5- female teen wcc

Question 1

HEEADS mneumonic

Answer 1

H - Home
E - Education and employment
E - Eating disorder screening
A - Activities
D - Drugs
S - Sexuality
S - Suicide risk and depression
S - Safety (fights, car, weapons)

Question 2

progression of anorexia

Answer 2

Bradycardia, electrolyte imbalances, arrhythmias, circulatory collapse, death

Question 3

order of puberty female

Answer 3

Breast buds appear (age 10-11 years), then,
Pubic hair appears (age 10-11 years) then,
Growth spurt (age 12 years) then,
Periods begin/menarche (age 12-13 years) then,
Attainment of adult height (age 15 years)

Question 4

order of puberty male

Answer 4

Growth of testicles ( age 12 years) then,
Pubic hair appears (age 12 years) then,
Growth of penis, scrotum (age 13-14 years) then,
First ejaculations (age 13-14 years) then,
Growth spurt (age 14 years) then,
Attainment of adult height (age 17 years)

Question 5

which tests to order in suspected bleeding disorder

Answer 5

Complete blood count (CBC) with platelets, red blood cell indices, and a smear
Reticulocyte count
Prothrombin time (PT) and partial thromboplastin time (PTT)
Platelet function test (which has largely replaced the bleeding time in most centers)
Factor VIII activity
von Willebrand factor antigen
• von Willebrand factor activity (also known as Ristocetin cofactor)

Question 6

von Willebrand’s Disease (vWD

Answer 6

mostly aut dom, 3 types

Ecchymoses (small hematomas in areas of trauma)
Epistaxis
Menorrhagia (why vWD is diagnosed more often in women than men)
Bleeding post-tonsillectomy and dental extractions
Gingival bleeds

Question 7

treatment of vWD

Answer 7

intranasal or intravenous desmopressin.

OCP to prevent menorrhagia

Question 8

ADHD criteria

Answer 8

> 5 inattentive or hyperactive-impulsive symptoms were present for at least six months and are inappropriate for the person’s developmental age
Several symptoms must be present before age 12 years
Symptoms are evident in two or more settings, (e.g., at home, school or work; with friends or relatives; in other activities).
Symptoms interfere with the individual’s functioning socially or at school or work
Symptoms are not attributable to another mental disorder

Question 9

red flag risk factors for LD

Answer 9

History of maternal illness or substance abuse during pregnancy
Complications at the time of delivery
History of meningitis or other serious illness
History of serious head trauma
Parental history of learning disabilities or difficulty at school

Question 10

side effects of stimulants for ADHD in kids

Answer 10

loss appetite
insomnia
decrease in growth velocity

Question 11

do ADHD stimulants cause tics?

Answer 11

no, but they can unmask them

Question 12

things to rule out to diagnose primary HTN

Answer 12

Placement of an umbilical arterial or venous line during the perinatal period may predispose to renal vascular disease.

UTIs –> HTN

Catecholamine excess–pheochromocytoma

family history of renal disease

coarctation of aorta

Question 13

what are preHTN and stage 1 and 2 HTN cutoffs in percentiles?

Answer 13

normal: <90th
pre: 90-95

stage 1- 90-99

stage 2: >99th

Question 14

differential for fatigue in teen female

Answer 14

anemia

bleeding disorder

hypothyroidism

depression

substance abuse