Adolescence Flashcards
first visible sign of puberty in males and hallmark of SMR 2
testicular enlargement 9.5yrs
followed by development of pubic hair
first visible sign of puberty in females and hallmark of SMR 2
appearance of breast buds (thelarche)
between 7 and 12 years of age
early adolescence
10-13 years old
middle adolescence
14-17 years old
late adolescence
18-21 years old
females attain peak height velocity of
8-9cm/yr at SMR 2-3 approximately 6 months before menarche
males attain peak height velocity of
9-10cm/yr later in course of puberty (SMR 3-4)
concrete operations
egocentric
follow rules and avoid punishment
early adolescence
preoccupied with changing body
self-conscious about appearance and attractiveness
early adolescence
same sex peer relations
early adolescence
emergence of abstract thought
middle adolescence
increasing introspection
middle adolescence
conflicts over control and independence
struggle for greater autonomy
increased separation from parents
middle adolescence
intense peer involvement
middle adolescence
exploration of sexual identity
middle adolescence
Idealism
improved impulse control
late adolescence
more stable body image
late adolescence
increased autonomy
late adolescence
peer group and values recede importance
late adolescence
consolidation of sexual identity
late adolescence
SMR STAGE (female) sparse, lightly pigmented straight pubic hair
SMR 2
breast papilla elevated as small mound
SMR 2
coarse, curly, abundant pubic hair
SMR 4
secondary mound
SMR 4
in males: coarse curly pubic hair
SMR 4
enlarged scrotum
SMR 2
larger, dark scrotum
SMR 4
increased sexual awareness and interest
early adolescents
refers to a person’s sense of being a boy/girl, girl/woman, other gender
Gender identity
refers to one’s role in society typically male or female
gender role
characteristics in personality, appearance and behavior that are in a given culture and time considered masculine or feminine
gender expression or social sex role
referes to attractions, behaviors, fantasies and emotional attachements toward men, women or both
Sexual orientation
develops early in life and typically fixed by 2-3 years old
gender identity
clinically significant distress of impairment in school/occupational or other important areas of functioning associated with incongruence between one’s experienced/expressed gender and assigned gender for atleast 6 months
Gender dysphoria
gender-affirming care includes
alleviate gender dysphoria
psychological evaluation and supportive therapy
puberty, suppression, feminizing or masculinizing hormone therapy
surgery
benign genital HPV infection is caused by
HPV types 6 and 11
HPV infection that can cause cervical cancer
HPV 16 and 18
repetitive and persistent pattern of behavior that violates the basic rights of others or major age-appropriate societal norms or rules
Conduct behavior
ex: physical fighting, deceitfulness, stealing, destruction of property, threatening or causing physical harm to people or animals, driving without license, prostitution, rape
what is used to assess an adolescents’ risk of violence
FISTS
Fighting Injuries Sex Threats Self-defense
used to screen for adolescents’ substance use
CRAFFT
common signs of anticholinergic syndromes
delirium with mumbling speech tachycardia dry, flushed skin, dilated pupils myoclonus slightly elevated temperature urinary retention decreased bowel sounds seizures and dysrrhythmias in severe cases
common causes: antihistamines, atropine, amantadine, antidepressants, antispasmodic, mydriatic agents
common signs of sympathomimetic syndromes
delusions, paranoia, tachycardia, hypertension, hyperpyrexia, diaphoresis, mydriasis
Common causes: cocaine, amphetamine, metamphetamine, marijuana, OTC anticongestants
common signs of opiate, sedative, or ethanol intoxication
coma respiratory depression miosis hypotension bradycardia hypothermia, pulmonary edema
common causes:narcotics, barbiturates, benzodiazepines, ethanol, clonidine
common signs of cholinergic syndrome
confusion cns depression weakness salivation lacrimation urinary and fecal incontinence GI cramping emesis diaphoresis muscle fasciculations pulmonary edema
common causes: organophosphate and carbamazepine insecticides, physostigmine, edrophonium and some mushrooms
what is the CRAFFT mnemonic tool?
Car Relax - to feel better Alone Forget things you did while on alcohol? Friends telling you should cut down Trouble
what are the clinical manifestations of alcohol?
CNS depressant
produces euphoria, grogginess, talkativeness, impaired short-term memory
increased pain threshold
how do we screen patients for alcohol?
CRAFFT or AUDIT
score >/= 8 identifies people who drink excessively
lethal dose of alcohol
> 500mg/dl
effects of nicotine
stimulates adrenal glands to release epinephrine causing immediate elevation of BP, RR and HR
most commonly abused illicit drug
Marijuana
what are the effects of halucinogen LSD?
3 categories: somatic, perceptual and psychic
somatic: dizziness, dilated pupils, nausea, flushing, elevated temperature and tachycardia
“seeing”, smells; “hearing” colors
what is the other name of MDMA?
“X”, ecstacy”
interact with serotonin levels
manifestations: euphoria
less likely to produce emotional lability, depersonalization and disturbances by thought
clinical manifestations of cocaine use?
strong CNS stimulant that increases dopamine levels by preventing reuptake
sympathomimetic effects: pupillary dilation, tachycardia, hypertension and hyperthermia
also known as the “ice”
metamphetamine: nervous stimulant
small amount: inc physical activity, rapid/irregular heart rate, inc BP and dec appetite
high dose: slowing of cardiac conduction, hypertensive and hyperpyretic
tx: Haloperidol for agitation and delusional behaviors
Correlates more closely with chronologic age than pubertal maturation
Cognitive development
Self perceived identification distilled from any or all aspects of sexuality
Sexual identity
Most prevalent viral STI
HSV2
Painless ulcer with well demarcated indurated borders and a clean base
Syphilis; primary
Hallmark of adolescent development
Separation from parents
Most popular drug among teens
Alcohol
Hallmark of adolescent development
Separation from parents
Most popular drug among teens
Alcohol
Hallmark of adolescent development
Separation from parents
Most popular drug among teens
Alcohol
Good estimate of predicted final adult height
Midparental height
Index of physiological maturation
Bone age
Ejaculation occurs at
SMR 3
Breast and areola enlarged; no contour separation
SMR 3
Sparse lightly pigmented pubic hair,straight, medial border of labia
SMR 2
Sequence of pubertal events in boys
Testicular enlargement —> adrenarch —> continued testicular and penile enlargement —> peak height velocity with peak eeight velocity
Sequence of pubertal events in girls
Thelarche —> adrenarche —> peak height velocity —> continued breast and hair development —> menarche —> completion of puberty
Menarche achieved by 90% of girls during
SMR breast 4
