First Aid Flashcards by Melissa Khalil

Mechanism in Fetal alcohol syndrome

Failure of cell migration

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Persistent cervical sinus

Branchial cleft cyst
In lateral neck, ant to sternocleidomastoid M.
Immobile during swallowing

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2 causes of abnormal male genitalia

No Sertoli cells or No MIF: male+female internal genitalia + male external genitalia
5 alpha-reductase deficiency: male internal G + ambiguous external G until puberty

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Anomalies ass w/ hypospadias + epispadias

Hyposp: inguinal hernia + cryptorchidism
Episp: exstrophy of bladder

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4 characteristics of Choriocarcinoma

Malignant gestational trophoblastic ds
Anaplastic cytotrophoblasts + syncytiotrophoblasts
No villi
Pulmonary metastasis: dyspnea, hemoptysis

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Testicular germ cell tumors

Very high hCG

Stimulate TSH receptors: hyperthyroidism

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FSH receptor deficiency

High FSH
Low inhibin
Normal: testo, LH, DHEA, DHEAS, androstenedione

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3 sources of estrogen + 4 sources of progesterone

Ovary (estradiol), adipose tissue (estrone), placenta (estriol)

Corpus luteum, placenta, adrenal cortex, testes

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4 causes of high hCG + 3 causes of low hCG

Multiple gestations, hydatidiform moles, choriocarcinomas, Down syndrome

Ectopic/failing pregnancy, Edward syndrome, Patau syndrome

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Low birth weight: consequences + complications

Impaired thermoregulation, impaired immune fct, hypoglycemia, polycythemia, impaired neurocognitive/emotional dev

Infections, resp distress sd, necrotizing enterocolitis, intraventricular hge, persistent fetal circulation

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Double Y males (XYY)

Normal phenotype; very tall
Normal fertility
Ass w/ severe acne, learning disability, autism spectrum disorders

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Ovotesticular disorder of sex development

46XX > 46XY
Ovarian+testicular tissues
Ambiguous genitalia

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46XX disorders of sex dev

Ovaries
External gen: virilized or ambiguous
Excessive exposure to androgenic sterois during early gestation
Congenital adrenal hyperplasia, exogenous androgens

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46XY disorders of sex dev

Testes
External gen: female or ambiguous
Androgen insensitivity sd (testicular feminizatin)

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Placental aromatase deficiency

Inability to synthesize estrogens from androgens
Ambiguous gen of 46XX
High testo + androsten
+/- maternal virilization in pregnancy

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Androgen insensitivity syndrome (46XY)

Defect in androgen receptor
Normal appearing female
Rudimentary vagina
Absent uterus/fallopian tubes
Normal functioning testes (removed)

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5 alpha-reductase deficiency

46XY
Inability to convert testo to DHT
Normal internal gen
Ambiguous ext gen until puberty (high testo) w/ masculinization
Normal testo/estrogen - Normal LH

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Kallmann syndrome

Failure to complete puberty
Hypogonadotropic hypogonadism
Defective migration of GnRH cells + olfactory bulb
Anosmia, infertility
Low GnRH+LH+FSH+testo

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Anticoagulation during pregnancy

Heparin
Not warfarin (bone deformities, fetal hge, abortion, ophth abnl)

5 risk factors for Placental abruption

Trauma
Smoking
HTN
Preeclampsia
Cocaine abuse

Presentation of Placental abruption

Abrupt painful bleeding (concealed/apparent) in 3rd trim

Possible DIC, maternal shock, fetal distress

3 risk factors of Placenta accreta/increta/percreta

Prior C-section
Inflammation
Placenta previa

2 risk factors + presentation of Placenta pevia

Multiparity
Prior C-section

Painless bleeding - 3rd trim

Triad of Vasa previa presentation

Membrane rupture
Painless vaginal bleeding
Fetal bradycardia (<110/min)

4 causes of postpartum hemorrhage

Tone (uterine atony) Trauma (ut rupture, incision, laceration) Thrombin (coagulopathy) Tissue (retained products)

5 risk factors for Ectopic pregnancy

``` Prior ectopic pregnancy History of infertility Salpingitis (PID) Ruptured appendix Prior tubal surgery ```

5 causes of polyhydramnios + 3 of oligohydramnios

PolyH: eso/duod atresia, anencephaly (inability to swallow); maternal db; fetal anemia; multiple gestations OligoH: placental insuff, bilat renal agenesis, post urethral valves (inability to excrete)

Ttt of gestational HTN

Anti-HTN: hydralazine, alpha-methyldopa, labetalol, nifedipine Deliver at 37-39w

Ttt of pre-eclampsia + eclampsia

IV magnesium sulfate Antihypertensives Delivery (for definitive ttt in pre-ecl) immediate (in ecl)

Peyronie ds vs penile fracture

Peyronie: fibrous plaque in tunica albuginea Fracture: rupture of corpora cavernosa

2 causes + 3 ttt of Ischemic priapism

Sickle cell ds Medications (sildenafil, trazodone) Immediate ttt w/ corporal aspiration, intracavernosal phenylephrine or surgical decompression

Lab findings in Cryptorchidism

Low testo if bilat, normal if unilat (Leydig unaffected) Low inhibin B (Sertoli affected) High FSH, LH

Premature ejaculation

Medical condition (prostatitis, thyroid ds) Substance use Psychosocial stressors Ass w/ anxiety, depression, erectile dysfunction Ttt: SSRI - topical anesthetics + psychotherapy

3 types of vaginal tumors

Squamous cell carcinoma: 2* to cervical SCC Clear cell adenocarcinoma: exposure to DES in utero Sarcoma botryoides: <4yo, desmin+, spindle-shaped

4 risk factors + 2 presentations of dysplasia + carcinoma in situ

Multiple sexual partners +++ Smoking Starting sex at young age HIV Asymptomatic or abnormal vaginal bleeding (postcoital)

11 most common causes of anovulation

Pregnancy, polycyst ov sd, obesity, HPO axis abnl, premature ov failure (<40yo), hyperprolactinemia, thyroid disorders, eating disorders, competitive athletics, Cushing sd, adrenal insuff

2 complications + ttt of Polycystic ovarian sd

High risk of db 2 High risk of endometrial cancer (2* to unopposed estrogen) Ttt: weight reduction, OCPs, clomiphene citrate, ketoconazole, spironolactone, (metformin if hyperglyc)

Malignant ovarian neoplasms: high risk and low risk

High: advanced age, infertility, endometriosis, PCOS, genetic predisp (BRCA1 or 2, Lynch, family hist) Low: pregnancy, breastfeeding, OCPs, tubal ligation

5 indications of Leuprolide

GnRH analog or antagonist Uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility

4 indications + 2 CI of estrogens

Hypogonadism + ovarian failure Menstrual abnormalities Hormone replacement therapy in postmenop Men w/ androgen-dep prostate cancer ER+ breast cancer History of DVTs

4 adverse effects of estrogen therapy

High risk of endometrial cancer Bleeding in postmenop Clear cell carcinoma of vagina if DES in utero High risk of thrombi

4 indications for Progestins

Contraception Endometrial cancer Abnl uterine bleeding Progestin challenge: withdrawal bleeding excludes anatomic defects, chronic anovulation without estrogen

Termination of pregnancy and emergency contraception

Termination: mifepristone w/ misoprostol Emergency: ulipristal

CI of combined contraception

Smokers >35 yo High risk of cardiovasc ds (venous TE, CAD, stroke) Migraine + aura Breast cancer HyperTg - pregnancy - decompensated or active liver ds

Ttt of BPH

Finasteride (5alpha-reductase) Tamsulosin (alpha1A,D receptor antagonist) Tadalafil (PDE type 5 inhibitor)