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399 Cards in this Set
- Front
- Back
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First thing you look at in checking for Preggers
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Last menstrual period
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Chadwicks Sign
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blue discoloration of cervix
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Hegars sign
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softening of the isthmus of the uterus
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Goodells sign
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Softening of the cervix
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when can you begin to hear fetal heart
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8 weeks
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Naegeles Rule
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add 9 mo and 7 days to LMP for due date
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What can you see 5-6 weeks on US
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gestational sac
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What can you see 6-7 weeks on US
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Fetal Pole
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What can you see 7-8 weeks on US
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Cardiac activity
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what is the definition of Labor
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Expulsion of products of conception resulting from regular uterine contractions and cervical changes
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False labor
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contractions with no cervical change
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Lightening
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presenting part descends into pelvis
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4 stages of labor
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"Onset of contractions to complete dilation of cervix
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what is pelvic station
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presenting part in relation (cm) to the ischial spine (at level is 0, above is -, below is +)
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Effacement
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obliteration of the cervical canal
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Steps of delivery
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"Internal Rotation
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Pre eclampsia triad
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"HTN
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Indication for C section
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"preeclampsia
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placenta previa
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placenta covers the cervix
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tx of overactive bladder
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detrol
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how does atrophic vagina cause incontinence
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estrogen falls, vagina atrophies, pH goes up, UTI sets in
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Definition of vaginitis
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inflammation irritation or infection of the vagina
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Etiology of vaginitis
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"Infection
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3 most common infectious causes of vaginitis
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"Bacterial vaginitis
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Normal vagina
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"pH 4-4.5
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How do yeast and trichomoniasis infections relate to menstrual cycle
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"Yeast is before menses
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what are you observing during the pelvic exam
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Squamo-columnar junction- cancer, cervicitis, cervical motion tenderness
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If your pt has cervical motion tenderness what are you thinking she has
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STDs- chlamydia and gonorrhea
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Tx for vaginitis
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"Metronidazole- gel
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Pt with normal vaginal pH and vaginitis
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Candida
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Tx of candida vulvovaginitis
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"Diflucan- 1 time pill
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Strawberry cervix"
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Trichomoniasis
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Tx for trichomoniasis
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Metronidazole
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5 things to think about in relation to pelvic mass
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Age, Symptoms, organ of origin, location
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Most common pelvic mass
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"Myoma
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Tests to perform for pelvic mass
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HCG, CA125 (<35), MRI, CT, Laparoscopy
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What can infect skenes gland
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chlamydida, gonnorhea
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Tx for fibroids
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"childbearing age- remove fibroid
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Where does most uterine enlargement occur during pregnancy
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Fundus
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Your patient wants advice on high impact exercise during pregnancy what do you tell her
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up until 12 weeks the uterus is completely hidden in the pelvis and shouldnt be affected by impact
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skin changes during preggers
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Linea nigra, melasma gravidarum, angiomas and palmar erythema
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where does most weight gain come from in preggers
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uterus and its contents, breasts, 3rd space fluid
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What are maternal reserves
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increases in fat, protein and extracellular water
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Normal pregnancy glucose status
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Fasting hypoglycemia, post-prandial hyperglycemia, and hyperinsulinema
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What is an important mineral to watch in pregnant women
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"iron- Fe def anemia common
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3 functions of pregnancy induced hypervolumemia
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"Protect agains orthostatic BP changes
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CBC changes in preg
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"Dec hem and hct
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CV changes
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"HR increases by about 10
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Increases in progesterone will affect
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"respiratory effort will increase
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kidney changes in preg
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"BUN and Creat fall
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most common location of ectopic preg
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ampulla
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Salpingectomy
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removal of the fallopian tube
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Salpingostomy
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Incision in the tube and remove the pregnancy
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High risk for ectopic preg
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"TUbal surgery
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Ectopic triad
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"Amenorrhea
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Dx ectopic
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Presence of any non cystic extraovarian adnexal mass in the absence of intrauterin pregnancy (98% spec)
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Medical intervention of ectopic
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Methotrexate
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preferred tx for ectopic
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"surgery
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How do ovaries make estrogen
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convert male hormones into estrogen
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Commander of the hormones
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GnRH
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Kallman's Syndrome
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"No sense of smell, no periods
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what kills GnRH
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Dopamine
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Mechanism of turning on and off GnRH
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adding/subtracting OH from dopamine (converting it to epi)
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how do mitochondria factor into the menstrual cycle
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needed to convert cholesterol into prenenolone (mother hormone)
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what happens to pregnenolone
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immediately converts into either progesterone or 17 hydroxypregnenolone
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the 5 androgens
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"testosterone
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What hormone is a common stop in all steroids
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Androstenedione
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What 2 androgens have receptors
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"Testosterone
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Consequences of giving estrogen to post menepausal women
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"Activates undetected breast cancer
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What do granulosa cells do
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"convert male hormones
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What do inhibins do
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"decreases FSH
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Can thyroid hormone cross placenta
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no
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Thyroid Binding Globule levels in pregnancy
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increase
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What thyroid function test do you order in pregnant women
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Free T4
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how does HcG relate to TSH
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hCG acts like TSH in the weeks 10-12 and controls fetal thyroid
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Importance of iodine in pregnancy
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fetus needs to make own thyroid hormones, if mother is deficient, it cannot make them
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Risks of a hypothyroid pregnant woman
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preeclampsia, HTN, abruption of placenta, anemia, post partum hemorrhage and small gestational age of newborn
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Risks to fetus in hypothyroid state
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"impaired neural and somatic growth
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Causes of maternal hypothyroid
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"hashimoto
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Dx maternal hypothyroid
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"Free T4
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TSH goal in pregnancy
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2.5-4 mu/L
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Tx for maternal hyperthyroid
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"PTU- stops synthesis
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What is ectopic breast tissue
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breast tissue that forms along the primative milk line, can develop into breast cancers
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lots of plasma cells in GU tract"
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"chancre from syphillis
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Endarteritis
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"inlammation of small blood vessels with plasma cell infiltration
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scattered small abscess"
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granuloma inguinale
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Donovan bodies
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"small rounded encapsulated bodies in histiocytes
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bx: stellate abscess w pale epitheloid cells"
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"Lymphogranuloma venereum
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Behcet's
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autoimmune, vasculitis in vulva
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Vulvar Vestibulitis
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"Chronic inflammation w lymphocyte infiltration
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Bartholin cyst
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"infection of bartholin gland (gonnorhea)
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Vulvar Vestibularis
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"Small glands in the vestibule become inflamed
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Lichen Sclerosis
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"Most common in elderly pop, if in children suspect abuse
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Histology of lichen sclerosis
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"atrophy of epidermis
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Gross appearence of lichen sclerosis
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white dry parchment like patches
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Lichen simplex chronicus
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"rubbing caused by puritits
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Hidradenoma papilliferum
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"can arise from ectopic breast tissue
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Condyloma acuminata
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"benign, branch like projections, fibrous stroma
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VIN"
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"premalignant
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VIN- differentiated variant
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"not hpv associated
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Risks for vulvar cancer
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"lots of sexual partners
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Verrucous carcinoma
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warty, large, exophytic lesion
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extramammary pagets disease
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"pruritic crust lesion with sharply demarcated lestion on labia majora
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Aggressive angiomyxoma
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"young women
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VAIN"
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"Squamous Cell
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Clear Cell adenocarcinoma
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"uncommon
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histology of HSV cervicitis
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multinucleated giant cells and intranuclear inclusions
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Tunnel cluster
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"proliferation of endocervical glands with side channels growing out
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Microglandular hyperplasia
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no atypia (diff from tunnel clusters)
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Diffuse Laminar endocervical glandular hyperplasia
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proliferation of medium sized evenly spaced well differentiated glands separated from the stroma
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HPV infection
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"infect immature basal cells or immature metaplastic squamous cells
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oncogenesis with HPV
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E6 and E7 proteins bind to Rb and upregulate cyclin E and interfere with p53
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LSIL
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"Low grade intrapithelial lesion
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HSIL
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"high grade intraeptithelial lesion
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identifying CIN
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staining KI-67 can identify HPV, lead you to SIL dx
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most common malignant carcinoma of the cervix
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invasive squamous cell carcinoma
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sx of invasive squamous cell carcinoma of cervix
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"at first asx
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adenocarcinoma of cervix
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"grossly similar to squamous
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minimal diviation adenocarcinoma"
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"not differentialed
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adenosquamous carcinoma
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"adenocarcinoma with well defined squamous component
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Pearl Index
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"how effective contraception is
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Synthetic progestin OC
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"induce endometrial atrophy
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Ethinyl estradiol OC
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suppress FSH, stabilized endometrium
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higher risk of blood clots, OC or pregnancy
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pregnancy
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low dose OC
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"no lower risk of DVT compared to 30/35 ug dose
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benefit of 24 on 4 off compared to 21 on 7 off OC
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24/4 is more effective, less risk of follicle recruit
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Plan B
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"Levonorgestrel
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Gold standard for evidence collection for assault victims
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DNA
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Sources of evidence
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Hair, Nail clippings, swabs, fibers, glass, clothing, all trauma
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Signs of strangulation
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contusions, fingernail marks, abrasions, ligature marks, hyoid fracture, petechiae, dusky brain
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Dusky brain
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cortical ribbon has dusky salmon color
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amount of time to go unconcious from strangulation
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10 sec
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key feature in court regarding strangulation
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10 sec will knock out, trying to hurt person would be longer result in ptechiae and death (3 min)
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Person dies from strangulation, no ptechiae
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vagal stimulation resulting in disrhythmia
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purpose of oxytocic agents
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promote labor and delivery
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Use of oxytocin
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"Labor disorder
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Ergonovine and Methylergovine
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increase rate and force of contractions
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Prostaglandin Agents
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"Stimulate uterine smooth muscle contractions
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Dinoprostone
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used for cervical ripening
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use of tocolytics
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uterine relaxants used for premature labor
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Ritodrene
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tocolytic, only IV, Beta2 and some beta1
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What causes false negatives on PAP tests
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Samping, screening, interpretation errors
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When do you start screening for HPV
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3 years after onset of vaginal intercourse or at age 21
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Protocal for screening
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"annual cytology or paps every 2-3
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ASCUS
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atypical squamous cells of undertermined significance
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Managment of ASCUS
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"can repeat pap or do colposcopy
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Management of CIN
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"repeat pap in 6 mo
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ASCH
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atypical squamous cells high risk
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Management of ASCH
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"repeat pap at 6 and 12 mo
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Managment of HSIL
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"LEEP
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AGC
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"atypical glandular cells
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Management of AGC
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"colposcopy
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where do you find the squamo-columnar junction
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moves around into the os and out varying with estrogen levels, post-menopause it retreats to the cervical canal, pregnant- found on ectocervix
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How can you make cervical lesions appear more clearly
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acetic acid
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Lugol's solution
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iodine solution, normal cells turn brown, abnormal cells lack glycogen and dont stain
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What is mosaicism indicitive of in cervical lesions
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vascularized lesion with capillaries
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where are most lesions of the cervix
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anterior lip
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Peau d'orange
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orange peel appearing cervix, abnormal blood vessels in the lesion
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Most common ovarian cancer
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"epithelial
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most common GYN malignancy
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"uterine
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most lethal Gyn malignancy
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ovarian cancer
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Ovarian cancer risks
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"BRCA
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Pathogenesis of ovarian cancer
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"Don't know
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screening for ovarian cancer
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"no good screen
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managing ovarian cancer
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surgery or chemo
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chemo for ovarian cancer
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carrboplatin, paclitaxel
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Gram neg diplos
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gonnorhea
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where does gonnorhea infect in the female GU tract
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endocervix and the fallopian tubes
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one is a 8 yo boy one is a 8 yo girl, both have gram neg diplos on grm stain. what do you do"
|
"call social services for boy
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How do you culture for gonnorhea
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"thayer martin or chocolate media
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gonorrheal syndromes
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"urethritis
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Tx for gonorhea
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"ceftriaxone- DOC 125 mg IM
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Dx syphilis
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"dark field
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tabes dorsalis
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"widestance gait- neurosyphilis
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#1 reason for false positive RPR
|
"pregnancy
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Tx for syphilis
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"2.4 MU PCN IM
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Lymphogranuloma venereum
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"chlamydia disease
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Pediculosis Pubis
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"crabs
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Molluscum Contagiosum
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"DNA virus
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Endometrial hyperplasia
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"premalignant
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how do you determine type of hyperplasia (endometrium)
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D and C
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Simple hyperplasia without hyperplasia
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"best one
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simple hyperplasia with atypis
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"loss of polarity
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Complex hyperplasia without atypia
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"crowded bizzare glands, branching, lots of mitosis, epithelium is actually normal
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Complex hyperplasia with atypia
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"overlaps with well differentiated adenocarcinoma
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how does the endometrium progress to carcinoma
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always step wise, simple hyperplasia- complex hyperplasia-complex atypical- CA
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most common type of endometrial cancer
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"carcinoma of the endometrium type 1
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Endometroid Cancer
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"PTEN, PIK3CA
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How does the grading system of endometroid cancer work
|
"<5% solid mass G1
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Carcinoma of the ENdometrium Type 2
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"older population
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Malignant Mixed Mullerian Tumor
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"carcinoma and sarcoma
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Most common benign tumor in females
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leiomyoma aka fibroid
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Morphology of leiomyoma
|
"well circumscribed grey white masses
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when do leiomyoma progress to leiomyosarcoma
|
NEVER
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Leiomyosarcoma
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"Solitary, infiltrating, polyploid
|
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TORCH
|
"toxoplasmosis
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Placental infection
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"ascending- more common
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Chronic Villitis
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"intrauterine growth retardation and stillbirth association
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acute funisitis
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"acute umbilical cord inflammation
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placental infarct
|
"villous necrosis due to obstruction
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gestational trophoblastic disease
|
Moles
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Complete mole
|
"all paternal DNA
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partial mole
|
"can see embryo (cant in complete)
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invasive mole
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"usually complete, villi go deep into myometrium
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choriocarcinoma
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"most aggressive gestational trophoblastic disease
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placental site trophoblastic tumor
|
"rare
|
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First thing you do when ob pt comes into office first time
|
verify pregnancy
|
|
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how to calculate EDD
|
First day of LMP, minus 3 mo + 1 week
|
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where should the fundus be at 20 weeks
|
umbilicus
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When using US to determine due date what kind of freedom exists in believing pt hx or US
|
"1st trimester- 1 week
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how do you determine gestational age using US
|
CRL
|
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what additional nutrional requirements do pregnant women have
|
"only about 300-500 kcals more a day
|
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what physical activities should be avoided during pregnancy
|
scuba diving, anything with lots of weight shifting (aerobics, change in center of gravity creates fall risk)
|
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Prenatal labs
|
Pap, Gonorrhea, chlamydia, pelvic shape, Type (Rh), cbc, rubella, vdrl/rpr, hepatitis B, HIV, sickle cell, urine CS
|
|
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1st trimester sequential screen
|
"11-14 weeks
|
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Nuchal Translucency
|
"on saggital section US, the area behind the neck, fetus must be in neutral positioning
|
|
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2nd trimester quad screen
|
risk for down, edwards, NT defects, AFP, HCG, Estriol and dimeric inhibin A
|
|
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what does an abnormal AFP mean
|
"twins? then shes fine
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labs showing neural tube defects
|
only AFP elevated
|
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labs showing down syndrome
|
"dec AFP
|
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Labs showing trisomy 18
|
"dec AFP
|
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when is the best time to look at fetal anatomy via US
|
18-22 weeks
|
|
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what defines IUGR
|
below 10th percentile in fetal weight
|
|
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Fundal Height vs Gestational time
|
1 cm per week after 20 (umbilicus)
|
|
|
good fetal heart tones
|
"110-160 with accelerations
|
|
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At what point does Rh factor start to become important
|
24-28 weeeks
|
|
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when do you give a Rh- mother rhogam
|
24-28 weeks
|
|
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When does the mom get a second dose of rhogam
|
postpartum if the baby is Rh+
|
|
|
Tests at Week 36
|
"Repeat all previous labs
|
|
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What should labor be like in order to go to the hospital
|
1 every five minutes lasting about a minute each
|
|
|
Amniocentesis
|
"done at 16 weeks or neer term
|
|
|
Chorionic Villous Sampling
|
Done if discrepancy between size and gestational age, sign of placental insuffiency. deliver baby and keep in NICU
|
|
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Method for kick counts
|
"lie on side for one hr. need 4+ kicks
|
|
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Non Stress test
|
Should have 2 accelerations in FHR in 20 min period
|
|
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What counts as an acceleration
|
"if 32+ weeks: 15 beats faster for 15 sec period
|
|
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AFI
|
"amniotic fluid index
|
|
|
How does AFI factor into deciding whether to keep mother pregnant
|
if AFI is in range, can stay pregnant, if low and past or near due date should induce labor
|
|
|
Biophysical Profile
|
"if have non reative NST
|
|
|
when can you discharge post partum
|
"everything stable= 24-48 hrs
|
|
|
how long do post partum blues last
|
"2 weeks
|
|
|
Imitators of gyn pelvic pain
|
"intestine
|
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Posture in pelvic pain
|
"anterior pelvic tilt
|
|
|
Normal N/V of pregnancy starts
|
"1st trimester
|
|
|
Definition of hyperemesis gravidarum
|
"persistant vomiting not related to other causes
|
|
|
What sx will HG NOT have
|
"Abd Pain
|
|
|
DDx for HG
|
"GI issue (almost any)
|
|
|
Hormone theories on HG
|
"hCG rises and falls along with N/V so possible link
|
|
|
Tx for N/V in pregnancy
|
"Multivitamin
|
|
|
Aging of the female reproductive tract
|
"starts at birth
|
|
|
Average age of natural menopause
|
"51
|
|
|
What defines a menopausal woman
|
12 consectutive mo of amenorrhea
|
|
|
How can menopause be induced
|
"surgical
|
|
|
what is early menopause
|
under 40, premature ovarian insufficiency
|
|
|
What can cause premature ovarian insufficiency
|
"idiopathic
|
|
|
how to dx premature ovarian insufficiency
|
age, 2 serial FSH levels a month apart are above 40 mIU/mL
|
|
|
What is perimenopause
|
3 years before FMP and 1 year after
|
|
|
sx of perimenopause
|
Vasomotor and vulvovaginal
|
|
|
Vasomotor sx of menopause
|
hot flashes night sweats
|
|
|
What is the cause of hot flashes
|
unknown
|
|
|
what are the vulvovaginal sx of menopause
|
"vaginal dryness
|
|
|
how do you tx mild VMS of menopause
|
"lifestyle mods
|
|
|
when should HT be started
|
"as close to actual menopause as possible
|
|
|
what is the difference between SGA and IUGR
|
"SGA is BIRTH weight under 10th percentile
|
|
|
Etiology of IUGR
|
"anything that disrupts flow of blood from mom to placenta to baby
|
|
|
Maternal causes of IUGR
|
anything that clamps down on vasculature
|
|
|
placental causes of IUGR
|
"1ary mosaicism
|
|
|
Fetal causes of IUGR
|
"inadequate or altered substrates
|
|
|
how does head/abd ratio change
|
head is larger than abd up til week 34, then should be 1, after that abd gets bigger
|
|
|
Management of IUGR
|
"lifestyle mods, diet, drugs, heparin
|
|
|
what do myometrial cysts imply
|
diffuse adenomyosis
|
|
|
endometrial CA on MRI
|
thick endometrial stripe
|
|
|
why does fetal heart rate slow down after 6-8 weeks
|
nervous system is forming an parasympathetics start regulating the heart rate
|
|
|
what is variable deceleration
|
"look like W and are a result of barometric receptors, increase in rate increase in pressure, slows down as reaction then goes back up w a slight overshoot
|
|
|
when are variable decels bad
|
last longer than 2 min and less than 10, keep your eye on it and maybe take resusitative measures
|
|
|
Early deceleration
|
nadir matches with contraction peak, usually head compression (vagal stime) and is benign
|
|
|
late decel
|
"concerning, onset to nadir is 30 sec with gradual return to baseline, occurs after contraction
|
|
|
variability
|
"a good thing, want a very jagged strip, shows baby is making adjustments in rate
|
|
|
when does cognition change during menstrual cycle
|
late luteal phase
|
|
|
progress of baby blues
|
5 days and tapering off over 2 weeks
|
|
|
the 3 parts of preconception care
|
protection, managing conditions, and avoiding exposures
|
|
|
how long should a woman wait between pregnancies
|
18-59 months
|
|
|
definition of infertility
|
"under 35 failure to concieve after a year
|
|
|
most common female factor in infertility
|
ovulatory dysfunction
|
|
|
Initial testing for infertility
|
"ovulation eval
|
|
|
menstrual cycle and infertility tests
|
"day 3- FSH test
|
|
|
indications for IVF
|
"tubal disease
|
|
|
after fertilization how long before you implant the eggs
|
3-5 days
|
|
|
benign breast masses
|
"cysts
|
|
|
what do cysts look like on US
|
Clear (fluid filled) single density well circumscribed
|
|
|
fibroadenoma
|
must be biopsied, well circumscribed and not fixed, clear with accoustic shadow
|
|
|
BI RADS system
|
"0- inconclusive
|
|
|
when is preterm birth
|
"20-37 weeks
|
|
|
PROM
|
"premature rupture of membrane
|
|
|
gold standard for endometrial cancer testing
|
DnC hysteroscopy or endometrial biopsy
|
|
|
Work up for endometrial cancer
|
biopsy, hysteroscopy, transvag US
|
|
|
tx for endometrial cancer
|
Surgery surgery surgery
|
|
|
T score
|
Bone dense compared to 35 yo
|
|
|
z score
|
bone density compared to same age
|
|
|
where is bone density measured
|
hips and spine
|
|
|
antiresorption meds for osteoporosis
|
bisphosphonates, SERM
|
|
|
Bone formation stimulant
|
teripartide
|
|
|
placenta invades deep
|
accreta
|
|
|
placenta goes into muscle
|
increta
|
|
|
placenta goes thru the uterus
|
percreta
|
|
|
what is the origin of innervation for the pelvic floor
|
anterior horn of the spinal cord called the onus nucleus
|
|
|
T11- L1
|
"sympathetics to kidneys
|
|
|
T10- L1
|
Upper ureter
|
|
|
L1-L2
|
Lower portion of ureter
|
|
|
Innervation to the reproductive tract
|
"Sensory T12-S3
|
|
|
3 steps in BLT
|
"Disengage- put in position of injury
|
|
|
Turner Syndrome
|
"45x
|
|
|
ovarian torsion
|
"pedunculated ovaries
|
|
|
follicular cysts
|
"unruptured graafian follicles
|
|
|
Luteal cysts
|
"physiologic
|
|
|
Stein Leventhal Syndrome
|
Polycystic Ovary Disease
|
|
|
PCOD
|
"multiple cysts
|
|
|
Pt with anovulation, obesity, hirsutism
|
PCOD
|
|
|
2nd sx of PCOD
|
inc LH, inc Est, inc androgen, masculinization
|
|
|
Stromal hyperthecosis
|
"postmenopause
|
|
|
Most common type of ovarian tumors
|
surface epithelial
|
|
|
what age group are malignant ovarian tumors more common in
|
40-65
|
|
|
Risk factors for ovarian cancer
|
"nulliparity
|
|
|
Most common ovarian tumor
|
"serous surface epithelial tumor
|
|
|
what is a borderline tumor
|
technically malignant, but hasnt invaded yet
|
|
|
besides Ovarian cancer what can elevate CA125 levels
|
any peritoneal irritation
|
|
|
Papillary formations filled with clear straw colored fluid
|
serous ovarian tumor
|
|
|
Most common malignant ovarian tumor
|
serous adenocarcinoma
|
|
|
mucinous ovarian tumor
|
"cystic, bilateral, middle adults, mostly benign or borderline
|
|
|
Endometrioid tumor of the ovary
|
"good prognosis
|
|
|
Clear cell carcinoma of the ovary
|
"premenopausal- 40-50
|
|
|
hobnail cytoplasm
|
clear cell carcinoma of the ovary
|
|
|
cystadenofibroma
|
"cyst, glandular, and fibrotic component
|
|
|
Coffee bean like nuclei
|
brenner tumor
|
|
|
Brenner tumor
|
"cells look like transitional cells
|
|
|
Acute Mastitis
|
"only associated with lactation
|
|
|
Duct ectasia
|
"older F, lots of pregnancy
|
|
|
Granulomatous Mastitis
|
"rare, dx of exclusion
|
|
|
Benign non proliferative dz
|
"Fibrocystic
|
|
|
Fibrocystic Change
|
"25-45 whites
|
|
|
Nonproliferative vs proliferative fibrocystic change
|
"Nonprolif- apocrine snouting, single layer
|
|
|
school of fish appearence of epithelial cells
|
Florid duct hyperplasia
|
|
|
Looks like a glomerulus
|
florid duct hyperplasia
|
|
|
atypical duct hyperplasia
|
"lose streaming appearance
|
|
|
DCIS
|
Precursor to breast cancer
|
|
|
Roman bridges
|
DCIS
|
|
|
How do you tell when DCIS has progressed to ductal carcinoma
|
loses myoepithelial layer
|
|
|
Atypical lobular hyperplasia
|
"raises cancer risk
|
|
|
Intraductal Papilloma
|
"bloody nipple discharge
|
|
|
Lactating adenoma
|
"reprod age
|
|
|
Stromal tumor
|
"found in preggers (gets bigger)
|
|
|
who do you test for BRCA
|
"ashkenazis
|
|
|
most common location for breast cancer
|
upper lateral quadrant
|
|
|
most common invasive breast cancer
|
Ductal Carcinoma
|
|
|
puckering of breast tissue
|
Ductal Carcinoma
|
|
|
Appearence of ductal carcinoma in pleural fluid
|
"cannonball, Ecadherin makes them stick together
|
|
|
LCIS
|
does not have ecadherin and has bridging lesions
|
|
|
Lobar Carcinoma
|
"high rate of bilateral
|
|
|
Tubular Carcinoma
|
"well differentiated
|
|
|
Mucinous carcinoma
|
"well circum
|
|
|
medullary carcinoma
|
"very common
|
|
|
Invasive papillary carcinoma
|
"papillary projections
|
|
|
Inflammatory Breast cancer
|
"peau de orange
|
|
|
Paget's disease
|
"inflammatory appearence
|
|
|
malignant phylloides tumor
|
"very aggressive
|
|
|
angiosarcoma of the breast
|
post radiation for breast cancer
|
|
|
Breast cancers with favorable prognosis
|
"tubular
|
|
|
Breast cancers with poor prognosis
|
"signet ring
|
|
|
Distinguish DCIS from atypical ductal hyperplasia
|
DCIS has necrosis
|
|
|
Mature teratoma
|
"most common teratoma
|
|
|
monodermal teratoma
|
one predominant tissue type, can have sx related to that tissue
|
|
|
struma ovarrii
|
thyroid tissue, might have hyperthyroidism
|
|
|
immature teratoma
|
"seen in young population
|
|
|
dysgerminoma
|
"bulky soft fleshy yellow
|
|
|
endodermal sinus tumor
|
"aka yolk sac
|
|
|
choriocarcinoma
|
placental origin, aggressive to LLB,
|
|
|
granulosa theca tumor
|
"postmenapause
|
|
|
Call exner bodies
|
"neoplastic cells producing gland like structure
|
|
|
Paraneoplastic effects of granulosa theca cell tumors
|
produce lots of estrogen, inhibin
|
|
|
Fibroma-Thecoma
|
"unilateral solid mass, hard, grey white, has intact serosa
|
|
|
Meige Syndrome
|
"Ascites, Hydrothorax, Rt sided pleural effusion, increased abd girth
|
|
|
Sertoli-Leydig Cell tumor
|
"20-30s
|
|
|
Krukenberg Tumor
|
"most common met to ovary
|
|
|
How does blood volume increase in pregnancy
|
chorionic blahblahblah stims renin, renin stims angio1->angio2->aldosterone increase Na... increase
|
|
|
how does BP stay the same as CO rises to compensate for decrease hct
|
SVR drops because blood is shunted to the placenta and baby, a low resistance system
|
|
|
why does bp rise towards the end of pregnancy
|
baby and placenta begin to have resistance to be ready for birth
|
|
|
trend of CO during pregnancy
|
increases all the way
|
|
|
trend for BP during preg
|
lowers then rises
|
|
|
3 catagories for all troublesome heart conditions during pregnancy
|
"Left ventricular function
|
|
|
How can you quickly test a pts left heart function
|
PMI, should be the size of a finger pad
|
|
|
Sound of the heart with stenosis
|
no S2
|
|
|
Real heart problems during preg
|
"aortic stenosis
|
|
|
Drugs to manage heart in preg
|
"NONE
|
|
|
definition of preeclampsia
|
"HTN after 20 weeks
|
|
|
Severe preeclampsia
|
"5 grams on 24 hr urine
|
|
|
HELLP syndrome
|
"hemolysis
|
|
|
higher incidence of preeclamp in
|
"twins
|
|
|
widely used tx for preeclamp
|
mag so4
|
|
|
what diuretic used in preeclamp
|
"nooooone dont do it
|
|
|
best drug for preeclamp
|
"labetolol... only if you really really need it tho
|
