UW 6 Flashcards
Risk factors for endometrial cancer
Unopposed estrogen activity:
Anovulatory cycles (POS)
Obesity
Tamoxifen use
Exogenous estrogen only therapy
Type II (Serous) has no relationship with estrogen but with the presence of p53 gene mutation
Abnormal uterine bleeding dxx
Polyps: pailess intermenstrual bleeding, no uterine elargment, 30-40 yoa
Adenomiosis: painful, heavy menstrual bleeding. Boggy, uniformily enlarged uterus. Normal menstrual cycle
Leyomioma: Heavy prolonged menses with an irregularly enlarged bulky uterus
Neoplasia: in patients with hx of unopposed estrogen activity.
Anpahylaxis presentation
Cardiovascular: vasodilatation (edema, low bp, tachycardia)
Respiratory: bronchoconstriction, upper airway edema (stridor, hoarness)
Skin: urticaria, pruritus, flushing
GI: nausea, diarrhea, vomiting
2 or more Systems affecred to make diagnosis. 20% dont show skin symptoms
Clues to renovascular disease
Related to HTN: resistant HTN, malignant HTN, onset of severe (180/120) HTN after 55, severe HTN with difuse atherosclerotic disease, recurrent flash pulmonary edema with severe HTN
Physical examan: abdominal bruit, size difference between kidneys.
Labs: unexplained rise in creatinine (>30%) after initiating ACEI or ARA II inhibitor
Imaging: unexplained atrophic kidney
Workup of a solid breast mass
<30 yoa: US +- mamography. If cystic lesion, do FNA (if patient desires). If complex cystic/solid do image guided biopsy
> 30 yoa: mamography +- US. If suspicious, do a core biopsy
Malignant hyperthermia presentation (6)
Produced by anesthetics, halothane, succinylcholine, heat
Muscle rigidity Rhabdomyolisis Tachycardia Hypercabia (resistant to increased minute ventilation) Hyperkalemia Hyperthermia (late finding)
(Looks similar to neurleptic malignant sd.; look for hx of antipsychotics)
Primary amenorrhea workup
Definite diagnosis:
With secondary sexual characteristics:
Outflow obstruction or 2nd amenorrhea evaluation
XX: mullerian dysgenesis (normal secondary sexual characteristics, normal female testosterone level)
XY: complete androngen insensitivity (breast develope but no pubic hair, very high testosterone)
Without secondary secondary sexual characteristics
Hypogondatrophic hypogonadism (Low LH/FSH). Kallman sd if anosmia
XX: premature ovarian failure
XY: Sawyer sd (gonadal dysgenesis)
XO: turner
XY females dxx
Complete androgen insensitivity
5-a reductase deficiency. virilization occurs at puberty
Effects of marternal diabetes on fetus (2)
High maternal glucose stimulates insuline and insuline-like growth factor. Promotes growth and fat deposition (macrosomia)
Fetal hyperglycemia induces osmotic diuresis and polyuria causing polyhydramnios
Uterine size discrepancy with gestational age
Estimation of Gestational age with fundal height
After 20 weeks, gestational age corresponds to fundal height +/- 2-3cm
Cause and complication of oligohydramnios
Index <5
Uteroplacental insuficiency Renal anomalies NSAIDs preeclamsia Abruptio placentae
Meconium aspiration, preterm delivery, umbilical cord compresion
Cause and complication of polyhydramnios
Index >24
Esophageal/duodenal atresia Diabetes Congenital infection Multiple gestation Anencephalia
preterm labor, preterm premature rupture of membranes, fetal malposition
Pathogenic mechanism of alzehimer
Cerebral amyloid deposition
Lead poisoning manifestations
Non-specific: fatige, irritability, insomnia
GI: constipation, abdominal pain, anorexia
Neuro: cognitive deficits, peripheral neuropathy (glove-stocking sensation loss, extensor weakness (wirst or foot drop)
Wernike-Korsakov sd.
Wernike: encephalopathy, ophtalmoplegia, ataxia
Korsakove: amnesia, nystagmus, confabulation
