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26 Cards in this Set
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- Back
- 3rd side (hint)
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17. types of hydatiform mole:
important USMLE |
Partial molar pregnancy: =
Complete molar pregnancy: = |
There is an abnormal placenta and some fetal development.
There is an abnormal placenta but no fetus. |
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18. Define Spontaneous abortion =
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loss of pregnancy before 20 weeks of gestation without outside intervention.
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19. Define ectopic pregnancy =
and most common location of ectopic pregnancy = |
Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen.
1.1 Tubal pregnancy 1.2 Nontubal ectopic pregnancy 1.3 Heterotopic pregnancy 1.4 Persistent ectopic pregnancy |
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20. Know mechanism of action (MOA) of methotrexate:
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MTX interferes with the synthesis of ___ ___ in the body ie preventing cells from ___ , especially rapidly dividing cells,
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folic acid
duplicating |
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Methotrexate limits DNA and RNA synthesis by inhibiting ___ ___ and ___ synthetase,
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dihydrofolate reductase
thymidylate |
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Methotrexate also competes with___ ___ in normal cells
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folic acid
causes significant side effects such as = 9ct |
abdominal pain
diarrhea hair loss, kidney damage liver low blood cell counts lung mouth sores nerve |
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21. Know the symptoms of low platelet (thrombocyte) count:
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Bruising easily,
Nosebleeds Bleeding gums, Petechia on legs/arms – bleeding is more visible when PL <30 000/mm3 -especially when the number is around 10 000/mm3 |
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22. Reason for stomach ache
MTX Tx (methotrexate): |
Causes stomach pain
because it breaks down the stomach lining, Can also cause severe liver damage |
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23. Know the signs and symptoms of gigantism.
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Insulin-like Growth Factor-1 (IGF-1)
GH hypersecretion. Hypersecretion of growth hormone causes gigantism in _________ = and _____in adults. |
children
acromegaly |
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24. Know causes of gigantism, growth hormone (GH) synthesis: GH is a _____ that is synthesized, stored, and secreted by ____ cells in the=
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polypeptide somatotropic
anterior pituitary gland, And negative feedback for = |
GH secretion: somatostatin (SS)
GH and IGF-1 (negative feedback on the pituitary and hypothalamus |
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25. Know the mode of action of GH: direct and indirect
a. Direct effects: = |
GH binds to receptors on target cells.
i. Ex: Fat cells broken down into lipids b. Indirect effects: = |
stimulates liver to secrete IGF-1, which acts on target cells and tissues and causes them to reproduce and grow.
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effect of GH deficiency in children
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micropenis
hypoglycemia exaggerated jaundice... both direct and indirect hyperbilirubinemia i |
bone maturation and puberty may be several years delayed. When severe GH deficiency is present from birth and never treated, adult heights can be as short as 48-65 inches (122–165 cm).
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effect of GH deficiency in adults.
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-Increased 5-alpha-reductase
-Reduced sex hormone-binding globulin (SHBG) -Reduced muscle mass and strength -Baldness in men -Reduced bone mass and osteoporosis -Reduced energy -Impaired concentration and memory loss -Increased body fat, particularly around the waistline -Lipid abnormalities, particularly raised LDL cholesterol -Increased levels of fibrinogen and plasminogen activator inhibitor -Cardiac dysfunction, including a thickened intima media |
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stimulators of GH =
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regulated by the neurosecretory nuclei of the hypothalamus. These cells release the peptides Growth hormone-releasing hormone (GHRH or somatocrinin)
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inhibitors of GH
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Growth hormone-inhibiting hormone
(GHIH or somatostatin) into the hypophyseal portal venous blood surrounding the pituitary. |
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Stimulators of growth hormone
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-(GH) secretion include:
peptide hormones -GHRH (somatocrinin) through binding to the growth hormone-releasing hormone receptor (GHRHR)[18] -ghrelin through binding to growth hormone secretagogue receptors (GHSR)[19] -sex hormones[20] -increased androgen secretion during puberty (in males from testis and in females from adrenal cortex) -estrogen -clonidine and L-DOPA by stimulating GHRH release[21] -hypoglycemia, -arginine[22] and -propranolol by inhibiting somatostatin release -deep sleep -niacin as nicotinic acid (Vitamin fasting) -vigorous exercise |
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Inhibitors of GH secretion include:
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-GHIH (somatostatin) from the periventricular nucleus
-GH and IGF-1 (negative feedback on the pituitary and hypothalamus) -hyperglycemia -glucocorticoids -dihydrotestosterone |
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types of herpes simplex viruses
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.
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significance of genital herpes in pregnant women and the risk for newborn.
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Neonatal HSV rates in the U.S. are estimated to be between 1 in 3,000 and 1 in 20,000 live births. Approximately 22% of pregnant women in the U.S. have had previous exposure to HSV-2, and an additional 2% acquire the virus during pregnancy, mirroring the HSV-2 infection rate in the general population.[2] The risk of transmission to the newborn is 30-57% in cases where the mother acquired a primary infection in the third trimester of pregnancy. Risk of transmission by a mother with existing antibodies for both HSV-1 and HSV-2 has a much lower (1-3%) transmission rate. This in part is due to the transfer of significant titer of protective maternal antibodies to the fetus from about the seventh month of pregnancy.[3][4] However, shedding of HSV-1 from both primary genital infection and reactivations is associated with higher transmission from mother to infant.[3]
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"ToRCH" is sometimes used in these contexts.[4]
Alternatively, the "O" is redefined as "other",[5] and the acronym is spelled out as follows: T – Toxoplasmosis / Toxoplasma gondii O – Other infections (see below) R – Rubella C – Cytomegalovirus H – Herpes simplex virus-2 |
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30. signs and symptoms of prolactinoma
Those that are caused by increased Prolactin levels are: |
Amenorrhea
Galactorrhea (infrequent in men) Loss of axillary and pubic hair Hypogonadism, gynecomastia, erectile dysfunction Those that are caused by mass effect are: |
Bitemporal hemianopsia
(due to pressure on optic chiasm) Vertigo Nausea, vomiting |
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(most common tumor of pituitary gland),
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prolactinoma
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prolactinoma
classification on micro macroadenoma tests and imaging to confirm the Dx. |
<10mm
> 1 cm |
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prolactinoma
Tx: = 2ct |
Bromocriptine (Parlodel)
Cabergoline (Dostinex) |
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sign and symptoms of Parkinson’s disease,
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S/S
TRAP: -Tremor at rest -Rigidity -Akenesia (bradykinesia) -Poatural Instability appearance of Lewy Bodies loss of Dopamenergic cells in = Loss of astrocytes & activate of microglia - alpha-synuclein protein (missense mutation) .... Leads to decreased thalamic excitation of motor pathways |
Substantia Nigra
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Parkinson’s
DDx (differential diagnosis) with |
idiopathic tremor,
chorea, normal pressure hydrocephalus |
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treatment of Parkinson’s
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MAO-B inhibitor and/or dopaminergic agent
with refractory tremor plus trihexyphenidyl, amantadine, or deep brain stimulation carbidopa/levodopa COMT inhibitor, dopamine agonist, MAO-B inhibitor, apomorphine amantadine deep brain stimulation selegiline |
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