More Diseases Flashcards
Dermatitis Seborrheic
Sebaceous gland inflam
Yellow pink flaky oily crusting
Elsewhere on body too
Sim to psoriasis and lichen simplex chronicus
Dermatitis Eczema
Flexor surfaces elbow, knee, scalp, behind ear
Spongiotic pattern
Lichen Sclerosis
Vulvar disease
Smooth, thin white diffuse onion skin
So smooth may lose anatomic landmarks
Assoc’d w/ familial thyroid and immune disease
Histo- band of chronic inflam lymphocytes
Steroid; unlikely full recover
Lichen simplex chronicus
Vulva disease Due to skin irritant, new soap Itch induces rough rash Hyperplastic, hyperpigment thick skin Good prognosis- anti-itch steroid
Lichen planus
Vulvar disease Disgusting one Wickham striae white/red lacy bands Red ulceration desquam of vagina Vaginal discharge Burning and pruritis Insertional Dyspareunia Cortisone douche treatment Basal cell liquefactive necrosis
Psoriasis
Red irritated skin w/ silver scale on top= Auspitz spot
Autosomal dom
Seen elsewhere body too
Histo- acanthotic diffuse hyperplasia
Vestibulitis
Insertional dyspareunia
Any touch to area painful
Cortisone, lidocaine, excise
SSRI, tricyclic antidepressant for pain
Endometriosis
Ground glass appearance Chocolate cyst Mostly on ovaries, then uterus- can go other places too lung brain etc Dyspareunia-Dysmenorrhea-Dyschezia Hemosideren-laden macs Stage 1-4, 4 severe and most infertile but least painful Nulliparous high achieving women Infertile
Adenomyosis
Endometriosis into uterine musculature
Occurs decade later w/ heavy abnormal menstrual bleed
Soft boggy uterus
Risk for genetic defect 1/180 and risk for Down syndrome is half of that
Hysterectomy
Turners syndrome
Female 45 XO Streak gonads don't produce estrogen- hypergonadotrophic hypogonadism Primary amenorrhea Short stature, webbed feet Need give GH and estrogen esp puberty
Mullerian agenesis- Mayer Rokitansky Kuster Hauser syndrome
No tubes but have ovaries Have estrogen and secondary sex dvlpmt but no tubes so no menses Secondary amenorrhea See reduplication of ureters, scoliosis Can try to surgically make tubes/vagina
Pregnant quantitative HCG
1200-2000
But if don’t see anything in uterus, must be ectopic :(
Asherman syndrome
Too much D&C dilation and curettage
Too much cervix dilation, uterine scraping that cause scarring; no longer able to dvlp endometrium
Secondary amenorrhea
PALM COEIN classification for dysfunct/abnormal uterine bleeding
PALM- structural related Polyps Adenomyosis Leiomyoma Mass
COEIN- non-structural related Coagulopathy Ovulating dysfunct Endometriosis Iatrogenic Not yet classified
PCOS polycystic ovarian syndrome
Oligo-ovulation, hyperandrogen, polycystic ovaries
Most common cause of androgen excess and hirsuitism
String of pearls on ultrasound
Insulin resistance acanthosis nigracans
Low steroid hormone bind glob so high free testosterone
Too much fat make estrogen which incr LH for more androgen
CAH congenital adrenal hyperplasia
21-Hydroxylase deficiency
Autosomal recessive
Can’t make DHEA estrogen, aldosterone so salt wasting too
Ambiguous genitalia
Pubarche precedes thelarche!!! B/c hair growth is androgen and breasts are estrogen!
Would have elevated 17-Hydroxylase since not going the estrogen pathway
That’s the ACTH test
Vulvovaginitis
Itchy red with vaginal discharge
Esp in pre-pubertal girls
lack of estrogen so does not produce protective cervical mucus
Anus close to vagina
Wet swimsuits
mostly 4 to 5-year-old girls because just learned proper wiping
Treat with soothing sitz bath
