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Blog Archive

Breast Cancer Jul 3rd, 2018

Breast cancerOccurs when the cells in the breast begin to grow out of control and can then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors. It usually arises from either ducts or the glands. Because it may take months...

Invasive Prenatal Testing for Aneuploidy Jul 3rd, 2018

Down’s syndrome and trisomies- meiotic non-disjunctionMajor organ abnormality or 2 more minor increased risk fetal aneuploidyAmniocentesis 15-20 weeks (accuracy > 99%)Loss rate 1in 300-500Vagina spotting/leakage 1-2% (perinatal survival after leak 90% seals)Chorioamnionitis < 1%Early amino 11-13 weeks- high preg loss rate 2-5% talipes 1.4% (Early amino should not be done...

Screening for Fetal Chromosomes Antenatal Testing Jul 3rd, 2018

Recommend 35 years by time deliveryHigh risk, family historyTriple screen 70% sensitivityAFP dec 0.7HCG inc 2.0Estriol dec 0.7Quad Screen 80%Add inhibin inc 1.77 (not used in trisomy 18)Nuchal translucency 1st trimester 11-13 weeks 70% aloneFluid collection back neck fetusNT+B HCG & PAPP-A (glycoprotein like HCG produced by trophoblasts dec 0.43)1st trimester 85%Combined...

Premenstrual Syndrome Jul 3rd, 2018

Premenstrual syndrome (PMS) is characterized by the presence of both physical and behavioral symptoms that occur repetitively in the second half of the menstrual cycle. It affects 75% of women with regular cycles and relieved with onset of menses.Physical symptoms: abdominal bloating (90%), breast tenderness, and headaches (50%)Behavioral treatment: sense of fatigue (90%),...

Osteoporosis Jul 3rd, 2018

Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist. Men as well as women suffer from osteoporosis, a disease that can be prevented and treated.Risk...

Infectious Diseases Lower Genital Tract Jul 3rd, 2018

Chlamydia is the number one bacterial sexually transmitted disease (STD) in the United States today. Pelvic inflammatory disease (PID), which can be caused by Chlamydia, is a leading cause of infertility, when left untreated.Symptoms: known as “silent epidemic” because three quarters of the women and half of the men with the disease...

Treatment of Urinary Tract Infections in Non-pregnant Women Jul 3rd, 2018

Most cases cause by ascending infections from urethra to bladder into the bladder. Female urethra is short and colonized by normal bacteria of the vagina.Occasional infection may arise from hematogenous spread or lymphaticMost common organisms 80-90% E.coli (O, K, H antigen serotypes)10-20% organisms staphylococcus saprophyticus, Proteus, Pseudomonas, Klebsiella and Enterobacter...

Vaginal Infections Jul 3rd, 2018

Vaginal infections, or vaginitis, describe the most common medical concerns women have in the area of their reproductive organs. Vaginitis is an inflammation of the vagina that creates discharge, odor, irritation, or itching. It is difficult to diagnose because vaginitis has many causes.The vagina creates its own environment and maintains...

Breast Disease Jul 3rd, 2018

Anatomy of breasts: large modified sebaceous glands within superficial fascia of the anterior chest wall.Wt: 200-300g, 20% glandular tissue and 80% fat and connective tissue.Composed of 12-20 lobes arranged radial fashion from the nipple.Lymphatics: 75% regional axillary nodes (30-60 #), other route internal mammary, direct spread to mediastinum-intercostal glands, subpectoral and...

Management Adnexal Masses Jul 3rd, 2018

Funtional or physiologix- follicles, hemorrhagic, corpus lutealInflammatory- PID, endometriomaOther benign-paratubal cysts, hydrosalpinx, ectopic, ovarian torsionBenign neoplasms-Germ cell- mature teratomaSex cord- fibromaEpithelial- serous or mucinous cystadenomaMalignant-Germ cell- dysgerminoma, immature teratomaSex cord- granulose cell tumor, epithelial ovarian cancerBorderline or low malignant potential- invasive epithelial, fallopian tube cancinomaRisk factors-Age- most important independent factorFamily...

Hysteroscopy Jul 3rd, 2018

Hysteroscopy- telescope that allows inspection of cervical canal and uterine cavity.Panoramic hysteroscopy is the most common method using a distension media compared to contact hysteroscopy.Ideal characteristics of a distending medium are:Allows clear visualizationNonconductiveInexpensiveShould be nontoxic, hypoallergenic, non-hemolytic, isoosmalar, rapidly cleared from bodyLow viscosity-electrolyte- normal saline or lactated ringer’s solutionThey can only...

Elective and Risk Reducing Salpingo-Oophorectomy Jul 3rd, 2018

Risk reducing implies ovaries are normal during the time of removalElective is ovaries are removed at time of another indicated surgery Menopause- 51 years, estradiol decreases by 90% because of follicular arrest and estrone becomes dominant estrogen.Estrone produced after menopause comes from peripheral conversion adrenal androstenedione by aromatase primarily in adipose...

Contraception Jul 3rd, 2018

Oral ContraceptionProgestin- inhibit ovulation and thickens cervical mucusEstrogen- maintains endometrium and prevents unscheduled bleeding and inhibits follicular development.Fixed combined dosaging- estrogen and progestin 3 weeksCombination phasic (biaphasic, triphasic) 2 to 3 different amounts of E & P from 5 to 11 days. Idea is to lower total dose of steroid...