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82 Cards in this Set
- Front
- Back
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Puberty order
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Growth spurt, breast budding, pubic hair, menses
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DES exposure
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possible if born prior to 1971
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Auscultate heart sounds at...
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2nd right ICS, 2nd, 3rd, 4th, 5th left ICS at sternal border, 5th left ICS at MCL
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First heart sound is...? Head best at?
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closing of AV valves?
heard best at mitral, 5th ICS MCL |
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Second heard sound is heard best?
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2nd ICS R sternal border, aortic pt?
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Normal female CBC
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RBC count: 4.2-5.4 million
HCT (% of total blood volume that is made up of RBCs): 37-47% (32% in pregnancy) HGB: 12-16, >11 if pregnant |
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Normal WBC count
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5,000-10,000
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Platelet count
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150,000-400,000
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Fasting glucose
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normal 70-105
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BUN and creatinine
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BUN 10-20
Creatinine 0.5-1.1 |
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Lipid Profile
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Total <200 (high if >240)
Triglycerides 35-135 (high if >200) HDL >40 (low if <40) LDL <130 (high if > 160) |
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HIV testing
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2 Elisa, confirm with Western Blot
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Hepatitis B test
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HBsAG indicates active HBV infection
HB |
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PPD positive when?
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high risk > 5mm
Mod risk > 10 mm General pop >15 mm |
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Calcium requirements, Vit D
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11-24 yo: 1200-1500
25-50 yo: 1000 Post-men 1200-1500 pregnant/ nursing: 1200-1500 Vit D 800-1000 |
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Varicella/ rubella and preg
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don't get pregnant for 4 weeks after shot
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Prolactin
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0-25, MRI if >35
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FSH and LH at ovulation
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3-8
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At what testosterone level should you supect a tumor?
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>200
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Squamous metaplasia is...
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normal!
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Uterine cycle
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Proliferative: endometrium thickens, from end of period to ovulation
Secretory: from ovulation to menses |
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Normal male fertility values
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Volume: 2-5 mL
Concentration >20 mill/mL Total sperm count >40 mill (20mill) Motility > 50% Morphology >14% (>50%) |
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Odd benefit of HRT:
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decreased colorectal CA
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condyloma acuminata =
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genital warts from HPV
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COC mechanism of action
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suppresses FSH and LH to inhibit ovulation, atrophic endometrium, thickens cervical mucus
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Estrogen OC SE?
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nausea, increased br size, cyclic weight gain, leukorrhea, cervical eversion
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Progesterone OC SE
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breast tenderness, HA
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Drugs that may decrease the effectiveness of OCPs
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Rifampin, griseofulvin, phenobarbital, phenytoin, topirimate, carbamazepine, primidone, st. john's wort
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OCPs may potentiate these drugs
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benzos, corticosteroids, bronchodilators
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If miss 2 pills:
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in week 1 or 2: take 2 pills today and 2 pills tomorrow, finish pack, back-up for 7 days
in week 3: discard pack and start new pack immediately, back-up for 7 days |
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Warning signs in OCP use: ACHES
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Abdominal pain, chest pain, headache, eye problems, severe leg pain
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Advantages of depo?
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no drug interaction profile
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Medical EAB with what drugs?
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mifepristone plus misoprostol
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Classic ndometriosis triad?
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dysmenorrhea, dyspareunia, dyschezia
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Umbilical cord- what vessels?
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2 arteries that carry fetal deoxygenated blood, 1 vein carries oxygenated blood
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Presumptive pregnancy signs
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amenorrhea, n/v, urinary freq, fatigue, breast tenderness, vasomotor symptoms,
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Probable pregnancy signs
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abdomen enlarged, enlarged uterus, palpation of fetal outline, ballotement, positive preg test, all the signs
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Positive pregnancy signs
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Fetal heart tones, sonographic evidnece, palpation of fetal movement
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Naegele's rule
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subtract 3 months, add 7 days
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Pregnancy changes in renal system
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dilation of renal everything, decreased bladder tone, increased renal blood flow
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Pregnant woman can get which vaccines?
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Hep B and tetanus
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Aldara
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self applied at home for genital warts, not in pregnancy
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H. ducreyi leads to...
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chancroid, dx with culture
Sx: painful genital ulcer and inguinal adenopathy tx: azithromycin, cipro, ceftriaxone |
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Pregnant cannot have...
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cipro, bactrim
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If she has 4+ ketones..
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24 hr diet recall
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If she has 2+ glycosuria think...
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altered renal function
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What are mullerian abnormalities?
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congenital abnormalities
karyotype normal may have problem with uterus, tubes, or upper vagina May have hx of preg loss, infertile, amenorrhea, dysmenorrhea, dyspareunia Might have ovaries --> secondary sex characteristics |
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What is Turner's syndrome?
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45X female
short, webbed neck, wide hips no secondary sex, amenorrhea, might have hearing loss Absent or streak ovaries |
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What is androgen insensitivity syndrome (testicular feminization)?
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46xy, genetically male but phenotypically female
Risk of malignant transformation of gonads Primary amenorrhe and infertile Abdominal testes Might have breast development |
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If Kell positive in pregnancy?
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baby with mild to severe hydrops - K-kills
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Type of diaphragm for woman with mild cystocele?
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arching type
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Metorrhagia definition?
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uterine bleeding at irregular intervals
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Menorrhagia definition?
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excessive uterine bleeding at the expected intervals of the menstrual period
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Toxoplasmosis in pregnancy
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1/1000 will transmit, leads to decreased IQ, deafness, congenital infection, SAB, IUGR, PTB
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Reliability vs. validity
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Reliability: consistency of your measurement, repeatability of the measurement
Validity: does it measure what it should |
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Test trigeminal nerve by...
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clenching teeth
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Lung sounds with bronchitis? asthma? foreith body?
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Crackles
Wheezing distant or absent breath sounds |
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Dilantin is a...
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seizure med. If on OCP increase dose to 50, if new start go with depo
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Ovulation happens how long after LH surge?
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32-44 hrs
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When is quickening?
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first preg- 20ish weeks
subsequent- earlier 14-16 |
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Normal values for 3 hr Gtt
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Fasting- 95
1 hr- 180 2 hr- 155 3 hr- 140 |
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What secretes Hcg?
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trophoblasts
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What drugs interact with diflucan?
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increased PT on warfarin, increased phenytoin, cyclosporin levels
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Floxin contraindicated under 18 b/c?
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bone and cartilage compromise
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Give a pregnant woman hep B vaccine if?
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HBsAG negative
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Vitamin C does what to estrogen effect in OCs?
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incrases
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Symtom of retroejaculation?
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sperm found in urine
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Check what labs when taking ketoconazole?
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liver studies
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Spirolactone: Indication? contraindications? SE?
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a potassium sparing diurectic indicated for edema, HTN, primary hyperaldosteronism, hirsutism, PMS, decreased metorrhagia, acne vulgaris
do not use if renal isufficiency, hyperkalemia, hepatic disease SE= agarnulocytosis, hyperkalemia, dehydration |
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Pregnancy- cannot have these HTN drugs?
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ACE and ARB
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Rhogam works by?
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temporary passive immunity
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Natural contraception- how know safe time?
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shortest cycle -18, longest cycle-11, no sex in this period
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Good vegetable sources of Ca?
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leafy greens, broccolli,
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Pregnant woman should keep heart rate below?
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140
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Phenobarb does what to OCs?
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breaks down estrogen and progestin
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Anti-lewis antibody in preg
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no significance
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med option for hyperprolactinemia?
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bromocriptine
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Pregnant women exposed to rubella?
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do u/s. concerned with hydrops
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Pregnancy pt with toxoplasmosis. Give what med?
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a mycin
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What meds increase prolactin?
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antipsychotics
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With prolonged metronidazole, what should you check?
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CBC
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Drug use/abuse and clonidine...
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increase effects on CNS
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