Adolescent Health - Fapb

Front 1

What is the first sign of puberty in girls? First sign in boys? and when?

Back 1

Girls: growth spurt, begins at 9yo and peaks between 11.5 and 12yo

Boys: first sign is scrotal and testicular growth, begins at 10-12 years of age

Front 2

When does the male growth spurt usually begin?

Back 2

11yo and peaks at 13.5 yo

Front 3

Breast Development - Stages

Back 3

I - Preadolescent
II - Breast bud (11yo)
III - enlargement, no contour separation (12yo)
IV - Secondary mound, projection of areola and papilla (13yo)
V: Mature, 15yo

Front 4

PH development - ages

Back 4

I - preadolescent
II - sparse, downy, straight G(12), B(13.5)
III - dark, coarser, more curled G(12.5), B(14)
IV - hair resembles adult, not to medial thighs G(13), B(14.5)
V - mature, G(14.5), B(15)

Front 5

Gonadal Dev Male - stages

Back 5

I - preadolescent
II - enlargement of scrotum and testes, darkening of scrotum and texture changes (12yo)
III - Enlargment of penis (13yo)
IV - increase in penis breadth and dev of glans (14yo)
V - Mature stage (15yo)

Front 6

Cholesterol Screening - Indications

Back 6

+ FHx including hyperlipidemia (>240), h/o MI, angina, PVD, CVD, sudden cardiac death, documented coronary atherosclerosis <55yo

Front 7

Primary Amenorrhea - definition

Back 7

absence of menses by 16yo

Front 8

Causes of Primary Amenorrhea

Back 8

1. Chromosomal
2. Congenital Outflow Tract Obstruction (vaginal septum,imperforate hyman)
3. Hypothalamic dysfunction (abnl GnRH secretion, no LH surge)
4. CNS tumors: prolactinoma, craniopharyngioma, dysgerminoma, Langerhans cell histiocytosis (s/s: HA, visual field defects)
5. Ovarian: Includes primary ovarian failure, PCOS
6. Endocrine: virilization disorders (CAH, Cushings Sy)
7. Physiologic delay of puberty
8. pregnancy

Front 9

Male Puberty in Order

Back 9

1. Testicular Volume
2. Penile enlargement
3. Growth spurt

Front 10

Female Puberty in Order

Back 10

1. Thelarchy
2. Pubarchy
3. Growth Spurt
4. Menarchy

boobs, pubes, spurt, squirt

Front 11

Delayed Puberty Definition Males, Females

Back 11

Males:
- no change in testes size by 14
Females:
- no changes by age 13
- no menses by 16

Both: >4-5 years from start to finish

Front 12

Minors may give consent for their own medical care if...

Back 12

1. they are living apart from their parents
2. are themselves the parent of a child
3. are in the armed services
4. if they are > or = 15yo, are "mature minors" can give informed consent for care including low risk procedures
5. any age can consent for HIV and STD testing/treatment, sexual health
6. ok to give consent at any age for treatment of substance abuse

Front 13

Definition of primary amenorrhea = absence of menses by

Back 13

16 years of age

Front 14

Chromosomal anomalies associated with amenorrhea

1. complete androgen insensitivity syndrome (46 XY)

Back 14

Defect: testosterone resistance 2/2 an androgen receptor defect.

Anatomy: phenotypic female; testes are present; no upper tract female structure; THELARCHE BUT NOT ADRENARCH at puberty

Labs/Tx: High serum testosterone. Pelvic ultrasound shows absence of upper vagina, uterus, and fallopian tubes. Excise testes dt increased testicular cancer risk.