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Clin Med 4
| Question | Answer |
|---|---|
| Infertility | A condition of inability to conceive and establish a clinical pregnancy after 12 months of regular, times, and unprotected sex |
| Infertility is not | A disease |
| Pretesticular | Secondary hypogonadism |
| Testicular | Primary hypogonadism |
| Post-testicular and androgen insensitivity | Testosterone malfunction |
| Anorchia | Failure to develop testes |
| Cryptorchidism | Failure for testes to descend |
| Iatrogenic injury to testes common from | Prostate cancer surgery |
| Primary testicular failure | Any process that results in impairment of the production of testosterone by Leydig cells or production of viable sperm by Sertoli cells |
| Kleinfelter syndrome genes | XXY karyotype not hereditary |
| Kleinfelter syndrome pathophys | Sertoli cell aplasia and dysfunctional Leydig cell development causing decreased testosterone and impaired spermatogenesis |
| Most common cause of ejaculatory dysfunction | Premature ejaculation |
| Anejaculation | Failure to ejaculate |
| Approach to infertility | Both individuals in an infertile couple should be simultaneously evaluated |
| Gold standard for infertile male lab | Semen analysis |
| IUI | intrauterine insemination |
| ICSI | Micromanipulation injection of sperm into egg |
| Follicular phase results in | Mature oocyte |
| Cohort of follicles grow | granulosa layers |
| Follicular phase gives rise to | Theca |
| Theca interna | Develop ability to secrete additional estrogen and progesterone |
| Theca externa | Capsule of the developing follicle |
| Luteal phaase | Luteinization of the ruptured follicle to produce the corpus luteum |
| theca cells job | Form androgens androstenedione and testosterone |
| Steroids are converted into estrogens by | aromatase |
| Lutein cells secrete | ihibin |
| Estrogen job | proliferation and growth of specific cells responsible for secondary sexual characteristics of females |
| Estrogen secretion by | Ovaries and a tiny bit from adrenal cortex |
| During pregnancy estrogen is secreted by | Placenta |
| Progesterone function | prepare the uterus for pregnancy and breasts for lactation |
| Progesterone secreted by | corpus luteum |
| Uterine cycle before ovulation | Proliferation of uterine endometrium |
| Uterine cycle after ovulation | Development of secretory changes in the endometrium |
| Menopause occurs around | 40-50 |
| Amenorrhea | lack of period |
| Dysmenorrhea | painful period |
| Ovulatory causes of infertility | Inadequate stimulation of the ovary or failure to ovulate |
| Tubal and pelvic causes of infertility | Failure of sperm or egg transport, failure of implantation, implantation in inappropriate location |
| Implantation | 5-7days after ovulation |
| Trophoblast | Develop over the blastocyst |
| Trophoblast job | secrete enzymes that digest adjacent cells of the uterine endometrium |
| Trophoblast becomes | Placenta |
| Day 8 blastocyst becomes | Bilaminar disc |
| Bilaminar disc layers | Epiblast and hypoblast |
| Epiblast layer will develop to form | the embryo |
| Amniotic cavity forms | Within the epiblast layer |
| Hypoblast layer | Located closer to the blastocyst cavity |
| Hypoblast layer will become | extraembryonic membranes (amnion, yolk sac, chorion) |
| Embryonic period | Fertilization - end of the 8th week |
| Fetal period | 9th week to birth |
| Birth occurs weeks | 37-42 after fertilization |
| After implantation job of progesterone | endometrial cells to swell even further to store more nutrients |
| Placenta provide nutrition when | 1 week after implantation (16 days after fertilization) |
| Colic | 3+ hr, 3+ days a week uncontrollable crying |
| Colic timeline | Starts about 2w, peak 4-6w, ends month 3-4 |
| Cytomegalovirus | Most common congenital infection |
| Herpes Simplex Virus | Suspect neonates with fever and meningitis symptoms |
| Infection early in pregnancy causes | More symptoms at birth |
| Toxoplasmosis causes | Undercooked meat, unpasteurized cheese, cat litter/urine |
| Bug that can cause neonate snuffles | Syphilis |
| Fever in neonate what to do | Admit for sepsis workup |
| Congenital hypothyroidism | Most common congenital metabolic disorder |
| First year delays are mostly | Motor |
| Second year delays | More complex development |
| Autism screening timelines | 18 and 24 months |
| Those who don’t cruise | Shouldn’t be bruised!!! |
| Inflicted bruise locations | Upper arms, anterior thigh, trunk, genitals, butt, face, ears, neck |
| Hand foot and mouth | Oral, palms, soles, self resolve 7-10d |
| Bug that causes hand foot and mouth | Enterovirus, echovirus, coxsachi |
| Herpangina | Mouth sores without skin involvement |
| Bugs of Herpangina | Coxsackie or Group A strep |
| Gianotti Crosti also known as | Papular acrodermatitis |
| Gianotti Crosti | Palms, soles, face, not torso, self resolve 2-4w |
| Gianotti Crosti bugs | Viral |
| Measles | Not palms and soles, rash head down, 3d prodrome, self resolve 10-14d |
| Rubella | Head down 3d rash |
| Rubella bugs | Matonaviridae |
| Measles bug | Paramyxovirdae |
| Erythema infectiosum also known as | fifths or Slap cheek |
| Erythema infectiosum | Fever, GI, respiratory, mouth pallor, rashes not palms and soles |
| Erythema infectiosum bugs | Parvo B19 |
| HSV1 | Mucocutaneous (lips, eyes, GU), vesicles w erythematous base |
| Herpatic Gingivostomatitis | Swollen, red gums, high fever |
| Herpetic Whitlow | Start near fingertips or toes, tingling to pain |
| Heretic Whitlow bug | HSV |
| Eczema Herpeticum | Vesicular eruption, previous eczema, puritic |
| Varicella | Dewdrop on a rose petal |
| Varicella bug | Herpes |
| Rosella infantum | 24-48h after fever get rash |
| Nikolsky sign | Unroof with little pressure |
| Staph scalded skin | Large bullae, fever and fussy |
| Scarlet fever | Sore throat, sandpapery, strawberry tongue |
| Erysipelas | Red, hot, pain out of proportion |
| Erysipelas Bug | Group A strep |
| Pivot point erysipelas v cellulitis | E- pain out of proportion and larger area |
| Staph Cellulitis | Red, swollen, painful |
| Cellulitis bugs | Staph or strep |
| Impetigo | Honey crusted |
| Impetigo bugs | Staph or strep |
| Meningococcus | Fever, petechia, mucus involved |
| Kawasaki | 5 days of fever, 2/5 symp |
| Erythema Multiforme Minor | Target lesions, hands and feet, not itchy |
| Erythema multiforme major | Spreads to mucosa |
| Henoch schonlein purpura | IgA vasculitis, tender to touch, nausea, vomiting, diarrhea, butt, legs, arms |
| Neonatal acne | Hormonal on face and trunk |
| Seborrheic dermatitis | Greasy flakes, not puritic |
| Eczema | Areas of friction, dry patches |
| Molluscum | Pearly waxy papule |
| Verrucae | Smooth or cauliflower like, asymptomatic |
| Verrucae causing bug | HPV |
| Pityriasis Rosea | Harold patch and Christmas tree pattern |
| Leading cause of blindness worldwide | Trachoma |
| Female age of puberty | 10.5 |
| Male age of puberty | 11.5 |
| Must do together | Mammography and breast palpitation |
| Post mastectomy PE | Add palpation of the scar |
| Orange peel sign of | Inflammatory cancer or mastitis |
| Orange peel sign about | Lymph block, thickened skin, enlarged pores |
| In situ breast cancers | Noninvasive and contained |
| Ducal carcinoma in situ | Spontaneous bloody, clear, or serous discharge |
| Most common place of breast cancer | Superior lateral quadrant |
| PCOS | Diagnosis of exclusion |
| Most common cause of anovulation | PCOS |
| Most common vulvar mass | Bartholion cyst |
| Most common cause abnormal discharge | BV |
| Second most common cause of vaginitis | Vulvovagainal candidiasis |
| 3rd most common gynocologic cancer | Cervical cancer |
| Treatment for Gonorrhea | Cephrtriaxone |
| Treatment for Chlamydia | Doxycycline |
| Gonorrhea symp | discharge, pain with sex, hard to differentiate from other STI |
| Chlamydia symp | discharge, pain with sex, hard to differentiate from other STI |
| Trichomonas Treatment | Metronidazole |
| Trichomonas symptoms | strawberry cervix, frothy dc, yellow/green dc |
| Treponma pallidum bug causes | Syphilis |
| Visceral pain | demyelinated. slow, dull, poorly localized |
| Somatic (parietal pain) | mylenated, injury to overlying, precise locations |
| Acute diarrhea virus | Rotavirus |
| Bugs of diarrhea | CCSSY and EVE |
| CCSSY | Campylobacter, C. diff, Shigella, Salmonella, Yersinia |
| EVE | E. coli, Vibrio, Entamoeba hist |
| Osmotic diarrhea gets better with | fasting |
| Secretory diarrhea stays the same with | fasting |
| Most accurate gestational age predictor | crown to rump |
| Vaccinations not safe during pregnancy | MMR, polio, varicella |
| Anatomy scan | 20 w |
| Glucose tolerance test | 24-28w |
| Always ask about | abd pain, vaginal bleeding/discharge, urinary symptoms |
| Glucose tolerance test 1hr screen + | >140 |
| Glucose tolerance test diagnostic | >95 fasting, >180 hr1, > 155 hr2, >140 hr3 |
| Begin biweekly checks on preg | 38 w to birth |
| Congenital hypothyroidism | Most common + on genetic screening |
| First year delays are mostly | gross motor, some fine motor |
| HCG peak | 10w |
| Fetal HR measure w | m mode |
| Normal fetal HR | 120-160 |
| Nitrofurantoin in pregnancy | Cleft lip/palate |
| Sulfonamide in pregnancy | esophageal atresia and diaphragmatic hernia |
| Tetracycline | yellow/brown teeth |
| Atrial septal defect | Systolic murmur LUSB |
| VSD | LLSB holosystolic, very squeaky |
| PDA | machine like on back |
| Tetralogy of fallot | LUSB, tet spell, boot shaped heart |
| Coarction of aorta | L back, S3 |
| Truncus arteriosis | VSD, DiGeorge, patent ductus arteriorsus |
| Transposition | did not twist, egg on a string |
| Most common cause of death from cardiac in first month | Hypoplastic left heart syndrome |
| Most common cyanotic defect | Tetralogy of fallot |
| Most common cardiac defect | VSD |
| Staph scalded skin | unroof w little pressure |
| Erysipelas | similar to cellulitis, but pain out of proportion |
| Erysipelas rx | Hospitalize for IV penecillin |
| Eosinophil esophagitis | scope, lots IgE in tissue, |
| Pulmonary agenisis | failure for lung to develop |
| Bronchopulmonary dysplasia | How much oxygen baby needs at 36w |
| Cystic fibrosis | Genetic condition with irreversible brachial destruction |
| Acute bronchitis | from viral infxn, dry hacking cough |
| Bacterial pneumonia | MCAT, H flu, Strep, Staph, fever |
| Highest rate childhood mortality | Bacterial pneumonia |
| Pulmonary hypoplasia | pulm HTN, hypoxia, disrupted formation of lungs in utero |
| Neuromuscular disorders | Generalized or local muscle weakness, can be congenital or acquired |
| Bacterial tracheitis | Cough, fever, respiratory distress, dont drool |
| Bacterial tracheitis rx | Admit, intubation, IV abx and steroids |
| Laryngomalacia | Stridor w minimal exertion, surgery if severe |
| Subglottic stenosis | Biphasic stridor, surgery |
| Vocal cord paralysis | High pitch inspiratory stridor, resolves spontaneously |
| Acute bronchiolitis | wheezing, hypoxia, rhinorrhea, fever, RSV |
| Most common cause of neonate wheezing | Acute bronchiolitis |
| bronchiolitis v bronchitis | Bronchitis is just the cough |
| Epiglottitis and bacterial tracheitis are both | lethal |
| Legg-calve-perthes | painless limp, decreased ROM, idiopathic avascular necrosis |
| Slipped capital femoral epiphysis | May or may not be able to bear weight, limp, painful, slipped ice cream |
| Ortho emergency | slipped capital femoral epiphysis |
| Genu Varum | bowed out legs |
| Genu Valgum | knocked knees |
| Osgood-schlatter | pain at tibial tubercle- male athletes |
| Talipes Equinov | Clubbed foot |
| Talipes Equinov rx | serial casting of foot |
| Second most common peds spinal deformity | Kyphosis |
| Glomerular IGA nephritis | 1-3d after URI, hematuria but normal renal function |
| Hemolytic uremic syndrome | Bloody diarrhea, hematuria, protein urea, from shigga toxin |
| DONT GIVE ABX with | Hemolytic uremic syndrome |
| Hirschsprung dx | rectal biopsy |
| Autosomal recessive polycystic kidney disease | cysts in renal collecting ducts, HN, liver involved |
| Mutation for autosomal recessive polycystic kidney disease | PHKD1 |
| Acute interstitial nephritis casts | WBC |
| Acute interstitial nephritis cause | meds |
| Glomerulonephritis post strep | 1-2w post strep, RBC casts, proteinuria, hematuria |
| Meckels diverticulum | Outpouching of gastric or pancreatic tissue in small intestine |
| Fibroadenoma | painless, hard lump, mobile |
| Adenomyosis | Endometrium in myometrium |
| Lymph venerum | small painless papules, fistulas, abx |
| Trachoma | conjunctivitis that progresses to cornea |
| Leading cause of blindness worldwide | trachoma |
| HELLP | hemolysis, elevated liver enzymes, low platelets |
Created by:
kendallmk