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1st Year Med > Adolescence (W3 KPH) > Flashcards

Adolescence (W3 KPH) Flashcards

1
Q

define puberty

A

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

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2
Q

what is puberty characterised by?

A

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

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3
Q

what does kisspeptin do?

A

stimulates GnRH secretion in the hypothalamus during the onset of puberty

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4
Q

what are the first signs of puberty?

A

M - testicular enlargement
F - breast development

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5
Q

what are the secondary signs of puberty?

A

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

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6
Q

what is tanner staging?

A

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

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7
Q

what is precocious puberty?

A

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

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8
Q

what is delayed puberty?

A

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

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9
Q

what are the gonadotropin dependant causes of precocious puberty?

A

hypothalamus/pituitary tumour
cerebral malformations
CNS injuries
idiopathic
genetic

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10
Q

what are the gonadotropin independent causes of precocious puberty?

A

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

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11
Q

what are some of the basic investigations for precocious puberty?

A

gonadotropin blood test
sex steroids
bone age

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12
Q

what are the main reasons for delayed puberty?

A

hypergonadotropic hypogonadism
hypogonadotropic hypogonadism
constitutional delay of growth

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13
Q

what are the general investigations for delayed puberty?

A

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

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14
Q

where is kisspeptin found?

A

hypothalamus:
AVPV nucleus and ARC nucleus

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15
Q

what does kisspeptin act with and how does it function?

A

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

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16
Q

describe what happens to kisspeptin during puberty

A

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

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17
Q

describe the secretion style of kisspeptin

A

pulsatile style every 60 mins during puberty
correlates with GABA pulses

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18
Q

explain the role of leptin in puberty

A

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

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19
Q

what can mutations in kisspeptin cause?

A

precocious puberty
delayed puberty (idiopathic hypogonadotropic hypogonadism)

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20
Q

what do GnRH pulses stimulate?

A

LH and FSH in the anterior pituitary

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21
Q

what is kisspeptin feedback controlled by?

A

oestrogen, progesterone and testosterone in the testis or ovaries

22
Q

explain the positive and negative feedback of kisspeptin

A

positive - increases secretion in the hypothalamus and AVPV

negative - inhibition through separate neuron to reduce secretion in ARC

23
Q

explain the role of kisspeptin in the placenta

A

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

24
Q

what does kisspeptin do during pregnancy?

A

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

25
Q

what is a proband?

A

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

26
Q

what is a consultand?

A

someone who has come to genetic services for advice

27
Q

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

A

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

28
Q

explain briefly the fraser guidelines for adolescent sexual activity

A

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

29
Q

what is the gold standard for emergency contraception?

A

copper IUD
use within 5 days of unprotected sex

30
Q

briefly explain the 2 pill options for emergency contraception

A

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

31
Q

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

A

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

32
Q

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

A

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

33
Q

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

A

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

34
Q

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

A

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

35
Q

what is the most effective form of birth control?

A

progesterone-only implant

36
Q

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

A

fully breastfeeding
no periods
less than 6 months post-partum

37
Q

how long after sex does a pregnancy test become accurate?

A

21 days

38
Q

what are the direct impacts of increased temperature on health?

A

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

39
Q

what are the indirect impacts of increased temperature on health?

A

water
food
disease carrying vectors
wildfires
ecosystems

40
Q

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

A

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

41
Q

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

A

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

42
Q

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

A

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

43
Q

what are some of the chemical components in a cigarette?

A

acrolein
arsenic
cadmium
formaldehyde
benzene
chromium
nitrosamines

44
Q

what are some of the other components in a cigarette?

A

lead
hydrogen cyanide
CO
nitrogen oxides
ammonia
nicotine

45
Q

what are some of the main health effects of smoking?

A

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

46
Q

what are some of the main reasons for smoking uptake?

A

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

47
Q

what is the recommended maximum alcohol intake per week?

A

14 units

48
Q

what are the physiological effects of exercise on mood state?

A

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

49
Q

how does exercise reduce inflammation?

A

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

50
Q

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

A

unhealthy diet
tobacco smoking
alcohol
lack of physical activity
air pollution

51
Q

explain lifestyle medicine

A

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

1st Year Med (52 decks)

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