Walls Tests Flashcards
Nerve injured with TVT
Ilioinguinal
Nerve injured with TOT
Obturator
Only true nerve through the pelvis
Obturator
Risk of underlying cancer with EIN
40-45%
Inheritance of AIS
X-linked (SRY gene problem)
Pelvic radiation causes (3)
Ovarian follicle loss
Impaired follicular maturation
Cortical and capsular damage
2.5-5.0 Gy
Permanent OI in 60%of females 15-40yo
No effect at 1.5Gy
Most common maternal complication with Cushing syndrome
HTN
Post exposure ppx for HIV
Tenofovir + emtricitabine (truvada)
& dolutegravir or
Raltegravir
Female with PMB and 10cm adnexal mass
Granulosa cell
Inhibin
Kallman’s syndrome possible anomalies
Anosmia, amenorrhea, and no breasts
-midline facial anomalies (cleft palate/lip, unilateral renal agenesis, cerebellar ataxia, epilepsy, neuro sensory/HEARING LOSS)
Aromatase inhibitors cause:
Osteoporosis
Most common cause of FGR worldwide
Malaria
Most common cause of FGR in US
CMV
Adolescent with symptoms of androgen excess, think…
Sertoli-Leydig (rare)
Medical treatment options of ACUTE menstrual bleeding in adolescents
Conjugated equine estrogens
Medroxyprogesterone acetate
TXA
Combined OCP
*check vW first
mL in super plus tampon
15-18mL
Lap sponge mL
100cc
Reytec mL
10mL
Regular tampon mL
5cc
Super tampon mL
10mL
Structure located during vasectomy
Ductus deferens
Half life of catgut
5-7days
Vegan patients use what suture?
Vicryl rapide
Poliglecaprone
Monocryl- monofilament
Polyglactin 910
Vicryl- braided
Normal BMI consume how many kilocalories/kg per day
30-35
30-40%fat
20%protein
40-50%carbs
Recommended exercise in preg
5days for at least 30 minutes (150mins)
Which drug is will affect cell free DNA?
LMWH
Superior rectal artery is branch of:
Inferior mesenteric artery
Nerve levels of obturator and femoral nerve
L2-4
Genitofemoral nerve level
L1-2, split nerve
Lumbosacral/sciatic nerve level
L4-S3
Cremasteric reflex
Genitofemoral nerve
Ilioinguinal/iliohypogastric nerve roots
T12-L4
Lateral femoral cutaneous nerve root
L2-L3
Arterial supply to breast originates:
Axillary
Advantages of LMWH (4) over heparin
Low risk for HITT
Decreased bone density loss
Predictable therapeutic range
Once daily dosing
Fetal heart completes development at
8wk
Minimal plt count to take someone to surgery with ITP
50,000
Which breech has highest risk for cord prolapse
Footling
HCG normalizes after mole when
By 2mos/8wks
5-6% will occur in 6mos=GTN
Micrograms of folic acid if previous NTD
4000 mcg=4mg
Nonpreg retest for CT/GC
3-4 mos
Preggo retest CT/GC
3-4wks
%acetic acid used in colposcopy
3-5%
Glyburide is contraindicated with what allergy
Sulfa (is sulfanomide)
Vaginal DNA test tests for (3)
G. Vaginalis
C. Albicans
Trich vaginalis
Most common genetic cardiac dz
Hypertrophic cardiomyopathy
%brow presentations that convert to face
30%
Mentum Anterior
Give to MA-ma, SVD
Mentum Posterior
Military police (MP) stop >C/S
Serous tubal and tubal intraepithelial lesions are located on
Fimbriates part of the tube
FHT shows fetal anemia
Sinusoidal
Occurrence malpractice
Covers all incidents during specific coverage period
Claims-made malpractice
Requires tail insurance
Only covers claims made during policy
Ashkenazi Jewish pts should be offered (8)
CF Canavan dz Tay-Sachs Familial dysautonomia Guacher’s Newman-pick Blooms Fanconi anemia
Maternal vit D def
Congenital rickets/fractures
Inflammatory breast CA
Breast CA that has ductal cells in dermal lymphatics
Triad typical of amniotic fluid embolism
Hypoxemia
Hypotension
Coagulopathy
Blood flow to gravid uterus at term
400-600mL/min
Ribavirin
Hep C tx
Associated with skull, palate, eye, skeleton, and GI abnormalities in fetus
Oocyte arrested between birth and ovulation at which phase
Prophase I
Oocyte arrests at which phase after puberty before ovulation
Secondary oocyte(haploid) METAPHASE II
What phase is cytogenetic largo type performed at?
Metaphase
Most common aneupoldy
X, 45
Most common trisomy associated with spontaneous abortions
Trisomy 16
% of placental DNA in maternal plasma
10%
Contraindication to beta3adnergix receptor agonist
Mirabegron, Tx OAB
Uncontrolled HTN
Tocolytic associated with behavioral teratogenesis
Terbutaline (beta-2 agonist)
DCIS
Ductal carcinoma in situ
“Do something”
Deadly
LCIS
Can Look for a bit
Smooth muscle tumor of uterus, low grade, composed of malignant mesenchymal component and benign epithelium
Adenosarcoma
Rarely metastasizes
% of early pregnancy loss are due to chromosomal abnormalities/aneuploidies
50%
Maternal risk with highest risk of stillborn
SLE
Most practical marker for reproductive aging
Mullerian inhibiting substance
1-4 normal
<1 abnormal
Recommended intraperitoneal insufflation pressure during LSC in pregnancy
10-12mmHg
Higher increases placenta vessel resistance
Most common gyn malignancy one preadolescent females
Germ cell tumor
Best measure of chronic asthma
FEV1
Most common complication from influenza
PNA
Virchow’s triad
Stasis
Local trauma
Hypercoagulability
Dz most likely to lead to end stage renal disease
DM (35%) then
HTN (25%)
Loss of houstra, lead pipe appearance
Think UC
Fat wrapping and fistulas/fissures
Think Crohn’s
Most likely risk factor for shoulder dystocia
Precipitous labor
Persistent transverse arrest
Platypoid pelvis
Tx of hemophilia A
Recombinant factor VIII
Hemophilia B
Factor IX
Hemophilia C
Factor XI problem
Tx FFP
1/3 of pts will have involvement of what portion of intestine in Crohn’s dz
Terminal ileum
Most valuable in detecting gas embolism
End tidal CO2
Maneuver to help with gas embolism
Durant (left lateral side with head down 5 degrees)
Murmur in gas embolism
Millwheel murmur
Drug that helps with HIP fractures
Bisphosphinates
Drug that helps with SPINE fractures
Raloxifine
Only drug that works on BLASTs
Recombinant parathyroid hormone
Anabolic
Denosumab
Anti-reabsorption on surface of osteoclast cells
Tx osteoporosis
Most common site of ureteral injury
Level of uterine artery
Length of ureter
25-30cm
Pelvic lymphadenectomy
Removal of nodal tissue from distal 1/2 of external common iliac arteries anterior and medial of the iliac artery and vein to point of deep circumflex iliac vein crosses external iliac artery and obturator fat pad to obturator nerve
Paraaortic lymphadenectomy
Nodal tissue removal over distal inferior vena cava from the level of the inferior mesentric artery to the mid right common iliac and the nodal tissue between the aorta and left ureter from inferior mesentric artery to mid left common iliac
Most common US findings of congenital CMV
Periventricular calcificAtions and symmetric FGR
Neonatal subclinical finding of CMV
Neurosensory hearing loss
Hypovolemic shock
NO BLOOD
Decreased CO and PCWP
Increased SVR (attempted to constrict, no volume)
Cardiogenic shock
Tamponade/MI, heart does not work
decrease in CO
Increase is PCWP (back build up of blood since heart can’t work) and increase in SVR
Septic shock
Infection leading to leaking vessels/third spacing
Decreased SVR
Increased CO (to over come lack of blood volumes)
Decreased/normal PCWP
Pt with vW mostly time to have bleeding
50% risk of PPH due it increase in vW level during preg followed by decrease PP
Pt with greatest risk for accreta
Prior C/S
MAP
(Systolic BP-diastolic BP)/3- diastolic BP
Downs is mostly
Robertsonian translocation
How many weeks after fertilization does neural tube form
3-4wks
How many week after LMP does neural tube form?
5-6weeks
Levonorgestrel IUD prevents pregnancy by
Increasing viscosity of mucous of the cervix
Chorioangioma is associate with (4)
Normal pregnancy
Arterial-venous shunting
Fetal anemia
FGR
Ratio of chest compressions to breaths in neonatal resuscitation
90 compressions to 30 breaths
Best in determining prognosis of breast cancer
Stage of disease at time of diagnosis
Melanoma metastasis to pelvic regions
MC clitoris
Prognosis of melanoma is
Based on depth of invasion
Most reliable tumor markers in pregnancy
LDH
What peaks mid luteal phase
Inhibin A
Produced by corpus luteum
Suppresses FSH
HLA-DR4
RA
Major support for uterus
Cardinal ligament
Major support for vagina
Uterosacral ligaments
Major support for ovaries
Infundibulopelvic ligament
Colposcopy finding most indicative of invasive cervical cancer
Atypical vessels
Pseudomyxoma peritonei can lead to death due to
Bowel obstruction
CEA is marker
Dysparenia, burning, vaginal discharge
Think erosive lichen planus
Rx corticosteroid suppository
MOA of Rhogam
Blocking D antigenic determinants on erythrocyte membrane
Perinatal period
Interval between 20 weeks gestation and 28 days postpartum
Yeast allergy
Can’t give HPV or Hep B vaccines
Femoral triangle
SAIL
Sartorius
Adductor longus
Inguinal ligament
Ionization radiation
Effects the nucleus in M phase
Urogenital sphincter (3)
Sphincter urethrae
Compressor urethrae
Urethrovaginal spincter
Days of menstrual cycle constitutes window of implantation
Day 20 to 24
MOA trichloroacetic acid
Coagulation of tissue proteins
Tx vaginal warts in preg
Tx hyperkalemia
Insulin and glucose
Or
kayexalate edema
*peaked T waves on EKG
Risk for neonatal death with uterine rupture
5%
Muscles overlies the sacrospinous ligament
Coccygeus
4mos infant with labia adhesions and breast budding with estrogen cream
Change to betamethasone cream
Serum marker elevated in fetal demise before 24wk
Alpha fetal protein
Most common complication of TVT
UTI
Think “vescial, vascular”
CAH inheritance
AR
Maximum bone density in female
19yo
Difficulty breast feeding leads to…
Postpartum depression
Filbanserin contraindicated in pts w/
Liver dysfunction
Treatment for mastitis refractory to first line medication
Trimethoprim-sulfamethoxazole
Most common postoperative complication from McCall’s culdoplasty
Dyspareunia
Hemaglobin F is produced
In yolk sac> mostly Fetal Liver
Most common cause of breast cancer
Ductal carcinoma
Most lethal breast cancer
Inflammatory breast cancer
Most common breast cancer
Invasive ductal carcinoma (80%)
Arises from epithelial lining of large or intermediate-size ducts
Type of study that looks at risk factors for disease and prognosis
Prospective cohort studies
Immature teratoma
Neuroepithelium
Markers: Ca125, LDH, and AFP
Arise from ectoderm, squamous component after menopause
Bone loading medications (8)
Glucocorticoids Excessive thyroxine SSRIs Proton pump inhibitors Aromatase inhibitors Thiazolidnedones (DM meds) Lithium Heparin Cyclosporine e
Antihypertensive that reduces urinary loss of calcium
Thiazides
Epidural must cover which dermatome for cesarean section
T4
What’s in FFP
Fibrinogen, antithrombin, factor V, XI, XII
One unit of FFP
Increases fibrinogen level by 10mg/dL
Volume of cryo
5 to 15mL
Each unit of cryo
Increases fibrinogen by 10mL/dL
What in cryo?
Fibrinogen, vWF, factors VIII, XIII
Level suspicious for adrenal androgen secreting tumor
DHEA > 700
dermatome for epidural for vaginal delivery
T10-L1
Afford to impulse from cervix and uterus
Second stage labor pain transmitted through which spinal roots
S2-4
Stretching of vagina, vulva, and perineum
Possible fetal anomaly with rivaroxban or other anti-Xa inhibitors
Cardiac? Limited study
Gestational age for greatest risk of ovarian torsion
Between weeks 10-16 with masses 6-8cm, due to displacement of ovaries outside the pelvis by enlarging uterus
Subclinical hypothyroidism is associated with (4)
PTD
Abruption
preE
gestation DM
What findings are suspicious for cancer in thyroid US
Microcalcifications
Cowden syndrome
Think PTen
Breast, thyroid, colon, endometrial CA