Uworld GU plus Preg Flashcards
What effect does a confounding bias have?
Exposure disease relatinship may be muffied by the effect of an extranous factors that has correlatsiont o both the exposures and disease.Think alcohol seen to be assoc w/ bladder cancer.But you stratify for smoking, alcohol has no effect.It’s because smoking is tied to bladder cancer, but smoking is assoc w/ alcohol.
What are the 3 factors that cause a positive (Downs) screen in Tripple screen?
DEC AFP, DEC Estriol, INC HCG.
What are hormonal signs seen in KlinefeltersTurners?
Klinefelers - XXY - INC FSH!!! INC LH, INC Estradiol (cause of other signs) DEC tesosterone.Turners- XO - INC FSH, INC LH, DEC Estrogen (cause of the other findings) IN BOTH CASES, ESTROGEN LEVELS (BASED OFF OF CHROMOSOME) IS THE DRIVER.
Why do you get gonorrhea multiple times?
Due to no vaccine - due to rapid antigenic variation of PILUS protein. AKA the surface antigen has high frequency of changes.
16 y.o w/ pain once a month - has secondary sexual characteristics, never had a menstrual period. Palpable mass anterior to rectum.
Imeprforated hymen - mucus in the vaginal canal (mucocolpos) may manifest as bulging introitus . Hematocolpos (accumulation of blood in vagina canal) -> marked distention of vagina -> Back pain and dififcultes w/ defecation/urination - may have vaginal bulge or mass palpable anteiror to rectum. Also mullerian duct anomaly is possible.
What recognizes stop codons on mRNA?
Releasing factors.
Painless sore on penis? Can be two things?If there are additional swellings and inflam, ulcer around groin?
Syphilis, Chalmydia Lymphogranuloma venereumOnly lymphogranuloma venereum (chlamydia_ L1,2,3, (buboes) ALSO SEE INTRACYTOPLASMIC INCLUSION BODIES.Syphilis: One would see treponemes in fluid from chancre. Not intracytoplasmic inclusiosn. Syphilis primary painless lesion can heal without treatmetn ina few weeks.
Two functions of aromatase?
Androstenedione ->: estroneTestosterone -> estradiol.
46 XX baby w/ ambiugous genitalia, INC teset, and androstenedioneMaternal virilization
Aromatse def.
Where does the proximal 1/3 of ureter get its blood supply from?Where do transplanted renal arteries/veins anastomose to?
proximal 1/3 of ureter receives blood from branches of renal artery. This is why it is typically viable during transplantation and taken into the new host.The donor original kidneys are usualyl left in place - therefore the donor kidneys are placed retroperitoneally in RIGHT Iliac Fossa - blood supply via recipients EXTERNAL iliac artery, and EXTERNAL iliac vein.
Lymph drainage (CA drainage) of Scrotum?Glans penisTestis?
Scrotum - superficial inguinal nodes (plus rest of cutaneous body inferior to umbilicus minus calf)Glans penis - Deep inguinal (cutaneous calf. First to popliteal, then to Deep inguinal)Testis - para-aortic.
Postauricular LNA in mom + polyarthralgiaWhat is this.What are the 3 things seen in kid?
Rubella - Deafness, Cataracts, PDA/cardiac
What can untreated endocervical gonorrhea infection lead to?
PID (endometritis, salpingits, tubo-ovarian abscess, pelvic peritonitis) - 8-10%. MOST SERIOUS/PERMANENT DMG = INFERTILITY - DUE TO SCARRING AND BLOCKAGE OF FALLOPIAN TUBES. Infertility is 15-20% of PID, and 50-80% for multiple PID.
What is the cell type of the ovary?
Simple bucoidal aka germinal epithelium.
What is the Eosinophil mech of action?
Eos regulate T1 HSR. Eos granules contain histaminase (degrades histamine) - reduces severity of atopic symptoms. Also contain leukotrienes and peroxidases which facilitate inflam. Also, w/ parasites - IgE binding to IgE Fc receptor on Eos cell surface. stimulation leads to antibody dependent cellular cytotox (Major basic protein etc) w/ enzymes from cytoplasmic granules M! and NK also rely on ADCC.
What types of agar can E Coli be grown in? What are appearances?What kinds of digestive ability for sugars does it have?
Blood - B hemolytic (clear circles)MacConkey - ferments, lactose, glucose, sorbitol (except EHEC no sorbitol fermentation)Eosin methylene blue(EMB) -> green metallic sheen.
What are virulence factors for different types of E Coli Disease?
Fibriae - cystis and pyeloneprhitisK1 capsule - meningitis, penumonia ( think japanese fight knock out)Heat lable - cAMGHeat stable - cGMPO - classifies gram negative. Lipid A - compoenent of LPS- similar for all enterobacteira.
Primary HSV-2 - treatment for time during present lesion and treatment preventing recurrence?
Acyclovir during episodeEither, Valacyclovir, acyclovir, or famciclovir DAILY ORAL PILLS to prevent recurrence
Small phalus and hypospaida - well devos testes in inguinal area. BP normal, karyotype normalWhat is this?
5a reductase DEF. May have ambiguous genitalia until puberty, when INC testosterone causes mauculination. Tesosterone/estrogen norma, LH normal. Intenral genitalia are normal
When is progesteronem, estradiol production by corpus luteum taken over by something else?What is that something else?
First trimester.Progetserone - from placentaEstronge - fetal adrenal gland + placenta
Why do women not lactate even though prolactin levels are high until after delivery?
estrogen and progesterone downregulate receptors for prolactin
What supplies all nerves, blood, lymph to the ovary?
Suspensory ligament (infundibulopelvic ligament) - supplie nserve,s arteries, veins, lymphatics. That means it connects from the aorta and vena cava/left renal vein. Parasympathetic from vagus.
If pt received blood transufsion -> difficulty breathing, dark urine …
Complemetn mediated cell lysis - acute hemolytic rxT2 HSR. C3a,5a anaphylatoxins + MAC
Body temp is septic shock?
Eiterhe levated or decreased.Early sesis - INC cardiac output via peripheral vasodilation (warm extremities)Progression -> Storke volume DEC - distal hypoperfusion. Advanced - cool/clammy. Delayed cap refil, etc. TNFa! IL1 IL6.
Plasma, urine findings in most pt w/ kdiney stone?
Idiopathic hypercalciuria - NORMOCALCEMIA.
What bleeding factor affected in SLE?
INC PTT. Normal PT.
Lady parts problem w/ SLE?
repeated miscarriages.
What is the chlamydia anomoly?
Chlamydia produces penicillin bidning proteins, and contains genes for peptidoglycn synthesis - HOWEVER, TEHRE IS NO PEPTIDOGLYCAN IN ITS CELL WELL.
2 most common cuases of NGU? Characteristics of bugs?
ChlamydiaUreaplasma urealyticumBoth lack peptidoglcan in cell wallChamyldia cant make ATPUU does not even have a cell wall to begin w! UU CAN make ATPBoth tx w/ antirobosomal - macrolides (azithromycin)m tetracyclines.
What is the structure of penicillin?>
Structural analog to D-Ala-D-Ala (inhibits transpeptuidase) as a decoy.
Transillumination in scrotum - think? Mech? wHERE?
Hydrocele! Not varicocele. Or they would say bag of worms etc.This is due serous fluid collecting within TUNICA VAGINALIS, which is derived from PERITONEUM - CAN REMAIN IN COMMUNICATION W/ PERITONEUM. Spermatic cord and tunica vaginalis are overlied by intenral spermatic fascia (transversalis fascia)
2 most common cause of normal development, primary eugonadotropic amenorrhea?
Imperforated hymen or mullerian duct anomalies (agenesis) - may have hsortened vaginal canal and rudimentary uterus.
What is indirect inguinal hernia cuased by?DirecT?What layers of fascia are they covered by?
Entering through internal inguinal ring -> lateral to Inf. Epigastric. Caused by persistent processus vaginalis and failure of INTERNAL INGUINAL ring to close - seen in male infants usu.Direct - olrder men - bulges through hesselbachs triangel, medial to epigastric, to reach EXTERNAL inguina ring - caused by weakness in transversalis fascia. Indirect (lateral)- covered by ALL 3 SPERMATIF FASCIA LAYERSDirect (medial) -EXTERNAL spermatic fascia ONLY. Because these do pass through deep inguinal ring - only through superficial inguinal ring.
What are these used for?DiethylcarbamazineIvermectinNifurtimoxPraziquantelMebendazole?
Diethylcarbamazine - Loa Loa, Wucheria bancroftiIvermectin - Onchocerca vovulus, StrongyloidesNifurtimox - TrypanosomesPraziquantel - Shicstosoma, Clonorchis, ParagonimusMebendazole - Enterobius
46 XY, normal leydig, total absence of SertoliWhat are the phenotypes?
Internal - both female and male (no MIF )External - Male
What is missing in breast milk?
D and K. K given as IM injectionD from sun. Dark skinned infants require more sunlight to rpdouce adequate vitD. Dark skinned infants w/o ample sunlight should receive vit D supplementation. DOES prodive enough folic acid, thiamine riboflavin.
Treatment of PCOS?For those trying to get pregnant?
PCOS tx - weight loss - OCPMedications needed to induce ovulation (such as clomiphene) - selective estrogen receptor modulator - prevents negative feedback inhibition on hyothalamus by circulating estrogens. -> INC FSH and LH and ovulaiton.
What is clomiphene? What are its uses?
Antagonist to Estrogen recpetors in hypothalamus – inhibits normal feedbakc inhibition - INC LH and FSH -> stimulates ovulation.may lead to mutliple simultaneous pregnancies, hot flashes, ovarian englargement - Tx for PCSO.
pathway of schistosoma invasion?
From snails -> skinTravel thru vascular/lymph -> liver.Mature into adults S japonicum and S mansoni -> mesentaryS haematobium -> vasical venous plexus. Remain in blood vessels for life (5-30 years!) - adhering to wall and releasing eggs. Result in TH2 mediated resposne to eggs. Granulomatous inflam and fiborsis -> ucleration of bowels/bladder/ureters. If they settle in the lvier 0-> hepatic schistosomias - can restrict protal venous flow/portal HTN.
Impetigo . What are later consequences?
Impetigo -> glomerulonephritisPharyngitis -> glomeruloneprhtiis OR Rheumatic fever SKIN INFECTIOSN DO NOT CAUSE RHEUMATIC FEVER.
For what is high dose IL-2 given? What is the mech?
ANTI-TUMOR EEFECT. IL2 (aldesleukin) - immunotherapy for metastatic melanomas and RCC> Works in approx 10% of ott. Enhances activity of NK cells. Produced primary by Th1.