Notes from Pad 1st two rotations 2 Flashcards
Most common age for breast cancer?
Late 40s - early 50s
Ages and frequencies for cervical screening
25-49 every 3 years = smear
50-64 = smear every 5 years
Two presenting features of cervical cancer
Post-coital bleeding - from contact with cervix
Abdominal distention - spread of cancer to abdomen
Risk factors for cervical cancer x5
HPV Immunosuppression Long term pill use Multiple sexual partners Early age 1st intercourse (Last 3 because increased risk of STI which increases risk of cervical cancer)
Details of stage 1 cervical cancer
Cervix only affected
Details of stage 2 cervical cancer
Cancer expands beyond cervix but not on lateral pelvic wall
Details of stage 3 cervical cancer
Cancer extends onto pelvic side wall
Details of stage 4 cervical cancer
Spread onto bladder and/or rectal mucosa (4a) or spread to distant organs (4b)
Treatment of different stages of cervical cancer
Stage 1 and 2 - surgery
Stage 3 and 4 - chemotherapy
What is Mittelschmerz
Lower one-sided abdominal pain on ovulation
Eczema synonym
Dermatitis
What is oppositional defiant disorder
Not as severe as conduct disorder, usually used for younger children - effectively difficult behaviour which affects functioning
What is eczema commonly complicated by?
Staphylococcal infection
Where does discoid eczema commonly affect?
Mostly lower legs but can go to arms and all over
Hormonal level differences in conduct disorder x2
Have lower cortisol levels therefore less scared when doing these behaviours
Also increased testosterone levels
Incidence of depression in young children
Very unlikely
In which children is depression usually diagnosed x2
Either very strong family history affective disorder or childhood abuse
Behavioural changes in depression in teenagers
Tend to overeat and over sleep rather than normal decrease in these activities
When must autism symptoms be present
Throughout life and in all situations
What is McCune-Albright Syndrome - 3 features
Genetic syndrome with at least 2 of 3 of polyostotic fibrous dysplasia (advanced bone age), cafe au lait skin pigmentation, autonomous endocrine hyperfunction (gonadotrophin independent precocious puberty)
What is pubarche?
Development of pubic hair, axillary hair and body odour
What is thelarche
Development of breasts - with/without bleeding
Definition of premature sexual maturation according to pubarche
Before 9 years old
Definition of PSM according to thelarche
Before 8 years old
What hormones cause pubarche and thelarche?
Androgens cause pubarche and oestrogens cause thelarche
Androgenic causes of PSM x3
Early physiological adrenarche (common)
Congenital adrenal hyperplasia (rare)
Tumours (v.rare)
Oestrogenic causes of PSM/thelarche x3
Normal variant of oestrogen activity (common)
True precocious puberty
Tumour (v.rare)
PSM according to puberty age
Before age 8 in girls or 9 in boys
Ethnic variation in puberty timing
US Black younger than US white which is younger than UK white
Signs of male puberty
Penis/testes/scrotum growth
Pubic and axillary hair and body odour
Signs of female puberty
Breast development, PV bleed
Pubic and axillary hair and body odour
Risk with precocious pathological puberty
Early fast growth can limit final height - not if physiological
Investigation of PSM - urine x2
Urinary steroid profile done in everyone - to exclude steroid synthesis disorder
24hr USP - for tumour vs adrenarche (if seriously suspect tumour)
Other investigations in PSM
Serum androgens - to characterise severity post diagnosis
What does 21-hydroxylase deficiency cause?
Intersex disorder
Virilized female
What is elevated in 21-hydroxylase deficiency
CAH, elevated ACTH
TTT of 21-hydroxylase deficiency
Replace cortisol and mineralocorticoid
True precocious puberty gender incidence
F»M
5-10:1
Cause of gender incidence of precocious puberty
Constitutional is more common in women and pathological is more common in males
Two types of pathological precocious puberty
Gonadotrophin-dependant (central eg. tumour) or gonadotrophin independent (peripheral eg. autonomous gonads)
What does hypothalamic hamartoma cause?
Precocious puberty - “infant hercules”
How long do you correct for gestational age in babies born
At least up until 1-2 years old
How long do you correct for gestational age in babies born
At least 2 years
Definition of short stature
Hormones which can contribute to short stature
Hypothyroidism
GH deficiency
Cortisol - cushings
