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
Age at peak height velocity in male
13.5 yr
Age at peak height velocity in female
11.5 yr
Average gain in height in male
28 cm
Average gain in height in female
25 cm
Average age of thelarche
10 yr
range 8-14 yr
Average duration for completion of puberty in females
4 yr
Average age at menarche among Filipino girls
13.3 yr
Delayed puberty in female:
- Breast SMR 1 beyond 13 yr
- Pubic hair SMR 1 beyond 14 yr
- Failure to menstruate beyond 16 yr
Delayed puberty in female
- Genital SMR 1 beyond 14 yr
2. Pubic hair SMR 1 beyond 15 yr
