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54 Cards in this Set
- Front
- Back
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Pubic hair Tanner stage 1
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no hair
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Pubic hair Tanner stage 2
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Sparse, downy hair; at base symphysis pubis
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Pubic hair Tanner stage 3
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Sparse, coarse hair; across symphysis pubis
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Pubic hair Tanner stage 4
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Coarse; pubic triangle; no spread to thighs
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Pubic hair Tanner stage 5
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Coarse hair spread to thighs
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Breast development Tanner stage 1
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Preadolescent
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Breast development Tanner stage 2
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Breast budding
Mean age 11 |
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Breast development Tanner stage 3
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Budding enlarged
Mean age 12 |
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Breast development Tanner stage 4
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Areola and papilla form secondary mounds
Mean age 13 |
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Breast development Tanner stage 5
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mature female breast
Mean age 15 |
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Male genital development Tanner stage 1
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Prepubertal
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Male genital development Tanner stage 2 (3)
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Enlargement scrotum/testes
Skin of scrotum redden Mean age 11.4 |
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Male genital development Tanner stage 3 (3)
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Enlargement of penis (length)
Growth scrotum/testes Mean age 12.9 |
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Male genital development Tanner stage 4 (4)
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Increased size of penis (breadth)
Development of glans Darkening of scrotal skin Mean age 13.8 |
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Male genital development Tanner stage 5 (2)
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Adult in size and shape
Mean age 14.9 |
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Prevalence of gynecomastia in adolescent males? how many u/l v. b/l?
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50% of boys
50% of which b/l; 50% u/l |
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How long does it take for gynecomastia regress?
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2 years
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Precocious puberty occurs at what ages? 2
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M: before 9
F: before 8 |
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Delayed puberty defined as
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Lack of secondary sexual development by age 14
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HEADSSS mnemonic
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Home
Education Activities Drugs Sex Suicide Safety |
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CAGE mnemonic
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Cut down
Annoyed Guilt Eye-opener |
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CRAFFT mnemonic
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Car driven by someone high/drunk
Relax using drugs/EtOH Alone when drugs/EtOH Friends tell you to cut down Forget to do things when high/drunk Trouble from using drugs/EtOH |
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Sexual Hx: 9
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Age when first had sex
Forms of sex/sexuality # of lifetime/current partners Age of partners Forms of contraception Emergency contraception Prior pregnancies/fathered child Nonconsensual physical contact/sex Exchange sex for $$/drugs |
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Suicide/Depression Hx:
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Positive/negative feelings of self
H/o depression/mental health problems SIGECAPS |
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SIGECAPS mnemonic
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Sleep - early wakings
Interest decreased Guilt Energy decreased Concentration decreased Activity decreased Psychomotor retardation Suicidality |
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ROS: nutrition 4
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dietary habits: skipped meals, diets, purging, +/- wt
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ROS: skin 4
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acne, moles, rashes, warts
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ROS: GU 5
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dysuria, urgency, frequency, d/c, bleeding
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ROS: Menstrual 5
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menarche, frequency, duration, pain, menometrorrhagia
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FHx 4
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Suicide, EtOH, substance abuse
Chronic medical conditions |
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Emancipated minors (NYS definition) 7
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Pregnant (considered prenatal care)
Have kids Married Armed services Economically independent Child seeks emancipation and granted by court "Mature minor" |
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Which adults consent to minor care? 3
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Parent (even if placed in foster care)
Guardian Local commissioner of social services |
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Who can consent for minor receiving vaccines?
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Parent, guardian, sibling, etc as long as has written authorization
-- even if can't consent to other stuff --- |
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What is emancipation
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Renunciation of parental rights to a child
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When test for HIV? 4
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13+
3-4 months after documented STI after new sex partner if pt high risk annually in high risk |
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How test for GC in sexually active M?
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NAAT (nucleic acid amplication test)
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When screen in sexually active males? 2
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Even if asymptomatic because high risk
3 months after + test |
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STI tests in females 5
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NAAT for GC/chlamydia
Wet mount saline/KOH Mid-vag pH cervical gram stain Pap if immunocompromised |
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When screen for cholesterol?
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Once during puberty
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Tdap names? When given?
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Boostrix @ 10
Adacel @ 11 |
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When give Tdap in adolescent? 3
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Routine
Booster Tetanus PPx |
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C/in to Tdap? 3
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preferred method when > 11 y/o
allergy to any component encephalopathy w/in 7 days receiving prior vax |
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Sz d/o and Tdap? 2
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Only once well controlled
Give DTaP c antipyretics x 24 hr |
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Progressive neuro d/o and Tdap?
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Defer pertussis until neurologically stable
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Types of meningococcal vaccine? 2 Contain? Age groups?
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Quadrivalent: A, C, Y, W-135; <2 y/o
Tetravalent: A, C, Y, W-135; 2-55 y/o |
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Why no meningococcal against group B?
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poor immunogenicity
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How is meningococal vax given? 2
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1st dose 11-12; booster @ 16
if 1st dose 13-15 y/o, can give booster at 16-18 |
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High risk groups that should get meningococcal vax @ age 2-10 then q 5 yrs? 4
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functional/anatomic asplenia
terminal complement def Properidin def HIV |
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Older high risk groups that should get meningovax 4
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College freshmen
Travelers to endemic US military Outbreak ctrl |
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2 types of HPV vax? protect against?
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Guardisil: 6, 11, 16, 18
Cervarix: 16, 18 |
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which HPV vax only given to males?
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Guardisil
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when/how give Guardisil?
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As early as 9 y/o but recommend 11-12
2nd dose at 2 months 3rd dose at 6 months (12 wk after 2nd) |
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what side fx a/w Guardisil? how should you watch them?
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syncope
obs x 15 min |
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ACHES mnemonic for severe complications from combine hormonal contraceptives
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Abd pain - pelvic/mesenteric vein thrombosis, pancreatitis
Chest pain - PE Headache - stroke, retinal vein thrombosis Severe leg pain - thrombophlebitis |
