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THIRD YEAR > Repro 3 > Flashcards

Repro 3 Flashcards

1
Q

HIV

A

retro virus transcribes its RNA using reverse transcription

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2
Q

normal CD4

OI CD4 count

A

500-1600

<200 but can get infections 200-500

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3
Q

HIV viral replication

A

rapid in very early and very late

new gen every 6-12 weeks

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4
Q

average time to death without treatment

A

9-11 years

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5
Q

infection

A

infection of mucosal CD4 (langerhan and dendritic cells) - regional LNs
infection established within 3 days

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6
Q

epidemiology of HIV

A

MSM

low SES

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7
Q

when do px present

A

2-4 weeks after infection

fever, maculopapular rash, myalgia, pharyngitis, headache/aseptic meningitis

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8
Q

pneumocystis pneumonia

A

CD <200
inside onset, SOB, dry cough, exercise desat

high dose co tramoxazole (+/- steroid)
proph for low CD4 low dose co -tramox

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9
Q

TB and immune reconstitution syndrome

A

immune system reactivated but is more aggressive

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10
Q

cerebral toxoplasmosis

A

CD4 <150
reactivation of latent virus
multiple cerebral abscess, chorioventinitis
headache fever decrease level of consciousness focal neurology seizures increased ICP

MRI ring enhancing lesions

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11
Q

cytomegalovirus

A

CMV
CD4<50
reactivation of latent virus - retinitis, colitis, oesophagitis
decreased visual acuity, floaters, abdominal pain, diarrhoea, PR bleeding

ophthalmic screening CD4<50

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12
Q

HIV assoc neurocognitive impairment

A

HIV1

reduce short term memory +/- motor dysf

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13
Q

progressive multifocal leukonencephalophathy

A

JC virus
cd4<100
rapidly progressive
focal neurology, confusion, personality change

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14
Q

haematological

A

anaemia thrombocytopenia

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15
Q

non opportunistic infection symptoms

A

mucosal candida, seborrheic derm, diarrhoea, fatigue, worsening psoriasis, LD, STIs, hep B, hep C

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16
Q

kaposkis sarcoma

A

HPV 8
more common in MSM
HAART, local therapies - systemic chemo

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17
Q

non hodgkins lymphoma

A

EBV

HIV and HAARTs

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18
Q

cervical cancer

A

HPV

women screened every year rather than every 3 years

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19
Q

risks of HIV transmission

A

concurrent STIs, anoreceptve sex, trauma, genital ulceration

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20
Q

types of HIV transmission

A

sexual
parental
maternal

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21
Q

risk of maternal tranmission

A

1-2%

<0.1% when viral load undetectable

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22
Q

what markers are used in HIV

A

viral rNA
antigen P24
antibody

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23
Q

3rd gen

A

ABs IgG/IgM

window period 20-25 days

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24
Q

4th gen

A

AB and AG P24

WP 14-28 days

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25
Q

rapid hiv testing (POCT)

A

finger prick or saliva
short wait. simple. good sensitive
expensive. not suitable for high load

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26
Q

recent infection testing algorithm

A

can be used to measure if an infection has occurred within the preceding 4-6 months
large margin of error

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27
Q

HAART drugs taken how

A

single tablet taking once daily
tenofovir (NERTI)
emtricitabine (NRTI)
efavicrenz (NNTRI)

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28
Q

preventing drug resistance main thing

A

compliance

29
Q

prevention of HIV

A

condoms
rx
STI screening and treatment
post and pre exposure proph

30
Q

hiv pos female and hiv neg male

hiv pos male and hiv neg female

A

insemination for baby

unprotected sex with HAART, inseminsation

31
Q

prevention of maternal transmission

A

HAART during preg
if viral load undetectable vaginal, if high CS
4 weeks PEP for neonate
formula feeding

32
Q

risk factors for breast cancer

A 
age
gene mutations BRCA1, BRCA2, TP53, PTEN, ATM, STKII/LKBI
hyperplasia 
birth of first born after 30
alcohol
early onset of periods
FH
early menarche 
low parity
no BF
late menopause
endogenous or exogenous hormones 
BMI
33
Q

what reduces the risk of BC

A

NSAIDs

34
Q

BRCA1

BRCA2

A

chromosome 17

chromosome 13

35
Q

pre meno

post meno

A

tamoxifen for 5 years

aromatase inhibitors such as letrozole, Anastrozole

36
Q

beyond 5 years adjuvant therapy

A

5 years of tamox and now post meno then aromatase

if 5 years of tamox and still pre meno then more years of temox

37
Q

HER2

A

tratsuzumab (herceptin) for a year

38
Q

phyllodes tumrou

A

can be malignant
cut surface looks like a leaf
stromal and epithelial but stromal bit is neoplastic

39
Q

angiosarcoma

A

post radiotherapy for breast cancer

40
Q

atypical lobular hyperplasia

lobular carcinoma in situ

A

<50% of lobule involved

>50%

41
Q

e cadherin gene

A

negative in lobular
CDH1 gene deletion
cell adhesion gene

42
Q

pagets

A

high grade DCIS
extending along ducts to epidermis of nipple
still in situ
cytokerin used to stain

43
Q

micro invasive carcinoma

A

DCIS high grade

invasion of <1mm

44
Q

ER positive

A

oophorectomy
tamoxifen
letrozole
gosenlin

45
Q

nottingham prognostico index
adjuvant online
PREDICT

A

histopatho
histopatho + ER +CF
histopatho + ER + CF + HER2 + mode of detection

46
Q

triple assessment

A

clinical history and exam
imaging - mam, USS, MRI
pathology - cytopathology, histopatho, therapeutic

47
Q

fibroadenoma

A

looks like phyllodes but phyllodes is in older women and are larger and increase in size

48
Q

fibroadenoma

A

peak in 30s and repro life
can grow rapidly if become pregnant
african women

49
Q

breast mouse

A

fibroadenoma

50
Q

cysts

A

late repro life

FNA to dx and rx

51
Q

tender before mentruation

A

cysts

52
Q

papilloma

A

benign intracytic papillary prolif assoc with bloody cyst fluid

53
Q

pagets disease

A

eczema like changes to nipple

54
Q

adenolipoma

A

smooth palpable mass

characteristic mam pattern

55
Q

apocrine metaplasia

A

of epithelial cells which enlarge and are eosinophillis

line cysts

56
Q

glactocele

A

FNA to dx and treat

57
Q

lipoma

A

palpable
think smooth borders on mam
adipose cells on biopsy

58
Q

inflam of being just under chest wall

A

mordoms
firm vertical cords and history of trauma
resolves spontaneously in 8-12 weeks

59
Q

gynacamastia

A

ductal growth but no lobular growth

60
Q

fibrocystic change

A

40-50s

smooth discrete lumps, sudden pain of ruptured cyst, cyclic pain which changes with menstrual cycle, lump

61
Q

haemartoma

A

circumscribed lesion composed of cell types normal to the breast but in abnormal proportion or distribution
not troublesome - left alone

62
Q

sclerosing lesions

A

benign disorderly proliferation of acini and stroma
can cause mass of calcification
may mimic cancer

63
Q

sclerosising adenoma

A

pain or tenderness or lump/thickening
often asymp
benign

64
Q

radial scar

complex sclerosing lesions

A

RA 1-9mm
CSL >10mm

mimic cancer
cancer in situ/invasive can occur in the middle

65
Q

stellate architecture

A

central puckering
radiating fibrosis
fibroelastic core
epithelial prolif

RS/CSL

66
Q

duct ectasia

A

green/purulent/bloody dc

assoc with smoking

67
Q

duct ectasia what is it

A

keratin plugging
causes stasis of secretion - can lead to infection
affects sub areolar ducts

68
Q

how long does it take for the hcg to double

A

in 48 hours in early

THIRD YEAR (27 decks)

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