Matthew Shared "Repro Exam 2" - 61 Picmonics

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Repro Exam 2

Klinefelter's Syndrome
Pathophysiology
Male (XXY)
Signs and Symptoms
Eunuchoid Body Shape
Gynecomastia and Female Hair Distribution
Testicular Atrophy
Dysgenesis of Seminiferous Tubules
Possible Developmental Delay
Hypogonadism
Decreased Inhibin B
Increased FSH
Abnormal Leydig Cell Function
Decreased Testosterone
Increased LH
Increased Estrogen
Barr body (inactivated X chromosome)
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6 mins
Androgen Insensitivity (Complete)
Defect in androgen receptor
Phenotypically female
(46, XY)
Female external genitalia
Rudimentary Vagina
Scant sexual hair
Testes often in labia majora
Testes surgically removed to prevent malignancy
Increased estrogen, testosterone, and LH
Absent uterus and fallopian tubes
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3 mins
5 Alpha Reductase Deficiency
Autosomal Recessive
Inability to Convert Testosterone to DHT
Normal Internal Genitalia
Ambiguous External Genitalia until Puberty
Masculinization During Puberty with Growth of External Genitalia
LH can be Increased
Normal Estrogen, LH, and Testosterone levels
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2 mins
Kallman Syndrome
Mutation in KAL-1 or FGFR-1 Gene
Failure of GnRH Secreting Neurons
Delayed Puberty
Anosmia
Hypogonadism
Infertility
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2 mins
Turner Syndrome
Signs and Symptoms
Female (XO)
Short stature
Shield Chest
Cystic Hygroma (Webbing of Neck)
Lymphedema in Hands and Feet
Ovarian Dysgenesis
Streak Ovary
Decreased Estrogen
Increased FSH
Increased LH
Dysgerminoma
Bicuspid Aortic Valve
Preductal Coarctation of the Aorta
Horseshoe Kidney
Menopause before Menarche
Amenorrhea
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5 mins
Fibroadenoma
Most Common Benign Breast Tumor
Stromal Tumor
Presentation
Women under 40
Small, firm mass
Sharp Edges
Increased tenderness and size with Estrogen
Management
Biopsy
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1 min
Intraductal Papilloma
Presentation
Bloody nipple discharge
Women 20-40 years old
Mechanism
Small tumor in lactiferous ducts
Occurs Centrally
Occurs Peripherally
Increased malignancy
Diagnosis
Too Small to Palpate
Galactogram biopsy
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1 min
Phyllodes Tumor
Presentation
Common in 40's
Large Palpable Mass
Mechanism
Benign
Rarely Malignant
Low-Grade Tumor
Leaf-Like
Stromal Tumor
Treatment
Wide Resection
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2 mins
Gestational Hypertension
New-Onset Hypertension
> 20 Weeks Gestation
Risk Factors
Nulliparity
Obesity
African American Females
> 35 years Old
Multiple Gestations
Family History of Gestational HTN (or Preeclampsia)
Complications
IUGR
Prematurity
Abruptio Placentae
Management
Fetal Monitoring
Alpha-Methyldopa
Beta-Blockers (Labetalol)
Calcium Channel Blockers
Hydralazine
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4 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
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2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
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1 min
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
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2 mins
Severe Preeclampsia
Mechanism of Action
Vasospasm and Decreased Organ Perfusion
Intravascular Coagulation
Increased Permeability and Capillary Leakage
Signs and Symptoms
Hypertension
Proteinuria or End-Organ Dysfunction
HELLP Syndrome
Hepatic Dysfunction and Hemolysis
Elevated Liver Enzymes
Low Platelet Counts
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3 mins
Hyperemesis Gravidarum
Signs and Symptoms
Excessive Vomiting
Significant Weight Loss
Dehydration
Hypotension
Electrolyte Imbalance
Interventions
Antiemetics
Frequent Small Meals
IV Therapy
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1 min
Chorioamnionitis
Fever
Maternal or fetal tachycardia
Leukocytosis
Foul Odor to Amniotic Fluid
Treatment: Antibiotics
Monitor uterine tenderness, contractions and fetal activity
Monitor maternal vital signs & FHR
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2 mins
Spontaneous Abortion Overview
Assessment
Bleeding < 20 weeks Gestation
Interventions
Identify Type
Bed Rest
Monitor for Hemorrhage
Save Pads and Linens
RhoGAM
Dilation and Curettage (DandC)
Cerclage
Emotional Support
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2 mins
Spontaneous Abortion Types
Missed Abortion
No Fetal Heartbeat, No Cervical Dilation, No Bleeding
Threatened Abortion
No Cervical Dilation and Minimal Bleeding
Inevitable Abortion
Bleeding and Cervical Dilation with No Loss of Products of Conception
Incomplete Abortion
Bleeding and Cervical Dilation with Loss of Some Products of Conception
Complete Abortion
Bleeding with No Cervical Dilation, with Loss of All Products of Conception
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2 mins
Gestational Diabetes
Signs and Symptoms
Usually Asymptomatic
Fetal Macrosomia
Polyhydramnios
Diagnosis
Glucose Intolerance After 24 Weeks Gestation
3-hr 100g Glucose Tolerance Test
Treatment
Diet and Exercise
Close Glucose Monitoring
Insulin
Ultrasound (or Nonstress Test (NST))
Delivery
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2 mins
Fetal Macrosomia
Pathophysiology
Increased Birth Weight
> 4500 g
Causes
Maternal Obesity
Gestational Diabetes
Diagnosis
Weigh Newborn at Birth
Ultrasound
Hadlock's Formula
Complications
Birth Canal Trauma
Neonatal Hypoglycemia
Shoulder Dystocia
Treatment
Planned Cesarean Section
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2 mins
Polyhydramnios
Pathophysiology
Increased Amniotic Fluid
Causes
Duodenal Atresia (or Gastrointestinal Atresias)
Maternal Diabetes
Multiple Gestations
Anencephaly
Hydrops Fetalis
Diagnosis
Ultrasound
Amniotic Fluid Index (AFI) > 25 cm
Treatment
Weekly Nonstress Test (NST) and Biophysical Profile (BPP)
Amnioreduction
Indomethacin
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3 mins

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