Lisa Adol-Gyn 1 - Medstudy/ Ucla/laughing

Front 1

18 yo F amenorrhea x 6 mo, lethargy, sore throat, parotid gland enlargement, soft palate petechiae,
-What's dx and abnl lab findings?

Back 1

Bulimia; ~ Low K, Low Cl, metabolic alkalosis ~ vomiting;
-

Front 2

what's criteria to hospitalize for PID?

Back 2

-can't exclude surgical emergency,
-pregnancy, failure of oral treatment, can't cooperate w/ or tolerate outpt tx;
-hi F, N, V; suspect tubo-ovarian abscess

Front 3

16 yo football player, gained 25 lbs, hi muscle mass, w/ acne, gynecomastia, suspended from school 3 x; what abnl lab findings would he have and what is he abusing?

Back 3

-steroids -->agressive behavior; liver tumors, diz;
-decreased testiclar size w/ oligospermia;
**HI LDL, LOW HDL, and early closure of bony epiphyses

Front 4

14 yo F w/ amenorrhea, never had a period, HCG neg; areola is recessed to general contour of breast and pubic hair - goes into thighs; what's cz of amenorhea ?

Back 4

out flow tract obstruction~ imperforate hymen;
-Primary amen w/ nomrla development of secondary sex charact ~ imperforate hymen or transverse vag septum, premature ovarian failure, low wt, chronic diz, disordered eating ~ exercise;

Front 5

List causes of primary amenorrhea w/ absent secondary sexual characteristics?

Back 5

-gonadal dysgensis ~ Turner (XO),
- Kallman ~ gonadotropin deficiency, decreased smell

Front 6

16 yo w/ diffuse RLQ abd pain, PE: RLQ mass 6 x 8 cm; nL hCG CT: mass has cystic fluid ~ areas of calcification and fat densitieis, what's dx?

Back 6

benign teratoma: most common ovarian neoplasm in adolescence
-a) immatura: poorly differentiated malignant tissue
-b) mature cystic: well-differentiated: most common benign: dermoid cyst, have calcifications

Front 7

when do we do paps on females ?

Back 7

by 21 yo or 3 yrs > sex, whichever first

Front 8

what effects do anabolic steroids have on kids?

Back 8

premature closure of growth plate, HTN, agressive mood swings, psychosis; hi liver enzymes, decreased testicular size, low sperm counts, decreased sexual function.

Front 9

during hospitalization of anorexia nervosa, 17 kg F bcomes irrtable, confused, delirious, devlops hypoxia, moderate CHF, what electrolyte imbalance causes all this?

Back 9

hypophosphatemia;
-leads to metabolic encephalopahty, irritabliity, confusion, delirium, sz, resp failure, CHF ~ low ATP; muscle weakness

Front 10

What's best OPC for girl who doesn't want breakthrough bleeding, wt gain, acne while on OCP?

Back 10

tripasic OCP: may relieve breakthrough bleeding regardless of time of menstrual cycle wen bleeding occurs

Front 11

Wha antbx interferes w/ effectiveness of OCP?

Back 11

Rifampin: , along w/ phenytoin, carbamazepine, anti HIV meds: decreased OCP effectiveness by increasing metabolism of contracepttive steroids; vs
-antifungals may increase levels of estrogen (decrease P450)

Front 12

sniffing glue can lead to what?

Back 12

sudden cardiac death from toleune

Front 13

what antidepressant is Contraindicated in pts w/ eating d/o?

Back 13

wellburin - buproprion bc increased risk of sz; suicide
- use SSRI for eating d/o; fluoxetine good;

Front 14

18 yo w/ mild dysuria, sexually active, on OCP, regular menses, has thin, white-gray vaginal d/c; 10% KOH makes a "fishy" odor;
-what's dx, pH and what does micro exam of d/c show, tx?

Back 14

-BV, exam: stipled or granular appearance of vaginal epithelial cells = " clue cells" -vag squamous epithelial cells covered by bacter-->stippled or granular appearance/ragged borders
** + whiff test: fishy odor!!; pH > 4.5 TX:metronidazole

Front 15

Nl age of puberty for boys/girls? how long can tanner take 2-5 take?

Back 15

Nl puberty: 9-13 boys/girls; Tanner 2-5 can take up to 5 years;

Front 16

Pre puberty ht velocity

Back 16

5-6 cm/yr;

Front 17

pk adolescent ht velocity ?

Back 17

9-10 cm/yr;

Front 18

Hi alk phos during puberty ~ what?

Back 18

~ growth spurt, and are Normal ; HCT increases w/ growth spurt

Front 19

Boys: ? delayed vs early - what age?

Back 19

delayed: no pubertal development by 14
early/precocious: < 9 yo: : abnormal ** (pubic hair or genital development)

Front 20

Order of developement for boys vs girls:

Back 20

Boys: - THPGA: testicular growth (> 2.5 cm: puberty onset) ~ 10-11 yo, hair growth (~ 1 yr later), penile growth, growth spurt, adrenarche
-Girls: TAGME: thelarche (~ 11 yo, delayed if not by 13), adrenarche (hair), growth spurt (tanner 3-4) , menarche (~ 2 yrs > thelarche, ~ 12/13 yo, Tanner 3 or 4)

Front 21

when do boys reach SMR 4 relative to ht velocity

Back 21

-Boys reach SMR 4 before goint thru pk ht velocity; Pk ht velocity usually > tanner stage 4

Front 22

when does axiallary hair reach tanner 5 ? what if boy has pubic hair, penis enlargment w/o testicular enlargement? mean

Back 22

- Axillary hair will develop only after pubic hair reaches Tanner 5
*pubic hair devlopement and penis enlargement in absence of testicular enlargement suggests androgen stimulation coming from outside gonadal area

Front 23

galactorrhea ~ what drug abuse?

Back 23

marijuana

Front 24

what age girls consider delayed vs early puberty?

Back 24

Delayed: no pubertal development by 13; ~ low bone density
- Early if < 8 yo is abnl/precocious (breast and pubic hair)
-growth spurt begins w/ breast development !!!:

Front 25

by menarche, girls are ? of adult ht

Back 25

4 cm/2 inches

Front 26

iF thelarche happens w/o pbuerache (+ breast, no pubic hair; assume ?

Back 26

androgen insensitivity – dx testicular feminization)

Front 27

white odorless mucoid d/c precedes menarche by 3-6 mo x several yrs

Back 27

phsiologic leucorrhea:

Front 28

breast development w/o pubic hair called what?

Back 28

Premature thelarche:

Front 29

Bone age < chronological age (bones catch up later)
-most common cz of delayed puberty in boys ***

Back 29

Constitutional growth delay

Front 30

what are CI to OCP?

Back 30

-liver diz, hi lipids, breast cancer, CVA, coronary artery diz, anticonvulsants