Module 2 Flashcards

genetic diseases, women's reprocuctive health, men's health, STIs

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1
Q

What family hx elements should be included when considering a genetic syndrome?

A
  1. the age and sex of family members
  2. when family members were affected by disease or when they died
  3. the ethnic background
  4. If there is consanguinity
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2
Q

What is the most common chromosomal abnormality?

A

Down syndrome

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3
Q

The underlying karyotype for Down Syndrome

A

95% nonfamilial trisomy 21 (47 total chromosomes),

3% to 4% unbalanced translocation

1% to 2% genetic mosaicism

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4
Q

Birth rates are highest among who?

A

mothers of advanced maternal age (one in 400 at 35 years of age, one in 105 at 40 years of age, one in 12 at 45 years of age); however, 80% of all children with Down syndrome are born to mothers younger than 35 years.

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5
Q

Risk Factors for Down Syndrome

A

maternal age > 35

Previous child with Down Syndrome

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6
Q

What are the common features of a baby with Down syndrome?

A

Flattened nasal bridge, small head, epicanthal folds, thick tongue, small ears, short neck

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7
Q

Non Pharm Mgmt for Down Syndrome

A

Annual eye and ear exams

Monitor for sleep apnea, GER, celiac disease and dysphagia

Annual thyroid testing

Monitor for the development of leukemia, heart disease, HTN, myelopathy

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8
Q

syndrome characterized by the partial or complete absence of one X chromosome (45,X karyotype)

A

Turner syndrome

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9
Q

Patients with Turner syndrome are at risk for

A

congenital heart defects (and may have progressive aortic root dilatation or dissection)

congenital lymphedema

renal malformation

sensorineural hearing loss

osteoporosis

obesity

diabetes

and atherogenic lipid profile

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10
Q

Physical manifestations in Turner’s syndrome

A

Physical manifestations may be subtle but can include misshapen ears, a webbed neck, a broad chest with widely spaced nipples, and cubitus valgus.

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11
Q

When should a Turner syndrome diagnoses be considered?

A

Turner syndrome diagnosis should be considered in girls with short stature or primary amenorrhea.

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12
Q

Klinefelter syndrome

A

boys born with an additional X chromosome

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13
Q

Symptoms of Klinefelter syndrome

A

infertility, small testes, decreased facial hair, gynecomastia, decreased pubic hair, and a small penis. Because of their long legs, men with Klinefelter syndrome often are taller than predicted based on parental height.

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14
Q

Tay-Sachs disease

A

a rare inherited disorder that progressively destroys nerve cells (neurons) in the brain and spinal cord

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15
Q

When does the most common form of Tay-Sachs disease become apparent?

A

In infancy

At 3 to 6 months, when their development slows and muscles used for movement weaken.

Affected infants lose motor skills such as turning over, sitting, and crawling. They also develop an exaggerated startle reaction to loud noises.

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16
Q

What abnormality is characteristic of Tay-Sachs disease?

A

An eye abnormality called a cherry-red spot, which can be identified with an eye examination, is characteristic of this disorder.

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17
Q

What distinctive facial features may infants with Tay Sachs have?

A

Affected infants may have distinctive facial features including almond-shaped eyes, a thin upper lip, a downturned mouth, a narrow bridge of the nose, a narrow forehead, and a disproportionately long, narrow head (dolichocephaly).

Distinctive facial features can be noticeable shortly after birth or may develop slowly over time.

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18
Q

Why are children with Tay Sachs diesase prone to obesity?

A

Between 4.5-8 years old, appetite and caloric intake usually increases, often thereafter developing a need to eat an extraordinarily large amount of food (hyperphagia) usually because they do not feel satisfied after completing a meal (satiety).

In addition, there is a decreased calorie requirement in people with PWS due to low muscle, decreased metabolism and decreased physical activity if not treated with growth hormone replacement. Consequently, overeating, rapid weight gain, and morbid obesity occurs if not controlled by others.

19
Q

Are males or females more affected by Fragile X Syndrome

A

error is on the X chromosome, so males are affected more and more severely than women

20
Q

Craniofacial features of Fragile X Syndrome

A

Large protruding ears

Elongated face/forehead

High, arched palate

21
Q

What is involved in the care of the pregnant patient in the 3rd trimester?

A

Managing:

premature labor vs Braxton Hicks

premature rupture of membranes

gestational diabetes

urinary frequency

swelling

22
Q

What is involved in the care of the pregnant patient in the 2nd trimester?

A

weight mgmt and healthy eating

assessing fetal heart tones, fundal height, fetal movement

screening for anemia and gestational diabetes

begin prep for childbirth and breastfeeding

23
Q

What is involved in the care of the pregnant patient in the 1st trimester?

A

Hx and physical

Mgmt of chronic disease

education, diet, exercise

prenatal vitamin with iron

Screening for HIV, STI, UTI, anemia

Domestic violence

24
Q

When the fertilized egg grows inside the tube or other extrauterine site

A

Ectopic pregnancy

25
Q

Treatment for ectopic pregnancy

A

If diagnosed early, methotrexate is prescribed to stop the growth of fetal tissue. Otherwise, the patient will require surgical removal

26
Q

What does estrogen cause during the 2nd trimester?

A

estrogen causes growth of of blood supply to things such as moles, warts and gums

27
Q

abruptio placenta

A

occure when placenta separates prematurely from the uterus

signs: decreased fetal movement, bleeding, hemmorhage, dizziness, shock, contractions

28
Q

preeclampsia

A

pregnancy induced endothelial malfunction accompanied by vasospasm

occurs after 20 weeks and up to 6 weeks post partum

elevated BP

proteinuria of 3+ or greater

headache, scotoma

Eclampsia = seizures

29
Q

What leads to gestational diabetes?

A

hyperinsulinemia and rapid weight gain

30
Q

Causes of premature labor

A

infection

uterine abnormality

smoking

drug abuse

HTN

31
Q

Care of the patient in the 3rd trimester

A

screening for infx, Broup B strep

32
Q

What is a cerclage?

A

the use of suture to hold the cervical os closed

33
Q

What are the characteristics of all hormonal methods?

A

All effect ovulation, the endometrial lining, thickness of the cervical mucus, change the production of FSH and LH (preventing egg recruitment and release).

34
Q
A
35
Q

Role of estrogen

A

decreases FSH

Prevents release of egg

stablizes the thickness of endometyrium, prevents shedding

NOT necessary to ptevent pregnancy

NOT a conctraceptive

36
Q

What can high levels of estrogen cause?

A

gestational diabetes

can alo interfere with latation

37
Q

What is a POP?

A

A progestin only pill - no estrogen

Good for breastfeeding mother, some headache patients

Need to start while bleeding

Take at SAME TIME EVERY DAY

Causes irregular menses

38
Q

Role of Progesterone

A

prevents LH surge, thickens cervical mucus, thins endometrium

Women with migraines may more sensitive to the combined or estrogen only pill, may want to use progestin only

Periods will not be regular on Progestin only pill

Progestin slows GI motility

39
Q

What is a COC?

A

“combined oral contraceptive”

contains noth estrogen and progestin

40
Q

Starting OCs

A

Same day/quick start - pregnancy test is negative

Sunday start - pregnancy test is negative, not likeley to be pregnant. Start next Sunday (period free weekends)

1st day start - start on 1st day of next menstrual period

41
Q

Contraindications of OCs

A

History of:

MI, CVA, or clot

Active breast or uterine cancer

Undiagnosed vaginal bleeding

Liver disease ot liver cancer

42
Q

Treatment for BPH

A

Alpha blockers

5-alpha reductase inhibitors

tadalafil

43
Q

Gold standard for vasomotor symptoms

A

HRT

44
Q
A