Associated Clinical Sciences
Introitus - vaginal orifice. Gravida - number of pregnancies.
Dyspareunia - pain during or after coitus. Para - number of live births.
Dystocia - painful or difficult labor. Pseudocyesis - false pregnancy, pseudopregnancy.
Dysmenorrhea - painful menstrual cycles, caused Menarche - first menstrual cycle.
by secretion of prostaglandins form uterus. Climacteric - cessation of menses, menopause.
Colostrum - initial breast milk secreted, contains IgA. Lanugo - fine hair covering newborns body.
Not found in mature breast milk. Meconium - newborn’s first intestinal discharge.
Vernix Caseosa - cheesy covering on skin of newborn. Lochia - vaginal discharge after delivery.
Lactation - can cause normal amenorrhea. Mittleschmerz - ovulation pain.
Alpha fetoprotein - increased amounts indicate neural tube defect.
Chloasma gravidarum - mask of pregnancy, brownish pigmentation of the face.
Hyperemisis gravidarum - pernicious vomiting of pregnancy.
Cardinal signs of toxemia (HEP) Hypertension, Edema, Proteinuria.
Preeclampsia - toxemia of pregnancy (3rd trimester)
Eclampsia - toxemia of pregnancy with convulsions (3rd trimester).
Braxton Hicks Contractions - intermittent contractions of uterus after 3rd month of pregnancy. AKA false labor.
Embryonic stages - zygote®morula®blastula.
Signs of Pregnancy:
Goodell - softening of the tip of the cervix.
Hegar - entire cervix softens.
Chadwick’s - bluish discoloration of the vagina.
Piskacek - asymmetrical softening and enlargement of the uterus.
Ladin - softened area denoting a change between cervix and body of the uterus.
Ballottement - movement of the fetus upon pressure to cervix through vagina.
Effacement - thinning of the cervix.
Quickening - mother’s perception of fetal movement.
Lightening - descent of uterus into pelvic cavity 2-3 weeks before labor.
Engagement - baby’s head reaches the ischial spines.
Stages of Labor: 1st stage - from first meaningful uterine contraction to full cervical dilation(10 cm). Longest stage.
2nd stage - from full dilation to delivery of the baby.
3rd stage - delivery of the baby to delivery of the placenta.
Placental complications: Placenta Abrupta - early detachment of placenta from uterine wall.
Placenta Previa - low lying placenta, usually interferes with internal cervical opening.
Placenta Accreta - retained placenta, MC cause of post partum hemorrhage.
APGAR scoring: Appearance(color), Pulse(heart rate), Grimace(reflex irritability), Activity(muscle tone),
Respiration(respiratory effort).
Moro Reflex - startle reflex in newborns.
Rooting reflex - touch the cheek of a baby the head turns to that side.
Down’s Syndrome - trisomy 21, mental retardation, low set ears, flat nose or bridge, simian crease on palm or sole.
Characterized by an increased incidence of leukemia.
Turner’s syndrome - 45X, female with short stature, low posterior hairline, short webbed neck, gonadal dysgenesis.
Klinefelter’s Syndrome - 47XXY, male with small testes, gynecomastia, long legs and subnormal intelligence.
Paget’s disease - can cause mammary duct carcinoma.
Endometriosis - ectopic endometrial tissue (uterine lining).
Adenomyosis - endometrial tissue found in the myometrium (muscular layer of the uterus).
Leukoplakia - precancerous lesion of white patches on mucous membranes.
Dermoid Cyst of the Ovary - teratoma (tumor made up of several germinal layers).
Hydatidiform mole - benign trophoblastic tumor, high levels of human chorionic gonadotrophin (HCG).
Choriocarcinoma - malignant trophoblastic tumor.
Mastitis - localized engorgement of the breast with red streaks.
Ovulation - surge of LH precedes, vaginal mucus stringy and clear.
Associated Clinical Sciences
Uterine involution - occurs during post partum period.
Gene Theory of Disease - Autosomal trait passed on by mother.
Spontaneous Abortion - MC cause of first trimester abortions, usually attributed to chromosomal defects.
CPR on child - 80-100 chest thrusts per minute.
Herpes Simplex - causes aseptic meningitis in the neonate.
Brachial Artery - best to palpate pulse on an infant.
Capillary Hemangioma - typically appears after birthing process on the scalp.
Hutchinson’s Signs - indicators of congenital syphilis; pegged teeth, deafness, interstitial keratosis.
Karl Jung - collective unconscious.
Sigmund Freud - Inner dynamics of the unconscious, free association.
Tripartite of the personality: Id - the unorganized, instinctual part, basic instincts.
Ego - the perceived self, here and now , reality testing portion.
Superego - the conscience.
Stages of development(child): Oral, Anal, Phallic.
Psychological testing:
Rorschach - Ink blot testing used to determine personality disorders.
WISC - Wechsler Intelligence Scale for Children, 5-16 years old.
MMPI - Minnesota Multiphasic Personality Inventory, personality testing.
Stanford Binet - MC used intelligence test for young children.
Psychological disorders:
Psychosis - severe disorganization of the personality associated with depression, delusions and hallucinations.
Neurosis - a form of maladjustment in which the person is unable to cope with anxieties, leads to the use
of defense mechanisms.
Schizophrenia - psychosis in which there is a lack of harmony between aspects of the personality.
Involutional melancholia - psychotic behavior associated with the climacteric, accompanied by
agitation, delusions, anxiety and paranoid reactions.
Defense mechanisms:
Reaction formation - the subject denies a disapproved motive or desire by giving strong expression
to its opposite.
Repression - a guilt or anxiety producing impulse or memory is denied by its disappearance from awareness.
Ex: amnesiacs. Bury a memory and not deal with it.
Regression - behavior characteristic of an earlier developmental stage.
Suppression - disapproved impulses or desires are not overtly revealed, or acted upon.
Sublimation - socially unacceptable motives or desires are expressed in socially acceptable forms.
Changing behavior to accepted norms.
Compulsion - neurosis characterized by an irresistible impulse to perform an act contrary to one’s
better judgment or will.
Obsession - neurosis characterized by recurrent thoughts, feelings, or impulses that the subject recognizes
as morbid and which he feels a strong resistance.
Narcissism - self-love or admiration.
Affective disorder - major depressive episode.
Hysterical - histrionics, theatrical gestures.
Schizoid - introverted and withdrawn, emotionally cold and distant.
Antisocial - psychotic/sociopath, acting out their conflicts with no remorse or guilt.
Paranoid - suspicious attitudes leading to aggressive feelings.
Electra complex - libidinous fixation of daughter toward father.
Oedipus complex -libidinous fixation of son toward mother.
Jacosta complex - libidinous fixation of mother toward son.
Phaedra complex - the love and attraction between a stepparent and a stepchild.
Associated Clinical Sciences
Jurisprudence:
Slander - verbal, to say something false about another person.
Libel - written, to write something false about another person. To recover one must prove damages.
Evidence - anything presented in court used by the judge or jury in making a decision.
Hearsay - evidence, which does not derive its value from the witness itself, but gained or acquired from another.
Deposition - a sworn statement of fact given before a notary public can be used as evidence.
Principal - one who retains an agent to act for him.
Contract - a promise to perform for which consideration is given and for which the law recognizes a duty to perform.
Must have: 1) mutual consent, 2) consideration, 3) competent parties, 4) object of contract must be legal,
5) reality of consent to contract. Offer + Acceptance = Contract.
Informed consent - the patient must be informed of the dangers inherent with a procedure before consenting to it.
Expert witness - a person qualified by special studies in special areas of knowledge, allowed to give their opinion.
Privileged communication - confidential communication that does not have to be revealed in court.
Husband/wife, doctor/patient, lawyer/client.
Contributory negligence doctrine - a person may not collect damages if their own negligence contributed to the cause.
Partnership responsibility - all partners are liable for the negligence of one another or of an employee. Release of one
partner releases liability for all.
Termination of partnership - In the event of death surviving partner can buy interest from the deceased estate.
Subpoena - a written legal order requiring one to appear in court to give testimony.
Summons - an official order to appear in court to respond as a defendant to a charge.
Respondent superior - an employer is responsible for the torts (civil wrong) of their employee.
Malpractice case - tried in a tort (civil wrong) court.
Voir Dire - to speak the truth. Res ipsa loquitor - the thing speaks for itself.
Res adjudicata - the matter has been decided.
Dermatology:
Pruritis - severe itching, cutaneous hyperesthesia.
Intertrigo - superficial dermatisis in the folds of the skin.
Pustule - small elevation of skin filled with lymph or pus.
Vesicle - blisterlike elevation on the skin filled with serous fluid.
Bullae - large blisters or skin vesicles filled with fluid, also called blebs.
Wheal - round elevation of the skin with a white center and pale red periphery accompanied by pruritis.
Nodule - a small node or aggregation of cells.
Papule - red elevated area of the skin, solid and circumscribed. Often precede vesicle or pustule formation.
Macule - discolored spots or patches on the skin, neither elevated or depressed. Ex: vitiligo, pellagra, rubella.
Keloid - overgrowth of scar tissue due to abnormal amounts of collagen in the scar tissue.
Albinism - melanocytes do not produce melanin ® no tissue pigment.
Vitiligo - acquired idiopathic destruction of melanocytes resulting in patches of depigmentation (often having
hyperpigmented border)
Tinea infections - Mycotic (fungal) skin diseases occurring on various parts of the body. Diagnosis confirmed
with a Wood’s lamp (UV light).
t. barbae - beard t. capitis - head t. corporis - body, AKA ringworm
t. cruris - groin/jock t. pedis - foot t. unguium - nails, AKA onychomycosis
Stasis (not moving) dermatisis - persistent inflammation of the skin in the lower extremities with a tendency toward
brown pigmentation. Associated with venous incompetence. Ex: bed sores, DM, overweight people.
Stasis ulceration - commonly seen lower leg and ankle region with diabetes mellitus.
Furuncle - staphylococcal infection of a hair follicle or sebaceous (oil secreting)gland.
Carbuncle - multiple furuncles.
Miliaria - AKA prickly heat, inflammation of sweat glands.
Urticaria - AKA hives, characterized by formation of wheals and hives.
Psoriasis - dry silvery scales usually on the extensor surfaces. Ex: elbows and knees.
Dermatomyositis - Heliotropic rash on the eyelid.
Associated Clinical Sciences
Rubella - AKA German measles, maculopapular rash 2-3 days. NB question - vaccinate mother to prevent in newborn.
Rubeola - AKA measles, acute contagious disease marked by fever, catarrhal (inflammation of mucous membranes)
symptoms and rose colored macular eruptions. Koplik’s spots - small red spots with blue white centers on the oral mucosa, usually precede cutaneous eruptions.
Varicella - AKA chickenpox, childhood disease characterized by fluid filled subdermal lesions that pass through
stages of macules, papules,vesicles and crusts. MC complication is secondary infection.
Icthyosis - dry skin (xeroderma), AKA fish skin or scaly skin.
Acne - papules, pustules, comedones and inflamed nodules. Inflamed hair follicle or sebaceous gland.
Rosacea - chronic inflammation of the nose, cheeks and forehead, MC in middle-age to older people. Characterized by
papules, pustules, telangiectasia, erythema and hyperplasia of the soft tissue of the nose.
Pityriasis rosea - skin condition which appears in “herald” or “mother” patches, etiology unknown.
Impetigo - superficial vesiculopustular lesions with bullae formation and honey colored crusts. Etiology strep or staph.
Hyperhydrosis - overactive sweat glands.
Lichen planus - pinhead sized papules that coalesce to form rough, scaly, polygranular, blue/purple lesions. Intense
pruritis with lesions concentrated on flexor surfaces of arms, trunk and genitalia.
Erysipelas - acute febrile disease, cellulitis, vesicles and bullae. Etiology: streptococcal.
Pemphigus - uncommon, potentially fatal skin condition characterized by formation of bullae on skin and mucus
membranes. NB question: middle aged Jewish male presents with multiple blister-like skin lesions.
Dermatitis herpetaformis - chronic inflammatory disease characterized by erythematous, papular, vesicular, bullous,
or pustular lesions with tendency to grouping. Intense burning and itching, primarily extensor surfaces.
Alopecia capitis - hair loss on head. Alopecia universalis - hair loss over entire body.
Hirsuitism - excessive hair growth in unusual places, especially in women. Increased androgen production or
metabolism. Often seen with pregnancy.
Addison’s disease - decreased adrenocortical hormones resulting in bronze colored skin, irregular patches of vitiligo.
Cushing’s syndrome - increased glucocorticoids resulting in edema , hair loss, skin discoloration and purple striae. Icterus - AKA jaundice, pigmentation of the tissues, membranes and secretions with bile pigments
Myopia - nearsighted, image formed before retina due to longer eye.
Hyperopia - farsighted, image formed behind retina due to shorter eye.
Astigmatism - irregular curvature of the cornea or lens causing diffusion of light rays on the retina.
Sexually transmitted diseases (STD)
Chlamydia - MC STD, causes non-gonococcal urethritis, non-specific cause, primary cause of Reiter’s syndrome.
Pelvic pain and swelling, rectal stricture. Lymphogranuloma venerum - unilateral lymph node enlargement.
Syphilis - caused by treponema pallidum, dx with dark field microscopy, tx with penicillin.
Primary - hard painless chancre, well defined, VDRL+ days after chancre appears.
Secondary - condylomata lata(flat vulvar warts), tiny brown spots on thorax, soles and palms.
Tertiary - tabes dorsalis, gumma formation, not contagious in this stage.
Congenital - Hutchinson triad (pegged teeth, deafness, interstitial keratosis), saber shin deformity.
Gonorrhea - caused by neisseria gonorrhoeae, contagious catarrhal inflammation of the genital mucus membranes.
Gram neg. diplococci, commonly leads to joint infections MC knee, female can be asymptomatic.
Trichomas vaginalis - caused by parasitic protozoa, persistent burning, redness and frothy, greenish yellow discharge.
Gardnerella vaginalis - caused by gram neg. bacilli, characteristic malodorous discharge, clue cells.
Candidiasis - AKA moniliasis, yeast infection caused by candida albicans. White cheesy plaques. Seen in DM,
pregnancy, babies (thrush).
Haemophilus ducreyi - caused by gram neg. bacilli, forms soft painful chancroid, highly infectious.
Molluscum contagiousum - pearly, smooth, waxy, dome shaped, umbilicated papules on the genitals/penis.
Condylomata accuminata - bulbous vulvar warts caused by human papilloma virus.
Parasites: Scabies - mite that burrows under the skin, causes intense pruritis.
Pediculosis - AKA lice, crabs. P.capitis = head lice, P. corporis = body lice.
Antidotes: Chemical - combines with poison to form harmless substance.
Mechanical - prevents absorption.
Physiological - counteracts poison by causing opposite physiologic effect.
Universal - 2 parts activated charcoal / 1 part magnesium oxide / 1 part tannic acid / ½ ounce warm water.
Associated Clinical Sciences
Hypertension: Systolic of =140 on 2 or more visits, and diastolic of =90 on 2 or more visits.
Essential - AKA primary or idiopathic hypertension, no definite etiology.
Benign - slow progression, chronic, relatively mild.
Malignant - rapid progression with severe vascular damage. Seen with renal necrosis/failure.
Category Systolic Diastolic
Very severe = 210 = 120
Severe 180-209 110-119
Moderate 160-179 100-109
Mild 140-159 90-99
Prescription medications: Bioavailability - portion of a drug that reaches the target tissue.