1.Arthritis resulting in degeneration of the bones and joints, especially those bearing weight and results in bone rubbing against bone.
2.Symptoms: pain after repetitive use; morning stiffness < 15 mins
3.Signs: tenderness, bone crepitus,swelling joint
Hand: Heberden’s node and Bouchard’s node
Foot: Hallux Valgus
4.Diagnosis: arthrocentesis; arthroscopy; joint replacement
5.NSAIDs: aspirin; ibuprofen; nabumetone; naproxen
6.Rheumatoid arthritis: is an auto immune disorder, may also affect the skin, eyes,lungs, heart, blood or nerves, and it’s a chronic disorder.
7.Risk factors: 40-50 years old; women > men
8.Morning stiffness > 1 hour; Joint pain is often felt on both sides of the body; The fingers (but not the fingertips), wrists, elbows, shoulders, hips, knees, ankles, toes, jaw, and neck may be affected.
9. Symptoms: Chest pain when taking a breath (pleurisy)
Eye burning, itching, and discharge
Nodules under the skin (usually a sign of more severe disease)
Numbness, tingling, or burning in the hands and feet
Joint destruction may occur within 1 - 2 years after the disease appears
10.Rheumatoid nodules: necrotizing granuloma坏死性肉芽肿
11. Sjogren's syndrome; pleuritis; pericarditis; anemia; Felty’s
syndrome: 1) rheumatoid arthritis;
2) an enlarged spleen (splenomegaly);3) an abnormally low white
blood count.
12. ACR 1987 criteria:
13.Diagnosis: 1) erythrocyte sedimentation rate;2) C-reactive protein; 3) rheumatoid factor
14.Medicine: methotrexate
15.Gout is a common painful form of arthritis. It causes swollen red hot and stiff joints. Gout occurs when uric acid builds up in your blood.
16.Causes: hyperuricemia: high levels of uric acid
17.Symptoms: podagra; tophus (tophi 复数): are chalky deposits of uric acid that commonly occur in the elbows and earlobes.
18.Medicine: 见5, but can use corticosteroids and colchicine(特有药)
19.Spinal disc herniation types:
1) disc degeneration: chemical changes associated with aging causes discs to weaken, but without a herniation
2) prolapse: the posterior longitudinal ligament remains intact but the nucleus pulposus impinges on the anulus fibrosus
3) extrusion: the nuclear material emerges through the annular fibers but the posterior longitudinal ligament remains intact.
4) sequestration: the nuclear material emerges through the annular fibers and the posterior longitudinal ligament is disrupted.
A portion of the nucleus pulposus has protruded into the epidural space.
20. Treatment: ESI: epidural steroid injection; laminotomy and discectomy
21. Osteoporosis: Decrease in bone mass that results in a thinning and weakening of the bone with resulting fractures. The bone becomes more porous, especially in the spine and pelvis.
特征：Dowager’s hump
骨质减少30%以上才能在X片中看出。
补钙药物：alendronate
22. Fracture: Closed / simple Incomplete
( Linear ,Greenstick )
Open/ compound or Complete (Transverse , Oblique,Spiral,Comminuted Impacted ,
Compression ,Depressed ,Epiphyseal )
23.Ovary: Produce female hormones---estrogen and progesterone.
Estrogen responsible for appearance of female sexual characteristics and menstrual cycle.
Progesterone maintains uterine environment for pregnancy.
24.Fetal appurtenances:Placenta; Fetal membranes; Umbilical cord; Amniotic fluid
25.Functions of placenta: Air exchange
Supply of nutrition
Remove the waste from the fetus
Defense function
synthetical function:
HCG: human chorionic gonadotropin HPL: human placental lactogen
HCT: human chorionic thyrotropin Estrogen
Progestogen
26. Umbilical cord: 27.Amniotic fluid: amount:300-1000ml Polyhydramnios: > 2000ml Oligohydramnios: < 300ml
Its function:
27. 三个阶段： first trimester: 1-12 weeks Second trimester: 13-27 Length 30-70 cm, average
50-60 cm
Diameter: 1.0-2.5 cm
Protect the fetus
1. The developing baby to move in the womb, which allows for proper bone growth
2. The lungs to develop properly
Protect the mother 1. Reduce the discomfort caused by fetal
Third trimester: 28-birth
28.Diagnosis of pregnancy:
Symptoms: 1. Amenorrhea
2. morning sickness
3. frequency of urination
PE/signs: Breast changes 8 weeks:Breast turns bigger
Tenderness
Sore nipples
Montgomery tubercles
Darkened areola
Reproductive organ changes: Hyperemia of cervix and vaginal wall
Cervix turns soft---Hegar sign 29.Auxiliary examinations: B-ultrasound: 5 weeks: gestational ring Ultrasonic Doppler
Pregnancy test
Progesterone test
Cervical mucus examination
Basal body temperature
31. An ectopic pregnancy (EP) is a condition in which a fertilized egg settles and grows in any location other than the inner lining of the uterus.
32. Tubal pregnancy (最常见)：interstitial
Isthmus
Ampullar(最常见)
Infundibular
Ovarian
Cervical
Broad ligament
Abdominal
33.给药：methotrexate
34.Diagnosis: Pregnancy test
Transvaginal ultrasound
Culdocentesis
Laparoscopy: indications: Patients with unruptured tubal pregnancy
Early stage of abortion
Acute abdomen with unknown reasons
35.Treatment: surgery: laparotomy: salpingectomy or conservative surgery
Laparoscopy
36.子宫肌瘤治疗：hysterectomy or myomectomy or new: UAE: uterine artery embolization
Medication: mifepristone
37.Abortion is the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. Pregnancy termination happens when the pregnancy is less than 28 weeks and the weight of fetus is less than 1000g. Early abortion < 12 weeks; late abortion > 28 weeks
38.Types: spontaneous and induced
39.自然流产分类：threatened: pregnancy
Inevitable abortion: complete
incomplete
40.Threatened pregnancy: A condition in which vaginal bleeding is less than in inevitable abortion and the cervix is not dilated, and abortion may or may not occur.
41.A missed abortion is when the embryo or fetus has died, but a miscarriage has not yet occurred.
42.Habitual abortion: The miscarriage of 3 or more consecutive pregnancies
43. Septic: An abortion associated with a uterine infection. The infection can occur during or just before or after an abortion.
44. Induced (before 10 weeks)
D&C: dilation and curettage
D&E: dilation and evacuation (in the second trimester of pregnancy, 12 weeks)
45.Placenta previa: occurs when a baby's placenta partially or totally covers the mother's cervix —the doorway between the uterus and the vagina. Placenta previa can cause severe bleeding before or during delivery.
46.Types: complete
Partial
Marginal
Low-lying
47. Influence: postpartum hemorrhage
placenta accreta
Puerperal infection
amniotic fluid embolism
Premature delivery and high mortality of perinatal infant
48.Placental abruption is the separation of the placenta from the uterine lining. This condition usually occurs in the third trimester but can occur any time after the 20th week of pregnancy.
49.Types: revealed abruption
Concealed
Mixed
50. EDC = (LMP(last men perious)-3month/+9month) + 7 days
51. Premature delivery: 28-37 weeks gestational age
Term delivery: 37- 42
Postterm delivery: after 42 weeks
52.宫口扩张 10cm
53. Mechanism of labor: Engagement
Descent
Flexion
Internal rotation
Extention
Restitution and external rotation
54.Threatened labor: False labor
Lightening
Bloody show
55.Total stage of labor:
The 1st stage—from onset of labor to full dilation of the cervix (about 10 cm);
nullipara:11-12 hours; multipara: 6-8 hours
The second stage is the time from full cervical dilation to delivery of the fetus.
nullipara:1-2 hour; multipara: a few minutes- 1 hour
The 3rd stage of labor begins after delivery of the infant and ends with delivery of the placenta.
5-15 minutes (shouldn’t be over 30 minutes)
56. Episiotomy: 会阴切开术
57.Acute appendicitis is a rapidly progressing inflammation of a small part of the large intestine called the appendix.
58.McBurney's point is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the navel. This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.
59.Types: Acute simple appendicitis
Acute purulent appendicitis
Gangrenous appendicitis
Perforationg appendicitis
Periappendiceal abscess
60. Symptoms: Pain first, vomiting next and fever last; abdominal pain,tenesmus = downward urge; gastrointestinal symptoms: 1. loss of appetite
2. nausea
3. vomiting
4. constipation or diarrhea