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55 Cards in this Set
- Front
- Back
Average duration of the growth spurt is _ and occurs _ earlier in females.
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2-3 years, 18-24 months
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What is "true puberty"?
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when gonadotropins and sex steroids increase
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Puberty begins _ later in males than in females.
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6-12 months
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Male's first sign of puberty?
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testicular enlargement (11-12)
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Females first sign of puberty?
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thelarche: breast buds (9.5 yoa)
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When should annual pelvic exams start in females?
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1) sexually active
2) h/o pelvic pain/vag discharge/abnormal bleeding 3) older than 18 yoa |
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Labs for Adolescent Health Screening. (5)
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1. h/h
2. U/A 3. Fasting lipid panel (if indicated) 4. HIV (if indicated) 5. PPD |
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5 Screens for adolescent females who are sexually active
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1) Gono cervical cx
2) serol. syphillis 3) Im Fl Ab for Chlamydia 4) PAP smear (HPV) 5) Vaginal wet mount (Trichomonas) |
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3 Screens for adolescent males who are sexually active
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1) Sero Syphillis
2) Urine ligase Chlamydia 3) U/A for pyuria |
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Diagnostic Criteria for Major Depression
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5/9 present almost every day for at least 2 weeks and must impair functional ability
1) depressed/irritable mood 2) diminished interest in activities 3) weight change 4) sleep cycle change 5) psychomotor agitation/retardation 6) Fatigue 7) feelings of worthlessness 8) diminished ability to concentrate 9)thoughts of death/suicide |
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Diagnostic Criteria for Dysthymic Disorder
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chronic mood disturbance that lasts at least 1 year (2/5)
1) change in appettite 2) sleep pattern change 3) loss of energy 4) difficulty concentratiting 5) hopelessness |
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Problem drinking?
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Drunk 6 or more within 1 year or having problems attributable to
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Binge Drinking?
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5 or more drinks at one sitting
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T/F - teens who smoke tobacco are more likely to try other drugs
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True
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5 Health Complications of smoking
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1) CAD/stroke
2) Cancer 3) CLD/asthma 4) PUD 5) Pregnancy complications |
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Define obesity?
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BW > 20% of ideal BW
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6 Health Effects of Obesity
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1) earlier puberty
2) HTN/ CV dz 3) High Chol/TG 4) T2DM 5) Gallbladder Dz 6) Ortho problems |
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Diagnostic Criteria for Anorexia Nervosa (4).
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caloric intake insufficient
with a delusion of being fat and obsessed with being thin. 1) Refusal to maintain BW, 15% below ideal 2) intense fear of weight gain 3) disturbed body image 4) abscence of 3 menstrual cycles |
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Diagnostic Criteria for Bulimia Nervosa (5).
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1) recurrent binge eating 2x weekly for 3 months
2) lack of control over eating with guilt afterwards 3) Purging 4) Rigorous exercise/diet pills 5) disturbed body image |
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HEENT PE finding for bullimia nervosa.
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Parotid swelling
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T/F - only condoms made of latex protect against transmission of HIV virus.
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True
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Vaginal diaphragm is placed _.
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Against the cervix (increased risk of UTI)
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Use of the Cervical cap requires?
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follow up pap smear to screen for cervical dysplasia (associated)
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IUD's increase the risk of _.
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PID
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Absolute C/I's to OCP (5).
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1) pregnancy
2) breast/endometrial cancer 3) stroke 4) CAD 5) liver dz |
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3 most common STDs
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HSV, HPV, C. trachomatis
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9 Risk factors for STD.
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1) lack of barrier contrac.
2) young age to start 3) spontaneous sex encounter 4) multiple partners 5) concurrent substance abuse 6) percieved lack of risk 7) teen preg. 8) homo/bi 9) cervical ectopy |
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Malodorous, yellow green discharge, with friable strawberry cervix? Lab? pH? Rx? Partners?
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Trichomonas vaginitis,
Wet mount, pH > 4.5, Metronidazole for pt and partner |
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Most common cause of vaginitis.
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Bacterial vaginosis
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Gray-white discharge and fishy smelling? Lab? pH? Rx? Partners?
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bacterial vaginosis, whiff test or wet mount "clue cells", pH >4.5, Oral Metronidazole, Just Patient Rx'd
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White Curdlike discharge with severe itching? Lab? pH? Rx? Partners?
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candidal vulvovaginitis, wet mount fungal hyphae, normal pH < 4.5, Oral Fluconazole, just patient Rx'd
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gold Standard Lab for Chlamydia Cervicitis.
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Culture of Endocervix
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Complications of Chlamydia Cervicitis
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1) PID
2) Tuboovarian Abscess (TOA) 3) infertility 4) ectopic pregnancy 5) chronic pelvic pain 6) Fitz Hugh Curtis Syndrome |
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Treatment of uncomplicated C. Trachomatis
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1) oral doxycycline (or) erythromycin (treat partners too)
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Disseminated Infection with Gonorrhea. (3)
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occurs in 3% of patients and is characterized by
1) asymmetric polyarthritis 2) papular/pustular skin lesion 3) rarely, meningitis/ endocarditis/ septicemia |
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Treatment of uncomplicated N. Gonorrhea
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1) IM ceftriaxone (or) single dose oral Rx with ofloxacin/cipro/cefixime (treat partners too)
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T/F - PID is more common in the second half of the menstrual cycle.
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False, 1st half
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Inpatient Rx for PID.
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IV cefoxitin + oral doxycycline (or) IV clindamycin + IV gentamycin
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Outpatient Rx for PID.
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14d with offloxacin + clindamycin or IM ceftriaxon (1) + 14d of doxycycline
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Cervical cancer causing HPV is detected by _ during colposcopy, which colors lesions white.
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3% acetic acid wash
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_ released by functioning corpus luteum creates a secretory endometrium.
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progesterone
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Most common menstrual disorder
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dysmenorrhea (primary no abnormality, secondary with abnormality)
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Primary dysmenorrhea is caused by _. Rx?
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increased production of prostaglandings, Rx use NSAIDs or OCPs
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Primary vs Secondary Amenorrhea?
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Primary: abscence in 16 yo with normal 2nd sex traits or 14 yo without traits,
Secondary: 3 cyles or 6 months after regularity |
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Lab evaluation of Amenorrhea.
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1) pregnancy test
2) TSH/ free T4 3) Fasting Prolactin level 4) FSH and LH levels |
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Amenorrhea with high FSH/LH, Think?
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Karyotype for Turners
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Amenorrhea with low FSH/LH, Think?
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Imaging for tumor exclusion
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T/F - DUB may result from anovulatory cycles.
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True
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T/F - in DUB, hormonal therapy should be used if patient is anemic.
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True
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T/F - Laboratory stuides are necessary for gynecomasti even if growth is normal and puberty has begun in healthy male.
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False, no labs necessary (usually resolves in 12-15 months)
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T/F - Torsion is a urologic emergency that must be performed within 6 hours to save the ball.
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True
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Blue dot sign is for _. Lab and Rx for ?
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Torsion of the testicular appendage. (note dopplers are normal and Rx is rest and analgesia)
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In Indirect inguinal hernia, an emergent referral is necessary if _
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any evidence of bowel incarceration (erythema, pain, tenderness)
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T/F - Hydroceles may be smaller in the morning and larger in the evening.
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True - Diagnosis with transillumination
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Varicocele referral to Urologist (3)
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1) painful
2) distended 3) small testicle |