Pediatrics Brs Chapter 3

Front 1

Average duration of the growth spurt is _ and occurs _ earlier in females.

Back 1

2-3 years, 18-24 months

Front 2

What is "true puberty"?

Back 2

when gonadotropins and sex steroids increase

Front 3

Puberty begins _ later in males than in females.

Back 3

6-12 months

Front 4

Male's first sign of puberty?

Back 4

testicular enlargement (11-12)

Front 5

Females first sign of puberty?

Back 5

thelarche: breast buds (9.5 yoa)

Front 6

When should annual pelvic exams start in females?

Back 6

1) sexually active
2) h/o pelvic pain/vag discharge/abnormal bleeding
3) older than 18 yoa

Front 7

Labs for Adolescent Health Screening. (5)

Back 7

1. h/h
2. U/A
3. Fasting lipid panel (if indicated)
4. HIV (if indicated)
5. PPD

Front 8

5 Screens for adolescent females who are sexually active

Back 8

1) Gono cervical cx
2) serol. syphillis
3) Im Fl Ab for Chlamydia
4) PAP smear (HPV)
5) Vaginal wet mount (Trichomonas)

Front 9

3 Screens for adolescent males who are sexually active

Back 9

1) Sero Syphillis
2) Urine ligase Chlamydia
3) U/A for pyuria

Front 10

Diagnostic Criteria for Major Depression

Back 10

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

Front 11

Diagnostic Criteria for Dysthymic Disorder

Back 11

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

Front 12

Problem drinking?

Back 12

Drunk 6 or more within 1 year or having problems attributable to

Front 13

Binge Drinking?

Back 13

5 or more drinks at one sitting

Front 14

T/F - teens who smoke tobacco are more likely to try other drugs

Back 14

True

Front 15

5 Health Complications of smoking

Back 15

1) CAD/stroke
2) Cancer
3) CLD/asthma
4) PUD
5) Pregnancy complications

Front 16

Define obesity?

Back 16

BW > 20% of ideal BW

Front 17

6 Health Effects of Obesity

Back 17

1) earlier puberty
2) HTN/ CV dz
3) High Chol/TG
4) T2DM
5) Gallbladder Dz
6) Ortho problems

Front 18

Diagnostic Criteria for Anorexia Nervosa (4).

Back 18

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

Front 19

Diagnostic Criteria for Bulimia Nervosa (5).

Back 19

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

Front 20

HEENT PE finding for bullimia nervosa.

Back 20

Parotid swelling

Front 21

T/F - only condoms made of latex protect against transmission of HIV virus.

Back 21

True

Front 22

Vaginal diaphragm is placed _.

Back 22

Against the cervix (increased risk of UTI)

Front 23

Use of the Cervical cap requires?

Back 23

follow up pap smear to screen for cervical dysplasia (associated)

Front 24

IUD's increase the risk of _.

Back 24

PID

Front 25

Absolute C/I's to OCP (5).

Back 25

1) pregnancy
2) breast/endometrial cancer
3) stroke
4) CAD
5) liver dz

Front 26

3 most common STDs

Back 26

HSV, HPV, C. trachomatis

Front 27

9 Risk factors for STD.

Back 27

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

Front 28

Malodorous, yellow green discharge, with friable strawberry cervix? Lab? pH? Rx? Partners?

Back 28

Trichomonas vaginitis,
Wet mount, pH > 4.5, Metronidazole for pt and partner

Front 29

Most common cause of vaginitis.

Back 29

Bacterial vaginosis

Front 30

Gray-white discharge and fishy smelling? Lab? pH? Rx? Partners?

Back 30

bacterial vaginosis, whiff test or wet mount "clue cells", pH >4.5, Oral Metronidazole, Just Patient Rx'd

Front 31

White Curdlike discharge with severe itching? Lab? pH? Rx? Partners?

Back 31

candidal vulvovaginitis, wet mount fungal hyphae, normal pH < 4.5, Oral Fluconazole, just patient Rx'd

Front 32

gold Standard Lab for Chlamydia Cervicitis.

Back 32

Culture of Endocervix

Front 33

Complications of Chlamydia Cervicitis

Back 33

1) PID
2) Tuboovarian Abscess (TOA)
3) infertility
4) ectopic pregnancy
5) chronic pelvic pain
6) Fitz Hugh Curtis Syndrome

Front 34

Treatment of uncomplicated C. Trachomatis

Back 34

1) oral doxycycline (or) erythromycin (treat partners too)

Front 35

Disseminated Infection with Gonorrhea. (3)

Back 35

occurs in 3% of patients and is characterized by
1) asymmetric polyarthritis
2) papular/pustular skin lesion
3) rarely, meningitis/ endocarditis/ septicemia

Front 36

Treatment of uncomplicated N. Gonorrhea

Back 36

1) IM ceftriaxone (or) single dose oral Rx with ofloxacin/cipro/cefixime (treat partners too)

Front 37

T/F - PID is more common in the second half of the menstrual cycle.

Back 37

False, 1st half

Front 38

Inpatient Rx for PID.

Back 38

IV cefoxitin + oral doxycycline (or) IV clindamycin + IV gentamycin

Front 39

Outpatient Rx for PID.

Back 39

14d with offloxacin + clindamycin or IM ceftriaxon (1) + 14d of doxycycline

Front 40

Cervical cancer causing HPV is detected by _ during colposcopy, which colors lesions white.

Back 40

3% acetic acid wash

Front 41

_ released by functioning corpus luteum creates a secretory endometrium.

Back 41

progesterone

Front 42

Most common menstrual disorder

Back 42

dysmenorrhea (primary no abnormality, secondary with abnormality)

Front 43

Primary dysmenorrhea is caused by _. Rx?

Back 43

increased production of prostaglandings, Rx use NSAIDs or OCPs

Front 44

Primary vs Secondary Amenorrhea?

Back 44

Primary: abscence in 16 yo with normal 2nd sex traits or 14 yo without traits,
Secondary: 3 cyles or 6 months after regularity

Front 45

Lab evaluation of Amenorrhea.

Back 45

1) pregnancy test
2) TSH/ free T4
3) Fasting Prolactin level
4) FSH and LH levels

Front 46

Amenorrhea with high FSH/LH, Think?

Back 46

Karyotype for Turners

Front 47

Amenorrhea with low FSH/LH, Think?

Back 47

Imaging for tumor exclusion

Front 48

T/F - DUB may result from anovulatory cycles.

Back 48

True

Front 49

T/F - in DUB, hormonal therapy should be used if patient is anemic.

Back 49

True

Front 50

T/F - Laboratory stuides are necessary for gynecomasti even if growth is normal and puberty has begun in healthy male.

Back 50

False, no labs necessary (usually resolves in 12-15 months)

Front 51

T/F - Torsion is a urologic emergency that must be performed within 6 hours to save the ball.

Back 51

True

Front 52

Blue dot sign is for _. Lab and Rx for ?

Back 52

Torsion of the testicular appendage. (note dopplers are normal and Rx is rest and analgesia)

Front 53

In Indirect inguinal hernia, an emergent referral is necessary if _

Back 53

any evidence of bowel incarceration (erythema, pain, tenderness)

Front 54

T/F - Hydroceles may be smaller in the morning and larger in the evening.

Back 54

True - Diagnosis with transillumination

Front 55

Varicocele referral to Urologist (3)

Back 55

1) painful
2) distended
3) small testicle