UW 8 Flashcards
Hyperandrogenism in pregnancy dxx
- Placental aeromatase deficincency: no ovarian mass, high risk of virilization for mother and fetus
- Luteoma: solid uni or bilateral ovarian mass. Moderate risk of virilizarion for the mother, high for the fetus
- Theca lutein cyst: cystic bilateral ovarian masses. modarete risk for the mother, low for the fetus
- Sertoli-leiding tumor: solid unilateral mass. High risk of virilization for mother and fetus
1, 2, 3: Regretion after pregnancy when B-hCG levels drop
- Remove during 2nd trimester or postpartum
B12 deficiency clinical manifestations
Peripheral neuropathy, paresthesia, confusion, irritabily, depresion, pyschosis
glositis (shiny tonge)
Subacute combine degenerations: affects dorsal colums, corticospinal and spinocerebellar tracts
requirements for strength training in kids
> 8 years old
shows interest in activity
supervised training
Clues to differentiate prerenal than intrinsic AKI
Sediment:
No sediment in prerenal
Intertitial nephritis: WBC on urianalysis
intranuclear ophtalmoplegia
impaired abduction on lateral gaze
Risk factors for MS (4)
Female, white, HLA-DRB21
Cold climates, farther from the ecuador , decreased sun light
Vitamin D deficiency
Smoking
Ca-125
Ovarian epithelial tumor (adenocarcinoma)
abdomial distation, bloating, bowel obstruction, adnexal mass
Ovarian tumor with
a. AFP
b. AFP+BhCG
a. Endodermal (yolk sack): Very agressive seen in young children. Gross exam shows a yellow solid mass
b. Embryonal carcinoma: seen in adolescents. May present with precocious puberty and abnormal uterine bleeding
Choriocarcinoma
Elevated B-hCG
During or after pregnancy. May be associated with theca-lutein cysts
Prenancy like symptoms. Severe nausea and vomiting
Dysgerminoma
Elevated LDH
Most common seen in adolescent
Fried egg appereance
Granulosa cell tumor
Elevated stradiol and ihibin
Seen en women in their 50s
Produces strogen and progesterone. Breast tenderness and enlargment
Endometrial proliferation. Hyperplasia or cancer. Abnormal uterine bleeding or postmenopausal
Call-exner bodies in histology
ABCDE of melanoma and other visual assesment
Asymetry, Border (irregular), Color variation (within lesion or compared to others); Diameter: >6mm, Evolving appearance over time
7 point check list (>1 major, >3minor)
major: change in size, color, shape
minor: >7mm, local inflamation, crusting/bleeding, sensory symptoms
Ugly dukling sing
Risk factors for aplastic anemia
Autoinmune
Post viral: Parvo, EBV, CMV, Hepatitis, HIV
Medications: Sulfa, chloranphenichol, propythiouracil, metamizol, sulfas, cabamazepine, alcohol, chemotherapy
Chemicals: cleaning solvents, benzene
Hypocellular bone marrow with fat infiltration
Pulmonary edema description on chest xray
Ground glass appearance
Triad of fat embolism
Respiratory distress
Neurologic dysfunction (Confusion)
Petechial rash
Sarcoidosis presentation
GRUELING Granulomas (non caseating) aRthristis (polyarticular migratory) Uveitis Erythema nodosum Lymphadenopathy (particularly perihiliar) Idiopathic Negative TB test Gammaglobulinemia
Also: 2nd a 3rd degree branch block. Hypercalcemia (granuloma), hypercalciuria, elevated ALP (if liver is involved), lymphopenia, elevated ACE, renal involment
HIV patient with bloody diarrhea and CD4<50
CMV: frquent small volume, bloody diarrhea and abdominal pain
Mycobacterium causes watery diarrhea with HIGH fever
Diarrhea dxx in HIV
CD4 <180: crysptosporidium
Severe watery diarrhea, low grade fever, weight loss
CD4<100: mycosporidium
watery diarrhea, fever is rare, crampy adbominal pain
CD4<50: Mycobacterium
watery diarrhea with HIGH fever
CD4<50 CMV:
frequent small volume BLOODY diarrhea and abdominal pain, low grade fever
CMV bowel biosy
eosinophilic intranuclear and basophilic cytoplasmatic inclusion
CMV diarrhea managment
Bowl biopsy
Gancyclovir and ARVT
Ocular examination to rule out concurrent retinitis
Travelers diarrhea
Short term
Rotavirus: brief
Norovirus: vominting common
ETEC
Salmonella
Shiguella: fever, bloody diarrhea, abdominal pain
Campylobacter; prominet abdominal pain, psudoapendicitis, bloody diarrhea
Long term: Entamieba: bloody Crysptospodrium Cyclospora Giardia: fat malapsorption, bloating or asymptomatic
Treatment for severe asthma exacerbation
B2 agonist
Ipratropium (muscarinic antagonis)
Corticosteroids
Considered endotracheal intubation if Hypercabia due to muscle fatigue
SSRI avoided in MI patients
Citalopran do to increased risk of prolongation of QT
