walls 2020 Flashcards
desquamative inflammatory vaginitis (4 criteria)
Need all 4 criteria:
•Vaginal symptoms (at least one must be present) – vaginal discharge, dyspareunia, pruritus, burning, irritation.
●Vaginal inflammation (spotted ecchymotic rash, erythema, focal or linear erosion).
●Vaginal pH >4.5.
●Saline microscopy – Increased numbers of parabasal and inflammatory cells with a leukocyte to epithelial cell ratio greater than 1:1
●Exclusion of other infectious etiologies – BV, yeast, trich, CT/GC when indicated
BV increases your susceptibility to which diseases
- pelvic inflammatory disease (PID)
- postprocedural gynecologic infections,
- sexually transmitted infections (STIs) such as HIV and herpes simplex virus type 2
what is the most common cause of hemolytic disease of the newborn
ABO incompatibility
what is flutamide’s MOA, indication and side effects
androgen-receptor agonist
(nonsteroidal antiandrogen) used for hirsutism
Most common side effect is dry skin, but its use has been associated with hepatitis in rare cases.
The risk of teratogenicity with this compound is significant, and contraception should be used
Finasteride MOA, indication and side effects
Finasteride inhibits both forms of the enzyme 5-α-reductase (type 1, predominantly found in the skin, and type 2, predominantly found in the prostate and reproductive tissues).
Used to treat hirsiuism in PCOS (Not FDA approved)
Finasteride is better tolerated than other antiandrogens, with minimal hepatic and renal toxicity; however, it has a well-documented risk of teratogenicity in male fetuses, and adequate contraception should be used
what are non-proliferative breast lesions and which is most common
simple cysts * most common mild hyperplasia (usual type) papillary apocrine change
relative risk of future breast cancer with these is 1.17
most common breast mass in adolescents and young women
fibroadenoma
what are the type of atypical hyperplasia of the breast and associated risk of cancer?
Atypical ductal hyperplasia and atypical lobular hyperplasia
Typically is an incidental finding on histologic evaluation of abnormal mammography findings or breast masses.
4x increased risk of subsequent invasive cancer in the affected breast and the contralateral breast
Lobular Carcinoma In Situ definition and associated risk
typically does not present as a mass or with specific breast imaging abnormalities. It usually is diagnosed as an incidental finding at the time of breast biopsy for another lesion. Unlike DCIS, LCIS usually is not considered a precursor lesion for breast cancer. Rather, it is a risk marker for future development of breast cancer in either breast.
10–20% risk of developing invasive ductal or invasive lobular cancer in the following 15 years (10x general population or 1% per year for life)
tx: increased surveillance can offer endocrine therapy. Does not require excision unless appears abnormal
Ductal carcinoma in situ (DCIS) definition and treatment
Ductal carcinoma in situ (DCIS) of the breast represents a group of neoplastic lesions confined to the breast ducts.
The goal of therapy for DCIS is to prevent the development of invasive breast cancer. Therapeutic approaches include surgery, radiation therapy (RT), and adjuvant endocrine therapy
The Pediatric Position Development Conference of the International Society of Clinical Densitometry definition of osteoporosis
defines osteoporosis in children as a Z -score less than –2 in addition to having secondary risk factors that reflect a short-term risk of bone mineral loss and fracture
work up if patient ammenorrhic for 6-12 months
primary placental estrogen
Estriol
treatement of lichen planus
initial treatment for lichen planus is a high-potency topical corticosteroid ointment
other treatments included topical calcineurin inhibitors, intravaginal steriods. dilators can be used to prevent scaring
swyers syndrome presentation and gene mutation
aka XY gonadal dysgenesis
normal hieght, typical female external genital appearance, intact müllerian structures, and streak gonads, no secondary sex characteristics, low testosterone, high FSH
46XY, SRY gene mutation
stage I twin twin transfusion syndrome
oligo in one twin, poly in other
stage II Twin-twin transfusion syndrome
Nonvisualization of fetal bladder in donor twin over 60 minutes of obs
Stage III Twin-twin transfusion syndrome
absent or revered umbilical artery diastolic flow
Stage IV Twin-twin transfusion syndrome
Fetal hydrops in one or both twins
Stage V Twin-twin transfusion syndrome
fetal demise of one or both twins
A Cephalohematoma is located between:
Skull and periosteum (since its sub-periosteum it will not cross suture lines)
sub-galeal hematoma
bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis.
primary treatment of late onset CAH
Corticosteroids
what evaluation of a stillbirth should take place in the absences of identifiable risks factors
Evaluation of a stillbirth should include fetal autopsy; gross and histologic examination of the placenta, umbilical cord, and membranes; and genetic evaluation. APLS and KB stain
risk factors for macrosomia
constitutional factors, preexisting diabetes and GDM, maternal prepregnancy obesity, excessive gestational weight gain, abnormal fasting and postprandial glucose levels, dyslipidemia, a prior macrosomic newborn (weight more than 4,000 g), and postterm pregnancy
