high
What is tx of ICP?
Ursodiol & delivery at 36-37 weeks
How to differentiate HELLP from AFLP?
HELLP more likely to have HTN
AFLP more likely to have hypoglycemia, inc PT/PTT, elevated Cr
What factors put mom at high risk of transmitting hep B to baby?
HBeAg+ and high DNA
What to do for baby born to HBV+ mom?
HBIG and hep B vaccine within 12 hours of birth
Mom with high HBV DNA - what should be done for tx to px spread to baby?
Antivirals starting 6-8 weeks prior to delivery
T/F: E/P decreases risk of CRC in women.
true
T/F: If women gets pregnant within one yr of liver TP, has inc risk of rejection during preg.
true
Serous cystadenoma findings
Female > 60, central scar on imaging, low CEA and amylase, glycogen rich on cytology
Which hormone increases LES relaxation in pregnancy leading to reflux?
Progesterone
What is MC type of constipation?
Slow transit constipation, especially in young F with chronic constipation
Name 4 main factors AW fecal incontinence in pts after delivery.
Fecal wt > 4g
Forceps delivery
Length of 2nd stage of labor
3rd or 4th degree perineal tear
T/F: PBC pts should have BMD testing at time of diagnosis and every 2 years following
True
Pts homozygous for what gene at risk of AFLP?
LCHAD
What is fertility rate for medically treated UC vs IPAA?
Tx UC - 85%
IPAA - 55%
T/F: Hyperemesis gravidarum can lead to elevated LFTs.
True - but typically get better with rehydration
T/F: IHCP has a risk of premature delivery.
True
T/F: MTX CI in preg but safe when breastfeeding
False, should not use in both cases
How to tx listeria?
Ampicillin
