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tsomkapQ > Ob/Gyn > Flashcards

Ob/Gyn Flashcards

1
Q

Why do pregnant women get Anemia?

A

Due to the dilution effect: RBC rises 30%, but body volume rises 50%

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2
Q

What are the degrees of Vaginal Lacerations?

A

1st Degree: Skin
2nd Degree: Muscle
3rd Degree: Anus
4th Degree: Rectum

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3
Q

What is Vernix?

A

Cheesy baby skin. (protects the baby’s skin from the outside world and helps with passage through the birth canal)

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4
Q

What is Meconium?

A

Green baby poop (first poop)

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5
Q

What is Lochia?

A

Endometrial slough. (normal discharge and uterus after birth)

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6
Q

What is normal blood loss during a Vaginal Deliver?

A

500 mL

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7
Q

What is normal blood loss during a C-section?

A

1000 mL

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8
Q

How do you treat A1 Gestational DM?

A

Diet

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9
Q

How do you treat A2 Gestational DM?

A

Insulin

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10
Q

What are Identical Twins?

A

Eggs split into perfect halves “Monochorionic”

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11
Q

What are Fraternal Twins?

A

Multiple eggs fertilized by different sperm

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12
Q

What is Ovarian Hyperstimulation syndrome?

A

Weight gain and enlarged ovaries after clomiphene use for infertility

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13
Q

Who Makes the Trophoblast?

A

Baby

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14
Q

Who makes the Cytotrophoblast?

A

Mom production of GnRH, CRH, TRH, and Inhibin

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15
Q

Who makes the Syncytiotrophoblast?

A

Mom and baby production of HCG and HPL

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16
Q

When does Implantation occur?

A

1 week after fertilization

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17
Q

When is Beta HCG found in Urine?

A

2 weeks after fertilization

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18
Q

When is B-HCG found in Blood?

A

8-10 days after fertilization

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19
Q

What makes Progesterone in >10 weeks gestation?

A

Placenta

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20
Q

What is the function of B-HCG?

A

Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)

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21
Q

What makes B-HCG?

A

Placenta (synctiotrophoblast)

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22
Q

How fast should B-HCG rise?

A

Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed

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23
Q

What is the fucntion of AFP?

A

Regulates intravascular volume

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24
Q

What is the function of HPL?

A

Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)

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25
Q

What is the function of Inhibin?

A

Inhibits FSH so there is no menstruation

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26
Q

What is the function of Cortisol in Pregnancy?

A

Decreases immune rejection of the baby out of mom and for lung maturation

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27
Q

What is the function Oxytocin?

A

Milk and baby ejection

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28
Q

What is the thyroid hormone levels during Pregnancy?

A

Increased TBG - leads to increased total T4 (Bound and free)

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29
Q

When can you first detect fetal heart tones?

A

Week 20

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30
Q

When can you tell the sex of the baby by US?

A

Week 16

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31
Q

What does an AFI <5 indicate?

A

Oligohydramnios (Cord compression)

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32
Q

What does an AFI >20 indicate?

A

Polyhydramnios (DM)

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33
Q

How fast should fundal height change?

A

Uterus grows 1 cm/week

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34
Q

What is the Pool Test?

A

Fluid in the vagina

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35
Q

What is Ferning?

A

Estrogen crystallizes on slide. (Amniotic fluid)

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36
Q

What is Nitrazine?

A

Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)

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37
Q

What is the risk of Chorionic Villus Sampling?

A

Fetal limb defects. (Done at 9-12 weeks)

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38
Q

What is the risk of Amniocentesis?

A

Abortion (2% risk)

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39
Q

What is a Biophysical Profile (BPP)?

A 
By US look for:
Non-stress test
AFI
Fetal heart tone
Fetal Activity
Breathing Movement
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40
Q

What is a normal BPP?

A

> 8-10

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41
Q

How much weight should a woman gain during Pregnancy?

A

1 lb/ week

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42
Q

When should Intercourse be avoided during Pregnancy?

A

Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes

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43
Q

What are the Leopold Maneuvers?

A 
To determine the position of the baby
Feel the fundus
Feel the baby's neck
Feel the pelvic inlet
Feel the baby's head
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44
Q

What is Stage 1 of Labor?

A

Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm

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45
Q

What is the Stage II of Labor?

A

Continues after the cervix is dilated to 10 cm until the delivery of the baby

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46
Q

What is Stage III of Labor?

A

Delivery of the placenta

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47
Q

How do you monitor Baby’s Heart Rate?

A

Doppler or scalp electrode

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48
Q

How do you monitor the Uterus?

A

Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)

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49
Q

What are Braxton-Hicks Contractions?

A

Irregular contractions with closed cervix. (preparing for birth)

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50
Q

What is a Vertex Presentation?

A

Posterior Fontanel (triangle shape) presents first (normal)

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51
Q

What is a Sinciput Presentation?

A

Anterior Fontanel (Diamond shape) presents first

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52
Q

What is Face Presentation?

A

Mentum Anterior preform forceps delivery

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53
Q

What is a Compound Presentation?

A

Arm or hand on head, vaginal delivery. (Mean’s Prolapse of fetal extremity with presenting part)

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54
Q

What is a Complete Breech?

A

Butt down, thighs, and legs flexed

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55
Q

What is a Frank Breech?

A

Butt down, thigh flexed, legs extended (Pancake)

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56
Q

What is a Footling Breech/Incomplete breech?

A

Butt down. Thigh flexed, one toe is sticking out of the cervical OS

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57
Q

What is a Double Footling Breech?

A

Two feet sticking outside the cervical OS

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58
Q

What is Shoulder Dystocia?

A

Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)

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59
Q

Can you try a Vaginal Delivery on a woman who has had a Classic Horizontal C-Section previously?

A

No, they must have C-Section for all future pregnancies

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60
Q

Can you try a Vaginal Delivery on a woman who had a LOW Transverse C-Section previously?

A

Yes, 70% are okay, Potential for uterine wall rupture

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61
Q

What is Early Deceleration?

A

Normal due to head compression

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62
Q

What is Late Deceleration?

A

Due to uteroplacental insufficiency because the placenta cannot provide oxygen and nutrients

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63
Q

What is Variable Deceleration?

A

Cord Compression

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64
Q

What is increased beat-to-beat variability?

A

Fetal Hypoxia

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65
Q

What is Decreased beat-to-beat variability?

A

Acidemia

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66
Q

What are the SYmptoms of Pre-eclampsia?

A

Headaches, changes in vision, and epigastric pain

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67
Q

What is Pre-Eclampsia?

A

Ischemia to the placenta causes HTN greater than 140/90

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68
Q

What is the Treatment for Pre-Eclampsia?

A

Delivery, MgSO4 (seizures), Hydralazine (BP)

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69
Q

What is HELLP Syndrome?

A

Hepatic injury causing:
H- Hemolysis
EL- Elevated Liver Enzyme
LP- Low Platelets

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70
Q

What is Eclampsia?

A

HTN with seizures

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71
Q

What is the Treatment for Eclampsia?

A

4mg MgSO4 IV (Seizure prophylaxis)

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72
Q

What is Chorioamnionitis?

A

Fever, uterine tenderness, increased fetal HR

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73
Q

What are the symptoms of Amniotic Fluid Emboli?

A

Mom just delivered Baby and mom has SOB, due to PE, leads to death

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74
Q

What is Endometritis?

A

Postpartum uterine tenderness

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75
Q

What is an Incomplete Molar Pregnancy?

A

2 Sperm + 1 egg (69, XXY) mom “cooks the parts” has embryo parts

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76
Q

What is a complete molar pregnancy?

A

2 Sperm and no egg (46, XX) both are paternal, bunch of graps, dad eats grapes, no embryo
(GROSS!)

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77
Q

What is Pseudocyesis

A

Fake pregnancy with all the signs and symptoms

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78
Q

What is the most common cause of first trimester maternal death?

A

Ectopic pregnancy

79
Q

What is the most common cause of first trimester spontaneous abortions?

A

Chromosomal abnormalities

80
Q

What are the most common causes of third trimester spontaneous abortions?

A

Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix

81
Q

What is a threatened Abortion?

A

Cervix is closed, baby is intact, treat with bed rest

82
Q

What is inevitable Abortion?

A

Cervix is open, baby is intact

83
Q

What is an incomplete Abortion?

A

Cervix is open, fetal remnants

Tx: D&C to prevent placenta infection

84
Q

What is a Complete Abortion?

A

Cervix is closed, no fetal remnants, check B-HCG level

85
Q

What is a Missed Abortion?

A

Cervix is closed, no fetal remnants

Tx. D&C

86
Q

What is a Septic Abortion?

A

Fever greater than 100.4 F, malodorous discharge

87
Q

What is Placenta Previa?

A

The placenta is implanted wholly or partially in lower uterine segment

88
Q

Waht is Vasa Previa?

A

placental blood vessels over OS

89
Q

What is Placenta Accreta?

A

Placenta is attached to the endometrium

90
Q

What is Placenta Percreta?

A

Placenta perforates through serosa

91
Q

What is Placenta Abruptio?

A

Severe pain due to premature separation of the placenta

92
Q

What is Velamentous Cord Insertion?

A

Fetal vessels insert between chorion and amnion

93
Q

What is Uterus Rupture?

A

Tearing sensation, halt of delivery

94
Q

What is an Apt Test?

A

Detects HbF in the Vagina, detects baby’s hemoglobin (Alkali denaturation test)

95
Q

What is Wright’s Stain?

A

Detects nucleated fetal RBC in mom’s vagina

96
Q

What is a Kleihauer-Betke Test?

A

Detects percentage of fetal blood in maternal circulation (Dilution test)

97
Q

What is Materninty Blues?

A

Postpartum crying and irritability

98
Q

What is Postpartum Depression?

A

Depression post-delivery for more than 2 weeks

99
Q

What is Postpartum Psychosis

A

Hallucinations, suicidal/infaticidal thoughts

100
Q

What does Seminal Vesicle give to Sperm?

A

Food (Fructose) and clothes (semen)

101
Q

What does the Bulbourethral/ Cowper’s Glands secrete?

A

Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)

102
Q

What does the Prostate Secrete?

A

The prostate HAZ it.
H- Hyaluronidase
A- Acid Phosphatase
Z- Zinc

103
Q

What is the Capacitation reaction?

A

Allow binding btwn sperm & egg

104
Q

What is the Acrosomal reaction?

A

Sperm release enzymes to eat the Corona Radiata

105
Q

What is the Crystallization reaction?

A

Wall formed after one sperm enters to prevent polyspermy

106
Q

Where does Testosterone come from?

A

Adrenal gland and testicles

107
Q

Where does DHT come from?

A

Testicles at puberty

108
Q

What is Pseudohermaphrodite?

A

external genitalia problem

109
Q

What is a True Hermaphrodite?

A

Internal genitalia problem (has both sexes)

110
Q

What is a Female Hermaphrodite?

A

Impossible because female is the default formation

111
Q

What is a Female Pseudohermaphrodite?

A

XX with LOW 21-OHase and HIGH Testosterone

112
Q

What is a Male Hermaphrodite?

A

XY with no MIF

113
Q

What is a Male Pseudohermaphrodite?

A

XY with LOW 17-OHase and LOW Testosterone

114
Q

What is Hirsutism?

A

Hairy female (Excess growth in normal male areas)

115
Q

What is Virilization?

A

Female that is Man like

116
Q

What is Testicular Feminization (Androgen Insensitivity Syndrome)?

A

Males with defective / bad DHT receptor, they are XY with a blind pouch vagina

117
Q

What is McCune-Albright?

A

Precocious sexual development, polyostotic fibrous dysplasia “whorls of connective tissue”, “coast of Maine” pigemented skin macules

118
Q

What is Cryptorchidism?

A

Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA

119
Q

Which stage of the Menstrual Cycle has the highest Estrogen levels?

A

Follicular stage (Has proliferative endothelium)

120
Q

What stage of the menstrual cycle has the highest Temperature?

A

Ovulatory stage, body temp will rise One degree during ovulation

121
Q

What stage of the Menstrual Cycle has the highest level of Progesterone?

A

Luteal stage (Has secretory endothelium)

122
Q

What form of Estrogen is highest at Menopause?

A

E1: Estrone (Made by Fat)
E2: Estradiol (Made by the ovaries)
E3: Estriol (Made by the placenta)

123
Q

What states have increased Estrogen?

A

Pregnancy, liver failure, P-450 inhibition, and obesity

124
Q

What is Adenomyosis?

A

Growth of the Endometrium, Myometrium, and patients will have an enlarged “boggy” uterus with cystic areas

125
Q

What does DES taken by Mom cause in her Daughter?

A

Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions

126
Q

What is Kallmann’s Syndrome?

A

No GnRH and Anosmia. (They can’t smell)

127
Q

What is Polycystic Ovarian Syndrome?

A

Increased cysts. No ovulation due to no Progesterone, leads to increased Endometrial CA, they cannot inhibit LH, obese, hairy, acne

128
Q

What is Savage’s Syndrome?

A

Ovarian resistance to LH/FSH

129
Q

What is Turner’s Syndrome (XO)?

A

High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve

130
Q

What does the Progesterone Challenge Test tell you?

A

Vaginal bleeding if she has estrogen. If she does not bleed, she has no E2 or ovaries
Increased FSH: Ovary problem
Decreased FSH: Pituitary problem

131
Q

What is SHeehan Syndrome?

A

Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk

132
Q

What is Asherman’s Syndrome?

A

Uterine scars from multiple D&Cs

133
Q

What is Oligomenorrhea?

A

Too few periods

134
Q

What is Polymenorrhea?

A

Too many periods

135
Q

What is the most common cause of post-coital Vaginal Bleeding?

A

Cervical CA

136
Q

What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?

A

Placenta previa

137
Q

What is the most common cause of Vaginal Bleeding in Post-menopausal women?

A

Endometrial CA

138
Q

What is Chronic Pelvic Pain?

A

Endometriosis until proven otherwise

139
Q

What is Dysfunctional Uterine Bleeding?

A

Diagnosis of exclusion, usually due to anovulation

140
Q

What is Dysmenorrhea?

A

PG-F causes painful menstrual cramps. (Teenagers miss school / work)

141
Q

What is Endometriosis?

A

Painful cyclical heavy menstrual bleeding

“Powder burns and chocolate cysts” due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)

142
Q

What is Kleine Rechnung?

A

Scant bleeding at ovulation

143
Q

What is Menorrhagia?

A

Heavy menstrual bleeding

144
Q

What are Fibroids (Leiomyoma’s)?

A

Benign uterus smooth muscle tumor
submucosal type: they bleed
Subserosal type: they cause pain

145
Q

What is Metorrhagia

A

Bleeding or spotting in btwn periods

146
Q

What is Mittelschmerz

A

Pain with ovulation

147
Q

What causes Syphilis?

A

Treponema Pallidum (Spirochete)

148
Q

What is Herpes?

A

ds DNA virus

149
Q

What is HPV?

A

ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD

150
Q

What is Chlamydia?

A

Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus)
Conjunctivitis

151
Q

What causes Gonorrhea?

A

Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort

152
Q

What causes Chancroid?

A

Haemophilus Ducreyi

153
Q

What causes Granuloma Inguinale?

A

Calymmatobacterium
Granulomatosis
Klebsiella Granulomatis

154
Q

What is Epididymitis?

A

Chlamydia Trachomatis. Unilateral scrotal pain decreased by support

155
Q

What is the most common cause of Epididymitis?

A

Chlamydia Trachomatis, N. Gonorrhea, E. Coli

156
Q

What is Condylomata Lata?

A

Flat fleshy warts, ulcerate = secondary syphilis

157
Q

What is Condyloma Acuminata?

A

Verrucous “cauliflower” warts, koilocytes, due to HPV 6 and 11

158
Q

How does Herpes present?

A

Primary: Painful grouped vesicles on red base
Secondary: Painful solitary lesion

159
Q

How does Syphilis present?

A

Primary: Painless Chancre (1-6 weeks)
Secondary: Rash and Condyloma Lata (After 6 weeks)
Tertiary: Neurological and Cardiac issues, in Bone (after 6 years)

160
Q

How does Chancroid present?

A

Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)
“School of Fish” pattern

161
Q

How does Lymphogranuloma Venereum present?

A

Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis

162
Q

How does Granuloma Inguinale present?

A

Spreading ulcer, Donovan bodies, due to Klebsiella Granulomatis (rod shaped), oval organism that can be seen in the Cytoplasms of Phagocytes or in tissue of people with grauloma inguinale

163
Q

How does chlamydia present?

A

Cervicitis (Yellow pus), conjunctivitis, PID

164
Q

How does Gonorrhea present?

A

Palmar pustules, arthritis/joint pain, urethral discomfor

165
Q

What is Epididymitis?

A

Unilateral scrotal pain decreased by support

166
Q

What causes Congenital Blindness?

167
Q

What causes Neonatal Blindness

168
Q

What is Lichen Simplex Chronicus?

A

Raised white lesions, chronic scratching

169
Q

What is Lichen Sclerosis?

A

Paper like vulva, itching, CA risk

170
Q

What is Hidradenoma?

A

Sweat gland cysts

171
Q

What causes non-bacterial Fetal infections?

A 
"TORCHS
T- Toxoplasma
O - Others (HIV, Measles, B-19)
R - Rubella
C - CMV
H - HSV-2
S - Syphilis
172
Q

What is Toxoplasmosis?

A

Multiple ring enhancing lesions, loves parietal love, from cat urine and feces

173
Q

What happens with Rubella infections in utero?

A

Cataracts, hearing loss, PDA, “blueberry muffin” rash (Rash on face that spreads to trunk)

174
Q

What do you see in CMV in utero infections?

A

Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications

175
Q

What is seen in newborn with HSV-2 in utero infections?

A

Temporal Lobe encephalitis, must offer C-section to mom with active lesions

176
Q

What is seen in newborns with Syphilis in utero infection?

A

Rhages (lip fissue), Saber shin legs (anterior bowing of the tibia), Hutchinson’s Razor teeth,Mulberry Molars

177
Q

What is Paget’s disease of the Breast?

A

Rash and ulcer around the nipple, breast CA

178
Q

What is Lobular Carcinoma?

A

Cells line up single file, contralateral breast is primary site of CA

179
Q

What is Comedocarcinoma?

A

Multiple focal areas of necrosis (blackheads) DCIS

180
Q

What is Inflammatory Carcinoma?

A

Infiltrates Lymphatics, pulls on Cooper’s Ligaments “Peau d’Orange”

181
Q

What is Cystosarcoma Phylloides?

A

Exploding Mushroom

182
Q

What is Intraductal Papilloma?

A

Bleeding from the nipple

Most common Breast CA

183
Q

What is Ductal Carcinoma?

A

Worst prognosis Breast CA

184
Q

What is Sarcoma Botryoides?

A

Vaginal CA, looks like a ball of grapes

185
Q

What is a Sister Mary Joseph Nodule?

A

Ovarian CA that has spread to the umbilicus
(Also GI cancers can cause)
(Indicates metastasis)

186
Q

What is Meig’s Syndrome?

A

Pleural effusion, ovarian fibroma, ascites

187
Q

What are the side effects of Estrogen?

A

Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins

188
Q

What are the side effects of Progesterone?

A

Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melisma (AKA Chloasma)

189
Q

What makes Progesteron <10 week gestation?

A

Corpus Luteum

190
Q

What are the four Painful Genital Lesions?

A

Herpes
Chancroid (It makes you cry… H. Ducreyi) Lymphogranuloma Venereum
Lymphogranuloma Inguinale

191
Q

How do you predict a due date with Nagele’s rule?

A

Subtract 3 mo. from LMP (last menstrual period)
Add 7 days, if her cycle is 28 days (i.e: LMP Jan 7, 2016 would have an estimated date of Oct. 14, 2016)
If her cycle is more than 28 days add 1 day for each extra day of the cycle

192
Q

Why is Nagele’s Rule Inaccurate?

A

Because it does not start from Ovulation date

193
Q

Male Hermaphrodite vs Male Pseudohermaphrodite vs Androgen Insensitivity syndrome (Test Fem)

A

Male hermaphrodite - absence of MIF
Male pseudohermaphrodite- low 17oh
AIS- TF

tsomkapQ (117 decks)

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