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Wall’s Associations Flashcards

1
Q

blue sclera

A

osteogenesis imperfecta

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2
Q

orange tears

A

rifampin

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3
Q

ACE inhibitors

A

chronic cough

diabetes

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4
Q

HUS & TTP commonality

A

fever

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5
Q

cocaine crosses placenta by…

A

simple diffusion

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6
Q

IDA

A

microcystic anemia

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7
Q

transition from latent to active (cm)

A

6cm

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8
Q

sugars cross placenta by …

A

facilitated diffusion

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9
Q

longest diabmeter of fetal head

A

supra-occipital mentum (12.5cm)

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10
Q

maternal mortality

A

100,000

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11
Q

complete mole

A

daddy’s girl, 46 XX

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12
Q

pulmonary fibrosis

A

bleomycin

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13
Q

chemotherapy cell cycle

A

S phase (most)

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14
Q

low AFP

A

GTN

trisomies

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15
Q

women

A

right

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16
Q

DVT

A

left side (90%)

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17
Q

CMV

A

intracranial calcifications

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18
Q

syncytiotrophoblasts

A

PAPP-A

bHCG

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19
Q

PAPP-A

A

low = BAD

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20
Q

inhibin A pregnancy is

A

high = BAD

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21
Q

macrosomia

A

4500g

4000g?

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22
Q

listeriosis

A

cantaloupe

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23
Q

limiting dimension of labor

A

mid pelvis

bi-spinous diameter

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24
Q

occiput posterior pelvis

A

anthrOPoid pelvis

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25
21-hydroxylase
autosomal recessive
26
polycystic kidney
autosomal dominant
27
anencephaly
multifactorial
28
Duchenne's
X-linked
29
dizygous
di/di pregnancy
30
ventilator
pseudomonas PNA
31
cardiomyopathy
myocarditis | cardiomegaly
32
PTU
agranulocytosis
33
normal placenta
heat stable ALP
34
cholestasis
heal labile ALP
35
factor V leiden
heterozygous "do not treat"
36
Lewis "LIVES"
IgM (cannot cross placenta)
37
hepatitis B
DNA virus | HCC
38
cardiomyopathy
EF <45%
39
atypical PNA
mycoplasma
40
thunderclap headache
intracranial aneurysm
41
lemon sign
spina bifida
42
banana sign
Arnold-Chiari
43
strawberry cervix
trichomonas
44
blueberry muffin baby
CMV | rubella
45
kernicterus
sulfonamides
46
rubella
cataracts cardiac defects deafness
47
microcephaly
radiation (M phase) CMV Zika virus
48
cerebral palsy
periventricular leukomalacia
49
#13
Patau Bishop score BRCA2
50
tetracycline
teeth staining
51
cat feces
toxo
52
neonatal sepsis
GBS
53
menarche
12.8 years
54
BPAM
breast, pubic, axillary, menarche
55
Kallman's syndrome
primary amenorrhea anosmia 5'6"
56
Klinefelter syndrome
47 XXY azoospermia gynecomastia
57
precocious puberty work up
bone age estradiol TSH McCune-Albright
58
McCune-Albright
cafe au lait spots
59
Sheehan syndrome
hemorrhage necrosis of pituitary poor breastfeeding
60
dysgerminoma
LDH | germ cell
61
cyclophosphamide
``` POF hemorrhagic cystitis (Mesna) ```
62
granulosa cell
Call Exner bodies
63
Krukenberg
signet ring cells
64
Brenner tumor
Walthard rests
65
nuclear grooves
granulosa cell | brenner tumor
66
Schiller-Duval
endodermal sinus tumor
67
hob nail
clear cell cancer
68
psammoma bodies
serous tumors
69
dilated pupils
cocaine
70
pinpoint pupils
heroin | morphine
71
13-18 yo mortality
accidents
72
GAIL model
relative risk breast cancer
73
average period blood loss
30-50 mL
74
TTP
tx: plasmaphoresis
75
ITP
tx: steriods
76
BPD at term
9.3 cm average
77
lithium
Ebstein's anomaly Osteoporosis Can give in place of iodide in thyroid storm
78
inhibin A (menstrual cycle)
AFTER ovulation
79
inhibit B (menstrual cycle)
BEFORE ovulation
80
greatest risk in GAIL model (breast cancer)
>2 primary relatives with cancer + 20 yo at age of first child
81
an effective vaccine exists for the prevention of the adult infection with this organism (commonly found needing re-immunization)
rubella
82
organism that may cause epidemics of peurperal sepsis
group A strep
83
meningococcal vaccine
age 13-19
84
varicella zoster vaccine
age >60
85
pneumonoccoccal vaccine(s)
age 65: 1 dose PCV20 OR PCV15 followed by PPSV23 **start at age 19 if medical condition (HIV, cancer, IC, etc.)
86
Risk Down’s syndrome age 30
1/1000
87
Risk Down’s age 35
1/365
88
What undergoes fertilization?
Secondary oocyte
89
Secondary oocyte
Haploid
90
Female paraurethral gland = male…
Prostate gland
91
Female round ligament = male…
Gubernaculum testis
92
Female gartner’s duct = male…
Vas deferens
93
Female bartholin = male…
Cowper
94
Uterus = male…
Utrical prostaticus
95
Female vestimbular bulb = male…
Corpus spongiosum
96
NT > 3mm assoc. with
T21 T18 Congenital heart disease/cardiac malformation Congenital diaphragmatic hernia
97
Fetal heart highest pO2
RA
98
Fetal heart highest pCo2
RV
99
Tetralogy of Fallot
``` PROVe Pulmonary stenosis Right ventricular hypertrophy Overriding aorta VSD ```
100
Active transport thru placenta
Amino acids Ca Ph Fe
101
SVR changes in pregnancy
SVR decreased in pregnancy
102
Progesterone increases
``` Appetite Minute ventilation Body temperature Nasal congestion LDL Depresión ```
103
Progesterone decreases
``` Tubal motility Lining of uterus Ureter mobility Esophageal sphincter tone HDL ```
104
Pulmonary changes in pregnancy
DECREASE: take the RV down to the ERv for some TLC because its FRcEE INCREASE: IC the TV
105
Coagulation changes in pregnancy
INCREASE finrinogen, 7, 8, 10, vW, PA1 &2 DECREASE 11, 13, protein S
106
Limiting dimension for delivery is
Ischial spines | Average bispinous diameter 10.5 cm
107
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
108
How many mg/day iron required in pregnancy
4 mg/ day
109
How much iron required for whole pregnancy? How much increase from steady state?
Whole pregnancy: 1000mg Increase need from steady state not preg: 800mg
110
How much iron absorbed per 325mg tab
6.5 mg elemental miron
111
Soluble FMS-like tyrosine kinase, oxidative stress, impaired VEGF signaling…think of
Peripartum cardiomyopathy
112
Mortality rate 2 years after diagnosis of peripartum cardiomyopathy
10%
113
Peripartum cardiomyopathy tx
Diuretics decrease preload Hydralazine decrease afterload Digoxin for inotropic effects Heparin fir anticiagulation
114
AD diseases
``` Marfans Neurofibromatosis Huntington chorea VWD PKD ```
115
Sex linked dz
``` Diabetes insipidus Hemophilia Muscular dystrophy Placental sulfatase definiency AIS ```
116
Multifactorial
``` NTD anencephaly Spina bifida CHD MA endometriosis ```
117
High msafp
``` Open NTD Ventral wall defects Cystic hygroma Congenital nephrosis Twins Fetal death <24w Osteogenesis imperfecta ```
118
Cystic hygroma assoc
Fetal hydrops Turners Noonans Increase MSAFP
119
Diet recs (kcal/kg)
30-35 kcal/kg
120
Rule of 32
32 wk GA = 1600-1900g 32 wk GA HC = AC 32 yo decreased fecundity
121
Pitocin
30 miu/500 cc | 60 u/24h
122
Apgar
Tone and color Hand to abdomen & RN for respirs and HR Baby grimaces to mom
123
Most common vacuum injiry Most lethal vacuum injury
MC: hyperbilirubinemia from cephalohematoma Most lethal: subgaleal hematoma
124
% cesarean for breech
3%
125
No mGy rads okay
<50 mGy
126
Most teratogenic infection in pregnancy
Rubella
127
Most common infection in pregnancy
CMV
128
Most lethal infection in pregnancy
Parvovirus
129
Worst time to get vzv in pregnancy
2nd tri
130
Things that cause limb hypoplasia in pregnancy
``` Tetracycline Early CVS amniotic band syndrome Thalidimide Obesity VZV ```
131
5 As
``` Ask Advise Assess Assist Arrange ```
132
Stages of change
``` Precontemplation Contemplation Preparation Action Maintenance ```
133
5Rs of residence to quitting
``` Relevance Risks Rewards Roadblocks Repitition ```
134
CAGE
Cut down Annoyed Guilty Eye opener
135
Women | TACE
Tolerance Annoyed Cut down Eye opener
136
Pregnancy | TWEAK
``` Tolerance Worried Eye opener Amnesia Cut down ```
137
Moderate persistant asthma
FEV1 60-80%
138
HBV natural infection
Anti HBc Anti HBs Positive
139
Frax treat when
>3% risk hip fracture OR >20% risk major fracture
140
Uterine artery arises from
Anterior branch of internal iliac (hypogastric)
141
Uterine vein drains into
Internal iliac veins
142
Right ovarian vein drains into
IVC (high pressure system)
143
Left ovarian vein drains into
Left renal vein
144
Ovarian artery arises from
Aorta
145
Vaginal lymphatics Upper Middle Lower
Upper - iliac Middle - hypogastrics Lower - inguinal
146
Vaginal artery supply Upper Middle Lower
Upper - cervical branch of uterine Middle - inferior vesical Lower - internal pudenal and middle hemorrhoidal
147
Nerves to uterus
Hypogastric plexus Sympathetica Frankenhaiser’s plexus
148
Pain to uterus | Pain to perineum
Uterus - t11-T12 Perineum - S2-4 (pudenal)
149
Levator ani
Ic PR PC iliococcygeus Puborectalis Pubococcygeus
150
Lateral vaginal mass
``` Gartners duct cyst (mesonephric wollfian) Obstructed hemivaginal (hematocolpos) Vaginal cancer Leiomyoma Adenosis Rhabdomyosarcoma ```
151
Anaphylaxis tx
Epinephrine 1:1000 (0.5 ml SQ)
152
Herpes genitalis latent phase at what dorsalroot ganglia
s2-4
153
What impact thyroid receptor antibody positive risk to fetus?
Risk fetal thyroid dysfunction
154
GBS ppx helps decrease…
Early onset GBS sepsis
155
Hx of DVT in prior pregnancy, negative thrombophilia w/u
PPX anticoagulation anteparum and postpartum
156
Thickened gallbladder and gallstones, in pregnancy, management
Expectant management
157
Most frequent major neurologic complication in pregnancy
Epilepsy
158
Stage 3 posterior POP, most common complaint
Splinting
159
Greatest risk delirium in elderly Least risk delirium in elderly
Greatest risk: xanax Least risk: antipsychotic
160
HSC fluid for bipolar HSC fluid for monopolar
Bipolar = NaCL (conducts current, dissipates energy, monopoluar useless) Monopolar = Glycine
161
10 mm defect in bladder dome repair
Two layer *1st layer interuppted Vicryl
162
Most common sex chord stromal tumor in tanner stage 1 female
Isosexual precocious puberty
163
Endometrioid endometrial cancer speads via
Direct extension
164
Ovarian cancer speads via
Intraperitoneal exfoliation
165
Dove tail sign
Disruption of EAS
166
Prolactinoma in pregnancy, when to treat and not treat If taking cabergoline…
``` Sx = treat Asx = don’t treat ``` If taking cabergoline in pregnancy, switch to bromocriptine
167
Strongest RF for breast cancer
Increasing lifetime of menstrual cycles
168
FDA approved Tx PMDD
Drospirenone (YAZ) = 4th gen progesterone
169
Urinalysis screening yearly starting at what age?
65 yo
170
Most likely cause postparutm fever POD#1
Endometritis
171
Pregnancy and new dx stage IAI (<3mm depth) cervical cancer, management
Stage I with negative margins, delayed intervention has not increased recurrence rates
172
21 yo is 38w and wants to be delivered today, best management?
41w
173
Nuchal arm
Breech | Arm posterior and flexed behind neck
174
Why not use meperidine anymore?
Prolonged half life | Not reversible
175
Paget’s disease associations
Eczematous rash Underlying breast cancer 2% vulvar disease Vulvar adenocarcinoma
176
EIN and wants to preserve fertility next step
IUD
177
Mortality rate with necrotizing fasciitis
30%
178
Sickle cell disease in pregnancy associated with
IUFD Pre-eclampsia Placental abruption DVT
179
Most predictive factor of how well SLE female will do in pregnancy
Flare in last 6 mo?
180
Most common adverse effect of MTX
Transient liver dysfunction
181
Pregnancy + increased sex hormones + bilateral ovarian masses =
Luteoma of pregnancy
182
Post meno + incidental EMS 7 mm + no PMB = next step
Expectant management
183
Follow up reassessment for recurrent UTI after starting daily ppx tx
6mo
184
colpo new dx of CIN III
LEEP
185
VIN III multifocal tx
CO2 laser
186
Diagnostic test besides testosterone to eval PCOS?
SHBG
187
Greatest risk factor for vasa previa
Placenta previa
188
Prerequisites for outlet forceps delivery
Cervix fully dilated Fetal position known Adequate maternal analgesia
189
Best initial step to decrease pulse pressure to uterus during PPH
O’Leary stitch
190
Suspect AFE, most improtant step?
ABCs - intubation and ventilation
191
Cryoprecipitate components
Fibrinogen Factors 3, 7, 8, 13 VWF
192
FFP (fresh frozen plasma) components
Coagulation factors 2, 7, 8, 9, 10, 11 Increase fibrinogen 5-10 mg/dL
193
Whole blood components
55% plasma 45% RBCs 1% WBC/PLT
194
1 pack PLT transfusion should increase PLT by
50,000-60,000
195
Blood products screened for
``` HIV HBV HCV HTLV Syphilis Malaria ABO RhD CMV ```
196
Volume of: PRBC FFP Cryo
``` RPBC = 250-350 mL FFP = 250 mL Cryo = 40 mL ```
197
>1mm vulvar squamous cell labia next step
Radial partial vulvectomy with unilateral/ipsilateral lymph node dissection
198
TLH with PCN anaphylaxis allergy = abx
Gentamicin | Flagyl
199
______ infection is most responsible for PID
Oviduct
200
Most pertinent when oophorectomy <50 yo
All cause mortality
201
Watched ureter efflux for 20 min after USLS next step
attempt passage of stent
202
Precocious puberty ddx does NOT include
Cowden’s syndrome
203
6 months after syphilis treatment, should have what dilution decrease to confirm positive treatment?
1:4
204
LGV painful nodes matted together is called
Groove sign
205
Granuloma inguinale best diagnostic test:
Microscopic evaluation of cytology specimen
206
VIN II/III margins should be
5 mm
207
Incident PPH with VWD?
50%
208
Mortality rate with peripartum cardiomyopathy
50%
209
Quad screen marker increased with IUFD
AFP
210
Pregnant women with antibody screen positive for Kell antibody, 1:16. Next step
Test FOB for Kell antigen
211
Twin Reversal arterial perfusion syndrome
Mono/mono
212
If fails dicloxicillin (mastitis), next best treatment is..
Bactrim (SMX-TMP)
213
why treat pregnant woman with cHTN with antiHTN Rx?
To prevent maternal end organ damage
214
Anticoagulant contraindicated in pregnancy
Eliquis - rivaroxaban
215
Suspect PE, what order first?
CXR
216
SHBP binds
Androgens
217
HRP preparations approved for ERPR pos breast cancer for vasomotor
None
218
Alcohol abuse and upcoming surgery, most important part of eval for surgery?
Coags
219
Orlistat MOA
Inhibits 30% of lipase in GI tract
220
Turner mosaic 45X/46XY best first step
L/S bilateral gonadectomy
221
Salpingostomy incision on the tube
Antimesenteric border
222
Clamp accidently place on ureter next step
Cystoscopy with stent placement
223
Thermal injury to ureter at level of ovarian artery best management
Ureteroneocystotomy
224
Burch culposuspension blood vessels most likely to be injured
Plexus of Santorini
225
Most likely post op outcome when thermal injury to bladder
Fistula
226
stitches in McCall original
3
227
Reversal for apixaban
Factor Xa concentrate
228
Max dose lidocaine 1% with epi (mg/kg)
7.5 mg/kg
229
Mill wheel murmur
Intracardiac air
230
POD#6 Right ureteral obstruction inside pelvic brim next step
Nephrostomy
231
Mortality rate of interstitial pregnancy
2.5%
232
9w GA + adenocarcinoma of cervix => next step
CKC in 2nd tri with cerclage
233
Specific cardiac finding with severe AN
Bradycardia
234
most common congenital anomaly of female repro tract
Incomplete perforation hymen
235
Optimal time to fix imperforate hymen
After thelarche
236
Associated with cervial atresia / unicornuate
Endometriosis
237
% transmission GBS
50%
238
TVCL 1.9 cm at 18w, next step
Vaginal progesterone
239
High spinal / respiratory muscles and diaphragm at what spinal level
C3-5
240
What level need analgesia for : C-section SVD
C-section to T4 (nipples) SVD to T10 (umbilicus)
241
Not a teratogenic effect of isotretinoin
VSD
242
32 yo + NILM + HRHPV positive (16/18 neg) = next step
One year follow up
243
Vacuum <34w most significant complication
IVH
244
First step to identify intraoperative ureteral injury
Cystoscopy with indigo carmine dye | ?
245
Most likely reason for increased rates chlamydia (and cervical dysplasia) in pt on OCP
Cervical ectopy
246
Low risk women with >___RBC per HPF need further eval
25
247
Thyroid parameter that decreases with OCPs
RT3U
248
16 yo POI, how manage
estradiol and progestins (not OCPS)
249
Best way to manage vesicovaginal fistula after rad hyst
Bladder drainage with Foley
250
Part of brain affected after eclamptic seizure
Occipital
251
When start MCA Doppler screening?
16-18w
252
Side effects of Chantix
Nausea Insomnia Abnormal dreams Depression
253
10 year old vulvar pain ulcer withpurulent base/raised edges
EBV
254
Most common cause of hemolytic disease of newborn
ABO incompatibility > jaundice IgM!
255
Vulvar CA s/p WLE with invasion to 0.9mm + clear margins, next step
Observe
256
Flutamide
Dry skin hepatitis teratogenic androgen receptor antagonist, tx hirsutism & prostate cancer
257
Fox Fordyce
occlusion of apocrine and glands, papular eruption THE ITCHY FOX
258
Nonpregnant BV increases risk of
HIV PID HSV2
259
MC nonproliferative breast lesion is
breast cyst (age 30-50, get USN)
260
Bleeding nipple ddx
``` intraductal l papilloma cancer pagets mastitis trauma ```
261
ductal ectasia and fat necrosis of breast
microcalcifications
262
z-score
pre-menopausa If -1.0 and athlete, requires investigation If -2.0 and lower, considered osteoporosis in adolescent
263
positive anti - I titer of 1:16
IgM, doesn't cross placenta, so OBSERVE
264
FDA tx for vasomotor sx and to prevent osteoporiosis in postmenopaupsal women with uerus >
conjugated estrogen and bazedoxifene (SERM, protects uterus and bones)
265
estrogen changes/increase production of serum coagulation globulins:
fibrinogen Factor VII Factor X (not antithrombin III, stays the same)
266
zolendronate contraindicated in
renal failure (cr >3.5)
267
cephalohematoma is between which layers
skull and periosteum
268
subgaleal hemorrhage between layers:
periosteum and aponeurosis
269
bromley criteria for adenomyosis
heterogeneous myometrium globular uterus cystic spaces greater or equal to 2mm indistinct border
270
3 anatomical causes of SUI
hypermobile urethra loss of urethral vesicle angle loss of intraabdominal urethra
271
childhood labial adhesions treat with
estrogen *if appears to be LS, then treat with steroid creams, especially with hx of sexual abuse
272
MC non-proliferative breast lesion
breast cyst
273
teratogenic window of warfarin (women with mechanical valves) and what does it cause
6-12 weeks GA di Sala syndrome: nasal hypoplasia, skeletal abnormalities, stippled epiphyses
274
most likely to have successful TOLAC?
twin gestation | and prior VBAC
275
best monitor for Follistim (recombinant FSH)
serum estradiol (until 2000 then hcg trigger)
276
most likely predisposing event to neonatal GBS sepsis
chorio
277
SSLS injuries (4)
ureteral kinking 2.9% Pudenal nerve and lower sacral nerve S3/S4 (nerve intrapment ) 1.8% excessive retraction: arterial middle rectal artery avulsion needle extends past: inferior gluteal or interal pudenal artery
278
mirabegron MOA
beta-3 adrenergic bladder detrusor agonist = bladder relaxation and allowing filling
279
medications that should be stopped prior to surgery
1. antihypertensives (night before) 2. anticholinesterases (except for MG, night before) 3. MAOIs (2 weeks before) 4. herbal 4. clopidogrel (7 days before) 6. Direct oral anticoagulants (2 days before)
280
medications that MAY be need to be stopped prior to surgery
1. cytokine modulators (2-4 weeks, delay healing) 2. Lithium (day before) 3. antipsychotics (day before) 4. ASA (7 days before unless safer for CV risk)
281
______ (chorionic structure) generates chorionic villi that transport ____ between mother and fetus
Villous trophoblast generate chorioinc villi which primarly transport oxygen, nutrients, and other componeds between fetus and mother
282
normal ABG for term newborn
``` pH 7.18 - 7...38 pCOS2 av 50 HCO3 av 22 PO2 6-30 BE -8 ```
283
holoprosencehaly mc chromosomal abnl
trisomy 13
284
start FH at
24 weeks
285
type I hypersensitivity
IgE | anaphylaxis
286
type IV hypersensitivty
cell mediated (Tcell) contact dermatitis, graft regjection
287
type II hypersensitivity rxn
IgG or IgM mediated cytotoxic, blood transfusion reactions, erythroblastosis fetalsis, AIHA
288
type III hypersentivity
immune complex-mediated, Ag-AB complexes, SLU, RA
289
obstetrical conjugate
diagonal conjugate - 1.5 cm = obstetric conjugate
290
adolescent obesity medication after no responding to lifestyle changes
tetrahydrolipstatin (Orlistat) | *ADEK sensitive
291
most important USN associated with placenta accreta is the presence of
placenta previa (present in 80% of accreta cases) other associations **MC: turbulent lacuna blood flow loss of hypoechoic zone beween placenta and myometrium decreased retroplacental myometrial thickness <1mm loss of Nitabuchs layer
292
deliver PAS at
34-35w6d
293
Measles
``` miscarriage stillbirth LBW increased PRD (no malformations) ```
294
which chemo does NOT risk POI
cisplatin **alkylating agents are associated with POI
295
one-two, buckle my shoe, three four kick the door, five six pick up sticks, severe eight lay them straight =
S1, 2 ankle jerk L3,4 knee jerk C5-6 biceps and brachioradialis C7-8 tricpes
296
MC cause acute onset genital pruritis and VD in 4 year old
respiratory = streptococcus
297
CXR PE signs
enlarged pulmonary artery (fleischer sign) hamptom hump, peripheral wedge of airspace opacity = lung infarction westermark sign, oligaemia pleural effusion enlarged right descending pulmonary and with sudden cut off
298
TVT nerve injury
ilioinguinal (sensory only)
299
tx EIN
hysteretomy (w/o SLND)
300
serum analytes in pregnancy adjusted for:
maternal age maternal weight gestational age (NOT ethnicity)
301
minimum ovarian radiation dose (mGy) with no affect on ovaries age <40
<=1.5 Gy
302
lithium
teratogenic for cardiac defects, epstein anomaly
303
valproic acid
teratogenic, NTD
304
tx for recurrent HA in pregnancy
amitriptyline, propranolol, metoprolol
305
transgender male tx counseling
- before starting, need to have HGB for polycythemia, LFTs, serum testosterone - increased risk of endometrial and ovarian cancer due to androgens - need to cmoplete cervical/breast screening until surgery
306
sexual assault does not treat for
syhpilis hBV +/- HIV Does treat for NG/CT/trich/pregnancy
307
10 cm mass + PMB + EIN, most likely tumor marker to be positive
inhibin b = increased estrogen > granulosa> increased inhibins
308
kallman's associations
``` anosmia amenorrhea lack of breast development midline facial abnormalities cleft palate unilateral renal agensis cerebellar ataxis epilespsy nesoryneural hering loss ``` Tx: HRT
309
anastrozole/letrozole SE
treatment for breast cancer = armatase inhibitor decrease peripheral estrogen = increased bone loss and fx
310
MC cause of FGR worldwide (infection) | "" USA
malaria (worldwide) | CMV (USA)
311
MC cause of persistent hyperandrogenism beyond early puberty in adolescent girls and women, 6-15%:
PCOS chronically elevated LH & insulin *hyperinsulinemia suppresses hepatic production of SHBG > increased levels of free testosterone LH = increased androgen production from ovarian theca cells
312
Do not use ___ for acute bleeding
depo provera
313
tampon blood
regular = 5cc super 10 cc super plus 15-18 cc
314
ergot alkaloids =
methergine do not give with HTN or HIV tx = reverse transcriptase inhibitors
315
vascetomy
vas deferens lumen is disrupted to block the passage of sperm from the testes. No scalpel with instrument that grasps the vas and surrounding skin. azospermia at 3 mo = 60%, 6 mo 98-99%, confirmed by SA
316
pomeroy tubal igatsion
0 plain gut
317
poliglecaprone 25
Monocryl absorbable monofilament suture lost within 3-4w
318
polyglactin 910
Vicryl absorbably braided suture remains at 2 wk
319
absorbable suture
1. chromic 2. poliglecaprone 25 = Monocryl 3. Vicryl polyglactin 91 4. PDS polydioxanone mono
320
permanent suture
1. nylong mono 2. Nurolon, brainded nylon 3. Prolene polypropyleneen mono 4. Pronova polyvinylidene fluoride mono 5. Mersilene polyester braided
321
Medication that can cause low fetal fraction CF DNA/NIPT
Lovenox (lMW heparin)main arterial supply to breast:
322
subvlavian artery > axillary > lateral thoracic & thoacoacromial brances *arterial supply to medial aspect of breast: internal thoracic artery/internal mammary artery - braince of subclavian artery
painless vaginal bleeding and discharge =
323
vaginal cancer
painless vaginal bleeding and discharge
324
hasselbach triangle
1. inguinal ligament 2. rectus 3. inferior epigastric
325
first functional organ system in fetus
cardiovascular system, weeks 5-8 | from splanchnic mesoderm
326
1st and 2nd line acents to visualize ureteral brisk eflux during cysto
1. indogo carmine (out of order) | 2nd: fluorescin (10% preparation, 0.25 - 1.0 mL IV)
327
BMI calculation
weight/height squared
328
Cervical IA1 dx and tx
invasion <3mm + without LVSI | = simple hyst
329
Cervical cancer IA2 dx and tx
invasion 3-5 mm | or <3mm with LVSI = radical hyst
330
bhcg normalizes after a molar evacuation in ____ months
2 months *PMGTN occurs within approx 6 mo, monthly for complete mole
331
% acetic acid used for colpo
3-5% *dysplastic cells with larger nuclei with reflect light and appear white
332
glyburide and ___ alergy
sulfa
333
elagolix / GnRH antagonist does/does not require contraception
DOES
334
screen Ashkenzi couples formost common cause of genetic heart disease
Tay-Schs CF Canavan disease familial dysautonmiaHOCM
335
thickenet NT + normal karyotype =
cardiac defect
336
ductal cells in dermal lymphatics =
inflammatory breast cancer | pathoneumonic!
337
FGR + polyhydrmanios =
trisomy 18
338
AFE triad
hypoexemia hypotension coagulopathy
339
oocytes arrested in ___ before birth oocytes arrested in ___ after puberty
prophase I metaphase II
340
ribavirin
tx for HCV teratogenic skull, palatate, eye skeleton, GI
341
karyotype performed on chromosomes arrested in what phase of replication?
metaphase
342
most common tripoloidy with SAB
chromosome 16
343
most common aneuploidy with SAB
Turner
344
best test for rectovaginal fistula
MRI
345
smooth muscle tumor of the uterus, low grade, malignant mesenchymal component, benign epithelium, rarely metastatsizes
adenosarcoma
346
GTN that metastases early
choriocarcinoma
347
10% of ovary CA is associated with endometrial cancer in 15-20%, gene mutation is
PTEN
348
endometrioid cancer of ovaries assocated with
endometiosis 40%of the time
349
Single strongest individual risk factor for macrsomia is
prior macrsomic infant >4000g
350
highest risk IUFD
SLE | even greater than prior hx IUFD
351
why uteroplacental blood flow decrease when intraperitoneal perssure insuff to 15mmHg
increases placental vessel resistasnce
352
most common gyn cancer in preadolescent females is
germ cell tumor
353
virchows triad
1. stasis 2. endothelial injury 3. hypercoagulability
354
key features of Crohn's
perianal disease (skin tags, anal fissures, perianal abscess) insidious onset RLQ masses and tenderness ulceration of the small intestine and colon (UC more mucous, urgency, cure if remove colon, lead pipe, loss of haustra)
355
Hemophilia a tx
Recombinant factor 8 | X linked recessive
356
Hemophilia b is a …
Factor 9 complicaron
357
Hemophilia c is a
Factor 11 complicaron
358
Most valuable in detecting afe intraop?
End tidal co2 | Capnigraphy decreases because of decrease in CO and increase in dead space
359
Normal urethral closing pressure
60 cm H2O
360
Calculate MAP
(Systolic-diastolic / 3) + diastolic (100-60)/3 = 13.33 + 60 = MAP 73
361
Ldh tumor marker
Dysgerminoma
362
Ca125 + ldh + Afl
Immature teratoma
363
High hcg tumor marker
Choriocarcinoma
364
Afp elevated tumor marker
Endodermal sinus
365
Afp + hcg Timor market elevated
Embryonal
366
MC neonatal injury with SD
``` #1 brachial plexus #2 fracture clavicle ```
367
Clopidogrel (Plavix) reversal
Plt transfusion Anti plt
368
Chroiocarcinoma
Mc gtn after term pregnancy Hematopoietic spread Early to Lung, vagina, vulva, kidney, liver, bowl, brain
369
Chorangioma assoc w
Normal pregnancy AVM FGR fetal anemia (NOT thrombosis)
370
Major ligament support to the uterus
Cardinal
371
Ligament supporting vagina
Uterosacral
372
Colpo most indicative of invasive cervical cancer
Atypical vessels
373
Test before rhogam administered for unsensitived rh neg
Indirect combs tests of mother
374
Rhogam prevents ido immunization by
Blocking D antigenic determinants of RBC
375
Erosive lichen planus of VAGINA presents as
Dyspareunia
376
Hpv vaccine, need to exclude allergy to
Yeast
377
Nec fasc mc finding
Vulgar edema Type 1 polymicrobial Type 2 monomicrobial
378
Radiation cell phase
M phase
379
Vw testing
Vwf antigen Vwf activity (ristocetin cofactor activity) Factor viii actividad
380
Types vwf
1 partial quantitative deficiency 2 qualitative deficiency 3 total deficiency
381
Components of urethral sphincter
SU sphincter uretgrae - wraps circumferential UVS urethrivaginal sphincter CU compressor urethrae
382
Most bacterial pna in pregnant
Streptococcus pneumoniae | Azithromycin
383
Nec fasv tx
Penicillin G 3-4 million IV q3-4h | Clindamycin 900 mg IV q8h
384
Muscle that overlies sacrospinous ligament
Coccygeus
385
Uterine rupture risk neonaral death
5%
386
Toxic shock syndrome
Major - temp 38.8 Skin desquamation ``` Minor - gI Mucous membranes Myalgia Renal Plt Hepatic Cns alerted toxicity ``` Tx vanco
387
Hemoglobin f produces in
Liver
388
Molar pregnancy + hyperthyroidism + prevent pulmonary edema with
Beta blocker before anesthesia to prevent precipitation of thyroid storm
389
Transverse lie RF
``` Abdominal wall relaxation from high parity (10 fold incidence 4 or more) Preterm Placenta previa Abnormal uterine anatomy Hydramnios Contracted pelvis ```
390
MC cause breast cancer
Infiltrating ductal carcinoma, 80% | Arises from epithelial lining of large or intermediate size ducts
391
2nd MC cause of breast cancer
Infiltrating lobular carcinoma 15% | Arise from the epithelium of the terminal ducts of the lobules
392
LCIS TX
CBE + mammo q6 mo alternating with MRI | Tamoxifen
393
DCIS tx
WLE + post op radiation
394
Large pale vaulcuolated cells on breast biopsy
Pagets | Increased likelihood underlying malignancy
395
Wuestion regarding risk factors and prognosis, best study
Prospective cohort
396
Histologic feature of endometrial hyperplasia associated with progression to invasion cancer is
Nuclear atypia
397
GTN mets worst risk “” least risk
Worst : brain & liver Least : lung & vagina
398
Score for gtb based on
``` Age Antecedent pregnancy Largest tumor size including uterus Number of mets Size of mets ```
399
Multiagency chemo for gtn
Mtx Dactinomycin Cyclophosphamide Etoposide
400
Antimicrobial that decreases ocps
Rifampin (and st johns wort & phenytoin & geiseo & phenobarbital)
401
Fetal valproate syndrome
``` Epicanthal folds Flat nasal bridge Small upturned nose Long upper lip NTDs in those affected ```
402
2nd most common germ cell tumor
Endodermal sinus tumor
403
Endodermal sinus tumor
``` Large 10-30cm Highly malignant Lymohatic mets Afp elevated Unilateral ooph + VBP (vincristine, bleomycin, cisplatin) ```
404
Posterior branch of internal iliac
I love sex Iliolumbar Lateral sacral Superior gluteal
405
Ovarian arteries from
Aorta L2
406
Anterior branch of internal iliac
``` OUUMII Obturator Uterine Umbilical Middle rectal Inferior gluteal Internal pudendal ```
407
Most important part of immature teratoma
Neuroepithelium | Ectoderm
408
Rheumatic endocarditis causes
Mitral stenosis
409
NOWS associated with
High pitched cry Poor feeding Uncoordinated sucking Irritability (NOT seizures)

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