Wall’s Associations Flashcards
blue sclera
osteogenesis imperfecta
orange tears
rifampin
ACE inhibitors
chronic cough
diabetes
HUS & TTP commonality
fever
cocaine crosses placenta by…
simple diffusion
IDA
microcystic anemia
transition from latent to active (cm)
6cm
sugars cross placenta by …
facilitated diffusion
longest diabmeter of fetal head
supra-occipital mentum (12.5cm)
maternal mortality
100,000
complete mole
daddy’s girl, 46 XX
pulmonary fibrosis
bleomycin
chemotherapy cell cycle
S phase (most)
low AFP
GTN
trisomies
women
right
DVT
left side (90%)
CMV
intracranial calcifications
syncytiotrophoblasts
PAPP-A
bHCG
PAPP-A
low = BAD
inhibin A pregnancy is
high = BAD
macrosomia
4500g
4000g?
listeriosis
cantaloupe
limiting dimension of labor
mid pelvis
bi-spinous diameter
occiput posterior pelvis
anthrOPoid pelvis
21-hydroxylase
autosomal recessive
polycystic kidney
autosomal dominant
anencephaly
multifactorial
Duchenne’s
X-linked
dizygous
di/di pregnancy
ventilator
pseudomonas PNA
cardiomyopathy
myocarditis
cardiomegaly
PTU
agranulocytosis
normal placenta
heat stable ALP
cholestasis
heal labile ALP
factor V leiden
heterozygous “do not treat”
Lewis “LIVES”
IgM (cannot cross placenta)
hepatitis B
DNA virus
HCC
cardiomyopathy
EF <45%
atypical PNA
mycoplasma
thunderclap headache
intracranial aneurysm
lemon sign
spina bifida
banana sign
Arnold-Chiari
strawberry cervix
trichomonas
blueberry muffin baby
CMV
rubella
kernicterus
sulfonamides
rubella
cataracts
cardiac defects
deafness
microcephaly
radiation (M phase)
CMV
Zika virus
cerebral palsy
periventricular leukomalacia
13
Patau
Bishop score
BRCA2
tetracycline
teeth staining
cat feces
toxo
neonatal sepsis
GBS
menarche
12.8 years
BPAM
breast, pubic, axillary, menarche
Kallman’s syndrome
primary amenorrhea
anosmia
5’6”
Klinefelter syndrome
47 XXY
azoospermia
gynecomastia
precocious puberty work up
bone age
estradiol
TSH
McCune-Albright
McCune-Albright
cafe au lait spots
Sheehan syndrome
hemorrhage
necrosis of pituitary
poor breastfeeding
dysgerminoma
LDH
germ cell
cyclophosphamide
POF hemorrhagic cystitis (Mesna)
granulosa cell
Call Exner bodies
Krukenberg
signet ring cells
Brenner tumor
Walthard rests
nuclear grooves
granulosa cell
brenner tumor
Schiller-Duval
endodermal sinus tumor
hob nail
clear cell cancer
psammoma bodies
serous tumors
dilated pupils
cocaine
pinpoint pupils
heroin
morphine
13-18 yo mortality
accidents
GAIL model
relative risk breast cancer
average period blood loss
30-50 mL
TTP
tx: plasmaphoresis
ITP
tx: steriods
BPD at term
9.3 cm average
lithium
Ebstein’s anomaly
Osteoporosis
Can give in place of iodide in thyroid storm
inhibin A (menstrual cycle)
AFTER ovulation
inhibit B (menstrual cycle)
BEFORE ovulation
greatest risk in GAIL model (breast cancer)
> 2 primary relatives with cancer
+
20 yo at age of first child
an effective vaccine exists for the prevention of the adult infection with this organism (commonly found needing re-immunization)
rubella
organism that may cause epidemics of peurperal sepsis
group A strep
meningococcal vaccine
age 13-19
varicella zoster vaccine
age >60
pneumonoccoccal vaccine(s)
age 65:
1 dose PCV20
OR
PCV15 followed by PPSV23
**start at age 19 if medical condition (HIV, cancer, IC, etc.)
Risk Down’s syndrome age 30
1/1000
Risk Down’s age 35
1/365
What undergoes fertilization?
Secondary oocyte
Secondary oocyte
Haploid
Female paraurethral gland = male…
Prostate gland
Female round ligament = male…
Gubernaculum testis
Female gartner’s duct = male…
Vas deferens
Female bartholin = male…
Cowper
Uterus = male…
Utrical prostaticus
Female vestimbular bulb = male…
Corpus spongiosum
NT > 3mm assoc. with
T21
T18
Congenital heart disease/cardiac malformation
Congenital diaphragmatic hernia
Fetal heart highest pO2
RA
Fetal heart highest pCo2
RV
Tetralogy of Fallot
PROVe Pulmonary stenosis Right ventricular hypertrophy Overriding aorta VSD
Active transport thru placenta
Amino acids
Ca
Ph
Fe
SVR changes in pregnancy
SVR decreased in pregnancy
Progesterone increases
Appetite Minute ventilation Body temperature Nasal congestion LDL Depresión
Progesterone decreases
Tubal motility Lining of uterus Ureter mobility Esophageal sphincter tone HDL
Pulmonary changes in pregnancy
DECREASE: take the RV down to the ERv for some TLC because its FRcEE
INCREASE: IC the TV
Coagulation changes in pregnancy
INCREASE finrinogen, 7, 8, 10, vW, PA1 &2
DECREASE 11, 13, protein S
Limiting dimension for delivery is
Ischial spines
Average bispinous diameter 10.5 cm
Cardiac hx and mortality in pregnancy, group 3 mortality 25-50% diseases:
Pulmonary HTN
complicated coarctation of the aorta
Eisenmenger syndrome
Marfan with aortic root >4cm
How many mg/day iron required in pregnancy
4 mg/ day
How much iron required for whole pregnancy?
How much increase from steady state?
Whole pregnancy: 1000mg
Increase need from steady state not preg: 800mg
How much iron absorbed per 325mg tab
6.5 mg elemental miron
Soluble FMS-like tyrosine kinase, oxidative stress, impaired VEGF signaling…think of
Peripartum cardiomyopathy
Mortality rate 2 years after diagnosis of peripartum cardiomyopathy
10%
Peripartum cardiomyopathy tx
Diuretics decrease preload
Hydralazine decrease afterload
Digoxin for inotropic effects
Heparin fir anticiagulation
AD diseases
Marfans Neurofibromatosis Huntington chorea VWD PKD
Sex linked dz
Diabetes insipidus Hemophilia Muscular dystrophy Placental sulfatase definiency AIS
Multifactorial
NTD anencephaly Spina bifida CHD MA endometriosis
High msafp
Open NTD Ventral wall defects Cystic hygroma Congenital nephrosis Twins Fetal death <24w Osteogenesis imperfecta
Cystic hygroma assoc
Fetal hydrops
Turners
Noonans
Increase MSAFP
Diet recs (kcal/kg)
30-35 kcal/kg
Rule of 32
32 wk GA = 1600-1900g
32 wk GA HC = AC
32 yo decreased fecundity
Pitocin
30 miu/500 cc
60 u/24h
Apgar
Tone and color
Hand to abdomen & RN for respirs and HR
Baby grimaces to mom
Most common vacuum injiry
Most lethal vacuum injury
MC: hyperbilirubinemia from cephalohematoma
Most lethal: subgaleal hematoma
% cesarean for breech
3%
No mGy rads okay
<50 mGy
Most teratogenic infection in pregnancy
Rubella
Most common infection in pregnancy
CMV
Most lethal infection in pregnancy
Parvovirus
Worst time to get vzv in pregnancy
2nd tri
Things that cause limb hypoplasia in pregnancy
Tetracycline Early CVS amniotic band syndrome Thalidimide Obesity VZV
5 As
Ask Advise Assess Assist Arrange
Stages of change
Precontemplation Contemplation Preparation Action Maintenance
5Rs of residence to quitting
Relevance Risks Rewards Roadblocks Repitition
CAGE
Cut down
Annoyed
Guilty
Eye opener
Women
TACE
Tolerance
Annoyed
Cut down
Eye opener
Pregnancy
TWEAK
Tolerance Worried Eye opener Amnesia Cut down
Moderate persistant asthma
FEV1 60-80%
HBV natural infection
Anti HBc
Anti HBs
Positive
Frax treat when
> 3% risk hip fracture
OR
20% risk major fracture
Uterine artery arises from
Anterior branch of internal iliac (hypogastric)
Uterine vein drains into
Internal iliac veins
Right ovarian vein drains into
IVC (high pressure system)
Left ovarian vein drains into
Left renal vein
Ovarian artery arises from
Aorta
Vaginal lymphatics
Upper
Middle
Lower
Upper - iliac
Middle - hypogastrics
Lower - inguinal
Vaginal artery supply
Upper
Middle
Lower
Upper - cervical branch of uterine
Middle - inferior vesical
Lower - internal pudenal and middle hemorrhoidal
Nerves to uterus
Hypogastric plexus
Sympathetica
Frankenhaiser’s plexus
Pain to uterus
Pain to perineum
Uterus - t11-T12
Perineum - S2-4 (pudenal)
Levator ani
Ic PR PC
iliococcygeus
Puborectalis
Pubococcygeus
Lateral vaginal mass
Gartners duct cyst (mesonephric wollfian) Obstructed hemivaginal (hematocolpos) Vaginal cancer Leiomyoma Adenosis Rhabdomyosarcoma
Anaphylaxis tx
Epinephrine 1:1000 (0.5 ml SQ)
Herpes genitalis latent phase at what dorsalroot ganglia
s2-4
What impact thyroid receptor antibody positive risk to fetus?
Risk fetal thyroid dysfunction
GBS ppx helps decrease…
Early onset GBS sepsis
Hx of DVT in prior pregnancy, negative thrombophilia w/u
PPX anticoagulation anteparum and postpartum
Thickened gallbladder and gallstones, in pregnancy, management
Expectant management
Most frequent major neurologic complication in pregnancy
Epilepsy
Stage 3 posterior POP, most common complaint
Splinting
Greatest risk delirium in elderly
Least risk delirium in elderly
Greatest risk: xanax
Least risk: antipsychotic
HSC fluid for bipolar
HSC fluid for monopolar
Bipolar = NaCL (conducts current, dissipates energy, monopoluar useless)
Monopolar = Glycine
10 mm defect in bladder dome repair
Two layer
*1st layer interuppted
Vicryl
Most common sex chord stromal tumor in tanner stage 1 female
Isosexual precocious puberty
Endometrioid endometrial cancer speads via
Direct extension