Adolescence (W3 KPH)

Question 1

define puberty

Answer 1

stage of physical maturation in which an individual becomes physiologically capable of sexual reproduction

Question 2

what is puberty characterised by?

Answer 2

appearance of secondary sexual characteristics
pubertal growth spurt resulting in final adult height
physiological, cognitive and social changes

Question 3

what does kisspeptin do?

Answer 3

stimulates GnRH secretion in the hypothalamus during the onset of puberty

Question 4

what are the first signs of puberty?

Answer 4

M - testicular enlargement
F - breast development

Question 5

what are the secondary signs of puberty?

Answer 5

axillary hair
body odour
pubic hair
acne
growth spurt
body composition changes
facial hair growth (M)
menstrual cycle beginning (F)

Question 6

what is tanner staging?

Answer 6

a stating system of 5 stages
stage 1 - pre-pubescent
stage 5 - adult
in M - genitals and pubic hair growth
in F - breast and pubic hair growth

Question 7

what is precocious puberty?

Answer 7

puberty occuring at an usually early age
in M - below 9
in F - below 8

Question 8

what is delayed puberty?

Answer 8

when a person lacks or has incomplete development of specific sexual characteristics past the usual age of puberty onset
in M - 14
in F - 13

Question 9

what are the gonadotropin dependant causes of precocious puberty?

Answer 9

hypothalamus/pituitary tumour
cerebral malformations
CNS injuries
idiopathic
genetic

Question 10

what are the gonadotropin independent causes of precocious puberty?

Answer 10

gonad/liver tumour
adrenal gland hyperplasia (CAH)
exogenous androgenic or oestrogenic steroids
genetic

Question 11

what are some of the basic investigations for precocious puberty?

Answer 11

gonadotropin blood test
sex steroids
bone age

Question 12

what are the main reasons for delayed puberty?

Answer 12

hypergonadotropic hypogonadism
hypogonadotropic hypogonadism
constitutional delay of growth

Question 13

what are the general investigations for delayed puberty?

Answer 13

visual field exam (tumours)
dysmorphic features
height/weight
family history

Question 14

where is kisspeptin found?

Answer 14

hypothalamus:
AVPV nucleus and ARC nucleus

Question 15

what does kisspeptin act with and how does it function?

Answer 15

kisspeptin (+) acts with GABA (-) to initiate reproductive development, induce puberty and regulate the HPG axis

Question 16

describe what happens to kisspeptin during puberty

Answer 16

KiSS1 neurons increase in the AVPV of the hypothalamus
number of neurons that contact GnRH increases
increase is larger in the female reproductive tract

Question 17

describe the secretion style of kisspeptin

Answer 17

pulsatile style every 60 mins during puberty
correlates with GABA pulses

Question 18

explain the role of leptin in puberty

Answer 18

leptin is released from adipose tissue when a certain body weight and body fat composition is reached
leptin stimulates increase in kisspeptin molecules

Question 19

what can mutations in kisspeptin cause?

Answer 19

precocious puberty
delayed puberty (idiopathic hypogonadotropic hypogonadism)

Question 20

what do GnRH pulses stimulate?

Answer 20

LH and FSH in the anterior pituitary

Question 21

what is kisspeptin feedback controlled by?

Answer 21

oestrogen, progesterone and testosterone in the testis or ovaries

Question 22

explain the positive and negative feedback of kisspeptin

Answer 22

positive - increases secretion in the hypothalamus and AVPV

negative - inhibition through separate neuron to reduce secretion in ARC

Question 23

explain the role of kisspeptin in the placenta

Answer 23

placental extravillous trophoblast cells express kisspeptin receptor
stimulation activates intracellular signalling pathways to increase Ca
kisspeptin also inhibits trophoblast cell migration

Question 24

what does kisspeptin do during pregnancy?

Answer 24

stimulates oxytocin during late pregnancy and lactation
involved in labour and milk maturation

Question 25

what is a proband?

Answer 25

a person who brings a family to the attention of genetics services

Question 26

what is a consultand?

Answer 26

someone who has come to genetic services for advice

Question 27

what features can indicate the type of genetic transmission in a pedigree?

Answer 27

vertical transmission male to male transmission both sexes affected knights move (2 related males affected bypassing unaffected female)

Question 28

explain briefly the fraser guidelines for adolescent sexual activity

Answer 28

UPSSI U - understanding P - parental involvement S - sexual activity ongoing S - suffering I - interests

Question 29

what is the gold standard for emergency contraception?

Answer 29

copper IUD use within 5 days of unprotected sex

Question 30

briefly explain the 2 pill options for emergency contraception

Answer 30

ulipristal acetate - progesterone receptor modulator, can be used 120 hours after unprotected sex LNG - delays ovulation, can be used 72 hours after unprotected sex, BMI over 26 or over 70kg needs double dose

Question 31

briefly explain how the contraceptive implant works and a pro and con of using it

Answer 31

small rod in upper arm preventing ovulation pro - lasts or 3 years con - unpredictable effect on periods

Question 32

briefly explain the LNG-IUD form of contraception and a pro and con of using it

Answer 32

IUD with LNG hormone, thins endometrium pro - lasts 3-8 years con - risk of perforation/bleeding

Question 33

briefly explain the non-hormonal IUD form of contraception and a pro and con of using it

Answer 33

IUD insertion, copper killls sperm and stops implantation pro - lasts 5-10 years con - risk of heavier periods

Question 34

briefly explain the progesterone injection form of contraception and a pro and con of using it

Answer 34

subcutaneous or intramuscular injection preventing ovulation pro - likely to stop periods con - can delay return to fertility

Question 35

what is the most effective form of birth control?

Answer 35

progesterone-only implant

Question 36

what are the 3 conditions that must be kept for the lactation amenorrhoea method of contraception to work?

Answer 36

fully breastfeeding no periods less than 6 months post-partum

Question 37

how long after sex does a pregnancy test become accurate?

Answer 37

21 days

Question 38

what are the direct impacts of increased temperature on health?

Answer 38

head cramps (muscular pain) heat exaustion (body fluid loss) heat stroke

Question 39

what are the indirect impacts of increased temperature on health?

Answer 39

water food disease carrying vectors wildfires ecosystems

Question 40

what are some of the causes of changes in distribution of vectors?

Answer 40

temperature rise rising sea levels urban environment population mobility animal population shifts

Question 41

why are children more vunerable to the adverse effects of climate change?

Answer 41

childrens ability to deal with environmental threats relies on resources provided to them physical/mental immaturity causes risks to development

Question 42

what are some of the susceptability factors of children in relation to climate change and health?

Answer 42

longer exposure over lifetime increased air/water intake worsening nutrition extreme weather displacement developing organs more permeable skin/BBB

Question 43

what are some of the chemical components in a cigarette?

Answer 43

acrolein arsenic cadmium formaldehyde benzene chromium nitrosamines

Question 44

what are some of the other components in a cigarette?

Answer 44

lead hydrogen cyanide CO nitrogen oxides ammonia nicotine

Question 45

what are some of the main health effects of smoking?

Answer 45

stroke gum disease cancer (lung, oral cavity, kidney, bladder) asthma COPD

Question 46

what are some of the main reasons for smoking uptake?

Answer 46

relation who smokes low socioeconimic status low parental supervision tobacco marketing exposure mental health condition peer pressure

Question 47

what is the recommended maximum alcohol intake per week?

Answer 47

14 units

Question 48

what are the physiological effects of exercise on mood state?

Answer 48

endorphin hypothesis mitochondrial function mTOR neurotransmitters (seratonin/dopamine) HPA axis (A - adrenal)

Question 49

how does exercise reduce inflammation?

Answer 49

visceral fat reduction change in cytokine release increase in vagal tone down regulation of toll-like receptors

Question 50

what are the main risk factors for non-communicable diseases?

Answer 50

unhealthy diet tobacco smoking alcohol lack of physical activity air pollution

Question 51

explain lifestyle medicine

Answer 51

lifestyle changes to prevent or treat chronic disease adopted alongside conventional practices focuses on root of disease rather than treating symptoms