UW 5 Flashcards
What are PCOS women deficient in
Progesterone
What is happening with estrogen in PCOS
Unopposed estrogen
Pt complains that straight lines appear wavy
Test?
Si/sx’s?
Macular Degeneration
- Grid test
- Driving and reading - activities affected
- Centrally located macula does fine visual acuity
When is enlarged blind spot seen
Papilledema
Karyotype and Presentation of Kallmann syndrome
Normal Karyotype: Female 46 XX, Male 46 XY
Normal genotype and internal productive organs
Absence of GnRH
- Females = Primary Amenorrhea, absent breasts
- Males = Eunuchoid, small external genitalia, absent secondary sexual traits - pubic hair, libido, deep voice
- Anosmia
Labs in Kallmann
Low FSH
Low LH
What is the cause of Secondary HTN in hyperthyroidism
Hyperdynamic state
- increased expression of myocardial sarcoplasmic reticulum Calcium dependent ATP
- Increased target organ sensitivity to endogenous catecholamines
Which kind of HTN in thyrotoxicosis
Predominantly Systolic
Hypothyroidism induced HTN
What kind and MOA
Diastolic
Increased SVR
Pathophys of thyroid level changes in pregnancy
- hCG stimulates TSH receptor
- Increased estrogen causes increase in production of TBG = increased TBG-bound T3 and T4, so total T3 and T4 are high
- SO increase in TBG, total T3, T4
Normal TSH, free T4, T3
Free air under diaphragm
Perforation
Porcelain Gallbladder
Presentation
TX
Calcium-laden GB Bluish/brittle Chronic Cholecystitis RUQ pain, mass TX: Cholecystecomy to prevent GB Cancer = Adeno
Gallstone ileus
pathophys
DX
TX
Large gallstones cause fistula formation bt GB and small intestine. Gallstone enters and obstructs intestine
DX: Presence of air in biliary tract
TX: Surgery
TX for TTP
Emergent Plasmapheresis to remove autoabs and replace deficient enzymes
TX for hypercalcemia
Symptomatic moderate and severe > 12
- IV Saline Hydration
- Calcitonin
During fasting, what happens to glycogen levels
Drop in first 12 hours
GN kicks in, and after 24 hrs - main source of glucose
Main substrates for GN
- Gluconeogenic amino acids - Alanine is main one
- Lactate
- Glycerol-3-Phosphate - intermediate break down of adipose
Alanine is converted to?
Pyruvate in GN
Lactate is converted to?
Pyruvate in GN
From anaerobic glycolysis
Older children w intussusception
Etiology
TX
Pathological lead point
Meckel’s diverticulum MCC in GIT
TX: Surgical resection
MC malignancy of thyroid gland
Papillary thyroid cancer
- Best prognosis