Rosh (1/11 - ...) Flashcards
1
Q
Treatment for toxo
A
To stop transmission: spiramycin
To treat current infection in fetus: pyrimethamine, sulfadiazine, folinic acid
2
Q
FRAX score indicating DEXA
A
> 9.3%
3
Q
EPDS downside
A
Requires population validation
4
Q
Most common mode of urinary tract injury
A
Electrosurgery
5
Q
KRAS
A
Hereditary colorectal cancer
6
Q
MSH2
A
DNA mismatch repair associated with lynch syndrome —> colorectal, endometrial, ovarian
7
Q
PTEN
A
Cowden —> hamartomas with risk for breast, endometrial, colorectal, kidney, and thyroid cancer
8
Q
Mastitis treatment if PCN allergy
A
Erythromycin
9
Q
Fetal effect of MS
A
FGR, birth defects
10
Q
Cervical cancer type by HPV type
A
Squamous 16
Adenocarcinoma 18
11
Q
Chemo for cervical cancer
A
Cisplatin
12
Q
To counteract toxic effects of MTX… it
A
Leucovorin
13
Q
How do OCPs treat hirsutism?
A
Increase liver production of sex hormone binding globulin which then bind androgens
14
Q
Second line agents for hirsutism
A
Spironolactone, flutamide, finasteride, cyproterone acetate
15
Q
Mechanism of finasteride
A
5-alpha reductase inhibitor to stop testosterone conversion to active DHT
16
Q
Spironolactone mechanism
A
Antagonist to aldosterone and androgen receptor
17
Q
Flutamide mechanism
A
Anti androgen
18
Q
Chemo for granulosa cell tumor
A
Bleomycin, etoposide, cisplatin (BEP)
19
Q
Effects of ace inhibitors on fetus
A
Renal and limb abnormalities -> oligohydramnios and possible pulmonary hypo plasma
20
Q
Embryologic origins of Gartner duct cysts
A
Mesonephric ducts
21
Q
Embryologic origin of ovary
A
Genital ridge
22
Q
Embryologic origin of uterus, fallopian tubes, upper vagina
A
Paramesonephric ducts
23
Q
Embryologic origin of labia minora
A
Urogenital folds
24
Q
Embryologic origin of the urogenital system
A
Intermediate mesoderm
25
Relationship of obesity and breast cancer risk
Premenopausal, protective
| Postmenopausal, higher risk
26
Treatment for magnesium toxicity
15-30 mL of calcium gluconate 10% solution IV
27
Cancer risk with Paget's disease
20% have invasive adenocarcinoma
28
Pre-operative evaluation in Paget's disease
Mammogram, colonoscopy, pap -- risk of additional sites of involvement
29
Treatment for hyperprolactinemia
Twice weekly cabergoline
30
Posterior pituitary hormones
ADH (vasopressin) and oxytocin
| Neurohypophysis, cell bodies in hypothalamus and directly released through posterior pituitary
31
Hypothalamus hormones
Releasing hormones: GHRH, TRH, GnRH, etc
32
Anterior pituitary hormones
Prolactin, TSH, GH, ACTH, LH, FSH
33
Dopamine
Inhibits prolactin production
34
Cabergoline
Dopamine agonist
35
Endometriosis increases risk of what cancer?
Endometrioid adenocarcinoma or clear cell
36
Contraindications to live flu vaccine
Immunocompromised, pregnant, age >50 y/o
37
Most common site of endometriosis
Ovary, uterosacral ligaments
| Bowel, after definitive hyst, BSO
38
Amsel criteria
To diagnose BV, 3/4 present:
1. Whiff test
2. Clue cells
3. pH >4.5
4. Thin white discharge
39
Fastest treatment of hirsuit hair growth
Eflornithine cream (6-8 wks), inhibits ornithine decarboxylase
40
Best SSRI's while breastfeeding
Sertraline, paroxetine
41
Antidepressant contraindicated with history of seizure
Bupropion
42
Vaccines safe in pregnancy
Hep B, flu, Tdap, meningococcal, rabies
43
Embryologic origin of the Bartholin's gland
Urogenital sinus
44
When to biopsy a Bartholin's cyst
>40 y/o
45
Characteristics of type 2 endometrial cancer
Papillary serous, clear cell, carcinosarcoma -- no association with estrogen, occur at older age (>60y/o), more agressive, more often p53 mutation
46
Ideal day of embryo transfer after fertilization
Day 5 - blastocyst
47
Hormone causing lighter, finer hair growth
Estradiol
48
Most common immune cell in decidua in early pregnancy
Natural killer cell
49
Lynch syndrome screening
EMBx and pelvic exam annually starting at 30 y/o
50
Serum marker associated with placenta accreta
AFP
51
When to do EMBx
Age >45 y/o or risk factors like obesity
52
Branches of SMA
Right, middle, and ileocolic arteries
53
Branches of IMA
Left colic and sigmoid arteries
54
Omental blood supply
R/L gastroepiploic, gastroduodenal, common hepatic, splenic
55
Branches of external iliac
Inferior epigastric, deep circumflex iliac, becomes femoral artery
56
Posterior division of internal iliac
Superior gluteal, iliolumbar, lateral sacral
57
Anterior division of internal iliac
Umbilical (to superior vesicle), uterine (to vaginal), middle rectal, obturator, inferior gluteal, internal pudendal
58
Ovarian arteries
From aorta, below renal arteries
| Supply ovaries, fallopian tubes, broad ligament, ureters
59
Ovarian veins
Left to renal vein, right to IVC
60
Quad weakness, lost knee extension, thigh numbness (medial, upper)
Femoral nerve (retractor or extreme hip flexion / rotation)
61
Anterior and posterior thigh pain / paresthesias
Lateral femoral cutaneous (retractor compression)
62
Numb vulva
Genitofemoral (during LND)
63
Lost adduction of thigh, upper medial thigh numbness
Obturator nerve (during LND or TOT)
64
Sharp pain from incision downward
Ilioinguinal / iliohypogastric (entrapped during fascial closure)
65
Sciatica
Sciatic nerve (long surgery, asst leans on thigh)
66
Foot drop
Common peroneal (knee in stirrups)
67
Butt pain
Pudendal (during sacrospinous ligament fixation)
68
Unable to use arm
Brachial plexus (stretch)
69
Claw hand
Ulnar (elbow compression)
70
Nerve running along psoas
Genitofemoral
71
Referral to onc for premenopausal adnexal mass
CA-125 > 200 and concerning TVUS
72
Most common ovarian cancer mets
Endometrial, breast, GI tract
73
VTE, hypercalcemia, hyperpyrexia, unilateral adnexal mass, early mets
Clear cell (epithelial) ovarian cancer
74
Schiller Duval bodies
Endodermal sinus tumor (yolk sac)
75
Virilization and amenorrhea with adnexal mass
Sertoli-Leydig tumor
76
Dysgerminoma markers
Beta hcg, LDH
77
Endodermal sinus markers
AFP
78
Choriocarcinoma markers
Beta hcg
79
Immature teratoma markers
AFP, LDH, CA-125
80
Embryonal carcinoma markers
Beta hcg, AFP
81
Granulosa cell marker
Inhibin B
82
Ovarian cancer stage with chemo required
IC -- capsule rupture and/or positive washings
83
Stage 2 ovarian cancer
Pelvic organs
84
Stage 3 ovarian cancer
Peritoneal surfaces with mets
85
Stage 4 ovarian cancer
Pleural effusion with positive cytology, hepatic / splenic mets
86
Endometrial hyperplasia classifications
Benign (no atypia) or intrapithelial neoplasia (atypia, precancer)
87
Stage 1 endometrial cancer
A <50% myometrium
| B >50% myometrium
88
Stage 2 endometrial cancer
Cervical stroma
89
Stage 3 endometrial cancer
A serosa or adnexa
B vaginal or parametrial
C1 pelvic LN
C2 paraaortic LN
90
Stage 4 endometrial cancer
A bladder or bowel
| B distant met
91
Most common cause of death in cervical cancer
Uremia
92
HPV oncoproteins
E6 inhibits p53
| E7 inhibits Rb
93
Cancer associated with DES
Vaginal adenocarcinoma (most other vaginal cancer is squamous)
94
Lymphtic drainage of vagina
Upper 2/3 to pelvic nodes
| Lower 1/3 to inguinal
95
Cervical cancer mets
Lung, liver, bony
96
Theca lutein cysts associated with
Complete mole (not partial) -- due to excessive beta hcg
97
Percent of moles that become invasive
10-15%
98
Monitoring following mole
Weekly beta hcg until neg x 3 weeks, then q4wks x 6-12 mos
99
Dx of GTN
Plateau of beta hcg x 4 measurements OR rise >10% in 3 wks, or hcg still detectable 6 mos later
100
GTD treatment
MTX or actinomycin D for low risk
| EMA-CO for high risk
101
Mechanism of doxorubicin, bleomycin, antinomycin D
Free oxygen radicals
102
Mechanism of etoposide, vincristine
Inhibits topoisomerase
103
Mechanism of taxanes
Inhibits microtubule polymerization
104
Mechanism of platinums
Cross links DNA subunits
105
Mechanism of bavacizumab
VEG-F inhibitor
106
Mechanism of cyclophosphamide
Cross-link
107
Alopecia
Taxanes, antinomycin
108
Cardiotoxicity
Doxorubicin
109
Hemorrhagic cystitis
Cyclophosphamide
110
Interstitial pneumonitis
Doxorubicin
111
Nephrotoxicity
Cisplatin
112
Pulmonary fibrosis
Bleomycin
113
Secondary malignancy
Etoposide
114
Peripheral neuropathy
Taxol
115
Timing for risk-reducing BSO
BRCA1: 35-40 y/o
BRCA2: 40-45 y/o
