Triads Flashcards
PKU
Phenylketonuria
Musty urine and body odor
Mental or growth delay
Autosomal recessive
Treatment: tyrosine, decrease phenylalanine
Granulosa Cell Tumor Histology Findings
Coffee bean nuclei
Call-exner bodies
Juvenille adnexal tumors
Granulosa cell tumors
Granulosa cell tumor marker
Inhibin
Alpha-fetoprotein is a tumor marker associated with:
Endodermal sinus tumor
Immature teratoma
Embryonal carcinoma
Lichen simplex chronicus
Persistent pruritus, plaque lesions, linear ulcerations
Can be in Juvenilles
Lichen planus
Deep, erythematous erosions; shiny purlple and pruritic papules; possible white lacy striae (Whickham striae)
Lichen sclerosus
Itchin and burning of skin
Thin, crinkling “Cigarette paper”
Hourglass “figure of 8”
Zoledronic acid, Alendronate, Risedronate
Bisphosphonate that inhibits osteoclast bone resorption
What causes damage to genitofemoral nerve or lateral femoral cutaneous nerve?
- Retractor use
- Dissection of external iliac lymph nodes
- Removal of large pelvic mass
Symptoms of genitofermoral nerve injury?
Parasthesia of labia and upper medial thigh
Symptoms of lateral femoral cutaneous nerve injury
Parasthesia and pain that radiates down the anterior and posterior aspect of the thigh
What causes obturator nerve injury?
Passage of trocar
Lymph node dissection in obturator fossa
Symptoms of femoral nerve injury
Weakness in quadriceps and iliopsoas muscle
Type of forceps for infant with molded head
Simpson forceps
Main coagulation factors increased with estrogen use?
Factor VII, Factor X and Fibrinogen
Which pelvis type is most associated with deep transverse arrest in labor?
Platypelloid
Alternate medical therapy for urinary continence in people that cannot tolerate antimuscarinic
Micabegron (beta 3-adrenoceptor agonist)
Overactive bladder medical therapy
Antimuscarinic agents - to block acetylcholine stimulation of muscarinic receptors
Adrenergic agonists - to promote beta-receptor stimulation of the sympathetic nervous system
Leads to detrusor smooth muscle relaxation, increased bladder capacity, decreased urgency
OCPs ____endometrial proliferation and ____ menstrual prostanoids. They ____ uterine hypercontractility by _____ serum levels of vasopressin
(Increase or Decrease)
Decrease endometrial proliferation
Decrease menstrual prostanoids
Decrease uterine hypercontractility
Decrease serum vasopressin
LeFort Colpoclesis
Aim: To reduce prolapse back into the pelvis by obliterating the vaginal canal
Indication: Symptomatic prolapse who are unable to tolerate or do not desire longer or more extensive procedures and who no longer desire intercourse
Posterior vaginal repair (posterior colporrhaphy) and perineorrhaphy - Aim and Indication
Aim: To correct posterior wall prolapse
Indication: For the treatment of rectocele, defects of the perineum, or both
Anterior vaginal repair (anterior colporrhaphy) - Aim and Indication
Aim: To correct anterior wall prolapse
Indication: To be used for the treatment of bladder or urethra prolapse
Sacrospinous fixation (aim and indication)
Aim: To correct upper vaginal prolapse
Indication: Performed at the time of hysterectomy or in patients with post hysterectomy vaginal vault prolapse
Uterosacral ligament suspension (aim and indication)
Aim: To current upper vaginal prolapse
Indication: Performed at the time of hysterectomy or in patient with posthysterectomy vaginal vault prolapse
Abdominal sacral colpoplexy (aim and indication)
Aim: Correct upper vaginal prolapse
Indication: Women with recurrent cystocele, vault prolapse, enterocele
Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH)
Vaginal agenesis (abnormalities in uterus, normal ovaries_
Pemphigoid gestationalis
An autoimmune bullous disease of pregnancy notable for intense pruritus, urticarial plaques, papules surrounding the umbilicus.
SPARES mucous membranes
Dx: measurement of serum levels of anti-BP180 antibodies by
The foramen ovale carries blood from the _____ to the ______.
Right atrium; left atrium
The ductus arteriosus carries fetal blood from the ____ to the ____.
Pulmonary artery, aorta
Presentation of Congenital Varicella?
Scarring in dermatomal pattern Limb abnormalities Microcephaly Hepatic calcifications Growth restriction
What is the threshold serum glucose value for a 75g, 2hr glucose tolerance test that is diagnostic of DM?
> 200mg/dL
Which type of pelvis is associated most with failed vaginal delivery and an increased rate of cesarean delivery?
Android pelvis
Pruritic urticarial papules and plaques of pregnancy
Periumbilical sparing and presence of lesions within abdominal striae
Teratogenic effects of carbamazepine
- Neural tube defects
- Cardiovascular defects
- Urinary tract defects
Teratogenic effects of valproic acid
- Spina bifida
- Clef palate
- Facial dysmorphism
Best antiepileptics in pregnancy (2)?
Lamotrigine, Levetiracetam
Klebsiella Granulomatis under the microscope
Under Wright-Giemsa stain, classic Donovan bodies are seen inside macrophages (appear to look like safety-pin)
Presentation of Klebsiella granulomatis vaginal lesions
Nodular lesions that develop into ulcers with rolled margins. Appear beefy red and expand outward. PAINLESS without lymphadenopathy.
Cushing’s disease presentation (7)
Rapid weight gain Proximal muscle weakness Moon face Dorsal and supraclavicular fat pads Wide violaceious stria Hirsutism Hypertension
Management of McCune-Albright Syndrome
- Aromatase inhibitor
- SERM (tamoxifen)
- Estrogen receptor antagonist
McCune-Albright Syndrome Triad
- Precocious puberty
- Cafe-au-lait spots (unilateral)
- Polyostotic fibrous dysplasia (fibrous tissue growth in multiple bones - prone to fractures and limping)
McCune-Albright Syndrome - What is it and what is the genetic defect?
Most common cause of GnRH-independent precocious puberty
Mechanism: Somatic mutation of the G-Protein that activates adenylyl cyclase, leading to continuous endocrine stimulation
Trisomy 21 Presentation
Thickened nuchal fold, mild ventriculomegaly, duodenal atresia, cardiovascular defects (including VSD, endocardial cushion)
Trisomy 13 (Patau Syndrome) Presentation
Holoprosencephaly
Polycystic kidneys
Polydactyly
Urogenital defects
Quad screen results
AFP, Estriol, B-Hcg, Inhibin A
Trisomy 21: Down, Down, Up, Up
Trisomy 18: Down, Down, Down, Normal
Trisomy 13: Normal, Normal, Down, Normal
Trisomy 18 presentation
Small mouth Micrognathia Growth restriction Pointy Ears Clenched Hands Clubbed or rocker-bottom feet Chorioid plexus cysts Congenital heart defects
Mechanism and side effect of Bleomycin
Inhibits DNA synthesis
Pulmonary toxicity
Management of PID (or septic abortion)
IV Antibiotics:
Cefoxitin + Doxycycline (or Clinda) + Gentamycin
Autosomal dominant diseases
Ehlers-Danlos, Marfan, Noonan, Peutz-Jeghers, Von-Hippel-Lindau, Neurofibromatosis
Autosomal recessive diseases
Cystic fibrosis, Sickle cell disease, spinal muscular atrophy, Tay-Sachs
X-linked diseases
Hemophilia, color blindness, fragile X syndrome
