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55 Cards in this Set

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