Adol Med Flashcards
Early adolescence (age)
Middle
Late
Early 10-13 yr
Middle 14-17 yr
Late 18-21 ye
First sign of puberty and hallmark of SMR 2 in males
testicular enlargement
beginning as early as 9.5 yr
First sign of puberty and hallmark of SMR 2 in females
breast buds (thelarche) between 8-12 yr
Peak height velocity females
8-9 cm/yr at SMR 2-3
approximately 6 mo before menarche
Peak height velocity males
9-10 cm/yr at SMR 3-4
SMR stage with secondary mound
SMR 4
Normal menses
cycle length
duration
blood flow
Length 21-35
7 days or fewer
6 pads or fewer
Treatment of Chlamydia
azithromycin 1 g PO once
or
Doxycycline 100 mg PO BID x 7 days
Treatment of gonorrhoeae (cervix, urethra, rectum)
Ceftriaxone 250 mg IM in a single dose
or
Single dose injectable cephalosporin plus azithromycin 1 g PO once
Treatment of gonorrhea (pharynx)
Ceftriaxone 250 mg IM in a single dose
plus Azithromycin 1 g PO once
Treatment of Treponema pallidum (primary and secondary syphillis or early latent syphillis)
Benzathine penicillin G 2.4 M u IM in 1 dose
Treatment of Treponema pallidum (late latent syphillis or syphillis of unknown duration)
Benzathine penicillin G 7.2 M u total, administered as 3 doses of 2.4 M u IM each week at 1 week intervals
Haemophilus ducreyi (chancroid: genital ulcers, lymphadenopathy)
Azithromycin 1 g PO in a single dose or Ceftriaxone 250 mg IM in a single dose or Ciprofloxacin 500 mg PO BID x 3 days or Erythromycin base 500 mg PO TID x 7 days
Chlamydia trachomatis serovars L1, L2 or L3 (lymphogranuloma)
Doxycycline 100 mg PO BID x 21 days
Trichomonas vaginalis
Metronidazole 2 g PO in a single dose
or
Tinidazole 2 g PO in a single dose
Phthirus pubis
Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes
or
Pyrethrins with piperonyl butoxide
Sarcoptes scabiei
Permethrin 5% cream applied to all areas from the neck down, washed off after 8-14 hr
or
Ivermectin 200 mcg/kg orally, rapeated in 2 wk
Herpes simplex virus
Episodic therapy for recurrences
Acyclovir 400 mg PO TID x 5 days
Herpes simplex virus
Suppressive therapy to reduce frequency of recurrences
Acyclovir 400 mg PO BID
WHO definition of adolescent, youth
adolescents: 10-19 yr
youth: 15-24 yr
Together they are the young people
3 developments in the hypothalamic-pituitary unit that trigger puberty:
- nocturnal sleep-related reinforcement LH secretion
- diminished sensitivity of the hypothalamus and pituitary to estradiol and testosterone, allowing increase in gonadotropins LH and FSH
- initiation of a positive feedback mechanism among females by which critical levels of estrogen trigger an increased release of GnRH, stimulating LH, initiating ovulation
Linear growth during puberty accounts for __ of adult height
20%
Timing of growth spurt in male
11.5 yr
SMR 3-4
Start of growth spurt in female
10 yr
SMR 2-3
