Jan 3 2020 Flashcards
What is the initial investigation for MIXED incontinence?
A voiding diary - keep track of fluid intake, urine output, leaking episodes, etc. to determine the predominant type
should you wait for spontaneous labour in IUD?
No - this generally takes 2-3 weeks and can cause coagulopathies
how should you deliver a women with IUD (>24 weeks)
induced vaginal delivery when they are ready
does a woman with O blood have anti-A or anti-B antibodies during her first pregnancy?
YES - we are exposed early in life from antigens in food - she will have igG antibodies
is ABO hemolytic disease serious?
No it is often very mild - may be asymptomatic or baby may have mild anemia/jaundice
does severe diarrhea cause acidosis or alkaloisis?
acidosis - from the loss of bicard
A sharp decline in spontaneous conceptino rates begin in what age in a woman?
35
what causes the decline in conception rates seen in women in their late 30s?
diminished ovarian reserve
do patients with 5-alpha-reductase deficiency develop breasts at puberty?
No - testosterone binds to the androgen receptor and prevents this
do patients with androgen insensitivity have breast development at puberty?
Yes - they have resistance to testosterone so breast development is not inhibited by it
Genotype of a patient with 5-alpha-reducatse deficiency?
XY
Genotype of a patient wiht androgen insensitivity syndrome?
XY
What changes are seen in a patient with 5-alpha reductase at puberty?
-virilization - a XY (phenotypically female) patient will have acne, male pattern hair development, increased muscle mass, etc. due to the increase in testosterone at puberty
3 causes of late post-partum hemorhage?
- retained products of conception
- placental site subinvolution
- postpartum endometritis
why are patients with intrapartum infection at increased risk for retained products of conception?
the inflamation allows the tissue to adhere more
sinusoidal wave patterns on a CTG are suggestive of…
severe fetal anemia (can be from blood loss)
lab findings of acute fatty liver of pregnancy
- hypoglycemia
- increased aminotransferase
- increased bilirubin
- thrombocytopenia
- DIC
management of acute fatty liver of pregnancy
immediate delivery
what happens to fibroids after menopause?
they usually decrease in size and become asymptomatic
how do you treat recurrent UTIs in a post-menopausla woman?
-topical estrogen therapy
+ consider antibiotic prophylaxis
a woman has atypical glandular cells on pap smear.. what are the next steps?
- colposcopy
- endocervical curretage
- endometrial biopsy
Interstitial cystitis AKA
painful bladder syndrome
presentation of interstitial cystitis
pain exacerbated by bladder filling and releived by voiding
interstitial cystitis is associated with…
-other pain disorders (IBS, fibromyalgia), and psychiatric disorders
presentation of primary syphilis
painless ulcer
presentation of secondary syphilis
- diffuse rash (palms and soles)
- lymphadenopathy
- conyloma latum
- oral lesions
- hepatitis
presentation of latent syphilis
asymptomatic
presentation of tertiary syphilis
CNS - tabes dorsalis, dementia
Cardiovascular - (aortic aneurysm, insufficiency)
Gummas
onset of anaphylaxis to blood transfusion
seconds to minutes
cause of anaphylaxis to blood transfusion
recipient igA antibodies against donor igA
Presentation of anaphylaxis to blood transfusion
- angioedema, hypotension, respiratory distress/wheezing, shock
- igA deficient
onset of acute hemolytic reaction to blood transfusion
within an hour
cause of acute hemolytic reaction to blood transfusion
ABO incompatibility (clerical error)
presentation of acute hemolytic reaction to blood transfusion
- fever
- flank pain
- hemoglobinuria
- DIC
- coombs test
which of the following has associated hemoglobinuria: acute anaphylaxis to blood transfusion or acute hemolytic reaction?
acute hemolytic reaction
immediate management of acute hemolytic reaction
IV fluids
