UW 22 Flashcards
Definition of precocious puberty
Development of secondary sexual characters
<8 girls
<9 boys
Hair, odor, acne: androgens
Breast: estrogen
Vaginal hematoma
Risks:
>4kg baby
Nullyparity
Forceps
Injury to the uterine artery and accumulation of blood in perivaginal space until is big enough to protrude
Expectant management if stable
Surgical management if unstable
Risk for preeclampsia
Systemic disease (lupus, chronic hypertension) Hypertension Multiple gestation Nullyparity Advanced maternal age
Diabetic mom needs a baseline protein level
Lupus mnemonic
DOPAMINE RASH
Discoid rash Oral urlcers Photosensitivity Arthritis Malar rash Immuno: DNA, sM antibodies Elevated ESR Renal impairment ANA antibodie Serositis Hematologic cytopenias: (autoimmune destruction)
Risk factor for surgical site infection
Malnutrition: hypoalbuminemia, obisity
Smocking
Poorly controlled DM, vascular disease, venous disease
Steoroids, immunosupresants, chemotherapy
Infection on other site of the body
Advanced age
Risk factors for Otitis media
Smocking exposure
Lack of breastfeeding
Age 6-18 months (eustachian tubes being straight and narrow)
Daycare
Treatment for otitis media
Amoxicillin
Amoxi-clav
Clynda or azithromycin for penicillin allergies
Choroid plexus papilloma
Brain tumor
Increases production of CSF
Macrocephaly, ventriculomegaly
Symptoms of Increased intracranial pressure
Contraindications of Dpt vaccine
Anaphylactic reaction
Encephalopathy, infantile spasm, uncontrolled epilepsy within a week of TDaP
Post exposure prophylaxis to Pertusis
Any close contact within 21 days of exposure
Azytro, Clarythro, Erithro
Management of Uterine invertion
Agressive IV fluis
Replace uterus
Remove placenta and uterotonics (after manual replacement)
Caustic injuries management
At home:
Remove clothing, clean person
Do not induce vomiting
At hospital arrival:
Confirm decontamination
Chest and abdominal x-rays
+/- Intubation if severe, gastric lavage
Later:
Upper endoscopy 12-24 hrs
Upper GI series
Consider nasogastric tube placement
Umbilicated papule skin lesion
Molluscum
Cryptococcus
Treatment for Cryptococcal meningitis
Anphotericin B + flucytosin for 2 week
Fluconazol for 8 weeks
Presentation of Cryptococcal meningitis
AIDS <100 CD4
Confusion, altered mental status
Sings and symptoms of elevated ICP (headache, nausea, vomitig, VII palsy)
May present with papular umbilicated lesions that look like Molluscum
Management of Hypertension and Diabetes after delivery
Gestational diabetes:
………. Fasting glucose at 24 and 72hr
………. 2hr glucose tolerance 6-12 weeks after delivery
………. Check every 3 years due to increased risk
Preeclampsia can develop up to 12 weeks postpartum
……… Check for urine protein if hypertensive
Target glucose level in pregnant patient
Fasting <90
1hr <140
2hrs <120
Non caseating granulomas (lung)
Hypersensitivity pneumonitis
Sarcoidosis
Goodpasture
Hypersensitivity pneumonitis
Acute and chronic presentation
Acute:
Episodes of “self limiting” pneumonia-like symptoms
Dyspnea, dry cough, malaise, fever, leukocytosis
Within 4-6 hrs of exposure
Mirconodular infiltrates
Chronic:
Progressive dyspnea, couch, weight loss
CMV retinitis
Central vision loss, scotomata (blind spots), floaters and photophobia
Sub acute presentation
Yellow fluffy lesion in the retina, close to retinal vassels
Examination of herpes simplex retinitis
Fluoresin dye test
Other CN deficits with vestibular shwanoma
CN V and VI palsy
Causes of Sensorineural hearing loss
Vestibular shwanoma
Meniere disease
Presbicusis
Aminoglycosides
RIne y Weber test
Rine:
Normal and conductive: AC>BC
SN: BC>AC
Webber
Lat toward affected side: conductive
Lat away from affected side: SN
Causes of conductive hearing loss
Cerumen Otitis externa or media Timpanic perforation Cholestoma Otosclerosis (worse in pregnancy, autosomal dominant)
Varizella vaccine and PEP
1 and 4 yoa
If Hx of diseases or to dosis: observation
Within 10 days of exposure
Immunocompetent: vaccinate
Immunocompromised/pregnant: VZIG
Myelocyte vs. metamyelocyte
Metamyelocyte is more mature
More in leukemoid reaction
What cell line is affected in Myeloid leukemias
Neutrophil
Huntintong chorea.. where is the lesion?
Caudate nucleus
Breast pain evaluation
Cyclic:
Mass: imaging
No mass: observation
No cyclic
Mass: biopsy
No mass: imaging
Immune reconstitution inflammatory sd
Patient with HIV recently initiated in antiretroviral therapy. Seem to get worse because of “reactivation of immune system”
Dupuytren contracture
Lo que tiene galdos
Imaging for ginecological pathology
US has higher sensitivity than CT
Eye exam in herpes simplex infection
Dendritic ulcers in the cornea and eye vesicle
CMV sequelae of intrauterine infection
Sensorineural hearing loss
Periventricular calcification
Toplasmosis sequelae of intrauterine infection
Chorioretinitis
Obstructive hydrocephalus
Intracerebral calcification
Eating disorder pharmacological treatment
Anorexia: olanzapine
Bulimia: fluoxetine
Binge eating: SSRI, topiramate, lisdexanphetamine
Complication of high voltage electrical injury
Compartment sd
Rhamdomyolisis
Heme pigment induced AKI
Management of gestational diabetes
First line: Dietary modifications
Second line: Insulin, metformin (equally effective)
