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GEN PEDS > ADOLESCENT > Flashcards

ADOLESCENT Flashcards

1
Q

Vulvar itching - with hyperemic and edematous vulva and thin, yellowish-green, frothy, malodorous discharge and punctate hemorrhages on the vagina / cervix. No cervical motion or adnexal tenderness

What is the condition? Treatment

A

Trhichomonas vaginalis

Flagyl x 7 days

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2
Q

What are the criteria for diagnosis of bacterial vaginosis (BV)? (3 out of 4 criteria)

Treatment?

A

1 - Clue cells
2 - Vaginal pH > 4.5
3 - “Fishy” odor precedes or follows addition of KOH to vaginal discharge
4 -Grayish-white, milky vaginal discharge

Treatment = Flagyl x 7 days

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3
Q

What bacterial vaginosis and vaginal trichomoniasis have in common ? (2)

What differentiates them?

A

Common: (1) elevated vaginal pH; (2) positive KOH test

Vaginal trichomoniasis presents with **intense inflammation of vaginal walls, punctate hemorrhages on vagina / cervix (“strawberry cervix”)

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4
Q

Painless cyst-like nodule around the testicle that transilluminates

What is it ?

A

Spermatocele

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5
Q

What is the recommendation to start Pap smear in asymptomatic, immunocompetent women?

A

Start at 21 years of age, regardless of age of sexual activity initiation

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6
Q

What is the recommendation to start Pap smear in HIV-positive patient?

A

Starting within 1 year of onset of sexual activity

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7
Q

Criteria for delayed puberty in males

A

SMR Stage 1 persists beyond 14 years
SMR Stage 2 persist > 2.5 years
SMR Stage 3 persist > 1.5 years
SMR Stage 4 persist > 2 years

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8
Q

Medications that can cause gynecomastia (1)

A

1 - Steroids
2 - Cimetidine
3 - TCA
4 - Calcium channel blockers
5 - ACEIs
6 - Spironolactone
7 - Ketoconazole
8 - INH
9 - HIV anvirirals
10 - Opioids

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9
Q

Male with dysuria, urinary frequency, mucopurulent urethral discharge

What is the STD? Treatment?

A

Gonoccoccal urethritis

IM Ceftriaxone 500mg (or cefixime) + PO Doxycycline (for Chlamydia) x 7d

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10
Q

Smooth, skin-colored, well-circumscribed papules on the shaft of penis

What is the finding? Cause?

A

Genital warts

Human papillomavirus

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11
Q

Small, grouped, painful vesicles on an erythematous base on the shaft of penis

What is the finding? Cause?

A

Hepertic lesions

HSV

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12
Q

Indurated, punched-out, painless ulcer with slight elevated margins on the foreskin

What is the finding? Cause?

A

Chancre in syphillis

(Treponema pallidum)

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13
Q

Painful, inflammed, shallow ulcer associated with grayish, fibrinous membrane and ragged, undermined border on the foreskin

What is the finding? Cause?

A

Bubo in Chancroid

Haemophilus ducreyi

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14
Q

Gram stain of a penile lesion.

What is the organism? What is the disease? Treatment?

A

Haemophilus ducreyi

Chancroid
Azithromycin OR IM ceftriaxone

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15
Q

Most common cause of abnormal uterine bleeding in adolescents (AUB)

A

Anovulatory cycles

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16
Q

Tendon pain / inflammation, painless vesiculopustular lesion on skin, joint pain

What is the condition called? Organism?

A

Arthritis-dermatitis syndrome
(1 of 2 types of disseminated N.gonnorhea)

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17
Q

ST depression, flat T wave, promient “U” wave on ECG

What is going on?

A

Hypokalemia

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18
Q

Male with small, painless, shallow papules on penis which then disappears, then 2-3 weeks later has lymphadenopathy in groin.

What is the infection?

A

Chlamydia trachomatis

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19
Q

Pathophysiology of athletic amennorhoea?

A

Loss of pulsatic GnRH -> low LH, FSH -> low estrogen

20
Q

Patient on combined oral contraceptive has acne.

What to try first?

A

Switch to high-estrogenic low-androgenic OCP

21
Q

Gram-negative intracellular diplococci

What is the organism?

A

N.gonorrhea

22
Q

Clue cells seen on smear

What is the diagnosis?

A

Bacterial vaginosis

23
Q

Most common cause of secondary amennorhoea?

A

Pregnancy

24
Q

Treatment of primary syphillis

A

Single IM benzathine penicillin G 2.4 million units

25
Q

Common electrolyte abnormalities caused by refeeding syndrome (3)

A

Hypokalemia
Hypomagnesemia
Hypophosphatemia

26
Q

Exfoliation of outermost laysers of the skin with slight rubbing, forming a blister within minutes

What is the sign? What are 2 associated conditions?

A

Nikolsky signs

Associated with
1 - Staph scalded skin syndrome (SSSS)
2 - Pemphigus vulgaris

27
Q

Calluses form on knuckles, in a teenage patient.

What is the sign? What is the underlying problem?

A

Russell sign

Bulimia nervosa

28
Q

Pink or red transverse lines in skin creases (elbow, wrist, inguinal region)

What is the sign? What is the associated condition?

A

Pastia sign

Associated with the pre-eruptive stage of scarlet fever

29
Q

First sign of puberty in male

A

Enlargement of testes

30
Q

Treatment of uncomplicated gonococcal infections

A

Ceftriaxone 500mg IM x 1

31
Q

What is the test of choice for diagnosing HIV infections?

What is the exception, and what to use in that exception?

A

Test of choice = HIV p24 antigen and HIV antibody

Exception = acute HIV infection (decreased test sensitivity during this window) -> use HIV viral RNA test instead

32
Q

Medications that may decrease effectiveness of oral contraceptives (2 types)

A

1 - Antiseizure medications (via increase CYP450 activity)
2 - Rifampin

33
Q

Average time of onset menarche following onset of puberty

A

2-2.5 years

34
Q

Specific indications for hospitalization in adolescent with anorexia (10)

A

1 - Weight < 75%
2 - HR < 50 bmp (<45 at night)
3 - Orthostatic increase in pulse > 20 bpm
4 - SBP < 90 or Orthostatic decrease in BP (sys > 20, dias > 10)
5 - Temp < 96F (35.5C)
6 - Refusal to eat
7 - Uncontrollable binging / purging
8 - Acute medical complications
9 - Acute psychiatric emergencies
10 - Failure of outpatient therapy

35
Q

Side effects associated with progestin-only contraception in adolescents (8)

A

1 - Delayed return to fertility (up to 18 months!)
2 - Weight gain
3 - Decreased bone density (should take calcium suppl)
4 - Irregular bleeding / spotting
5 - Acne
6 - Nausea
7 - Breast tenderness
8 - Mood changes
9 - Headache

36
Q

Cauliflower-shaped, flesh-colored plaques in perianal area

What is it? Most common causal organisms?

A

Genital warts

HPV 6 & 11

37
Q

A warm tender mass appx between 4 - 8 o’clock position with respect to the introitus, causing vaginal pain

What is going on? Treatment?

A

Bartholin gland abscess

Incision and drainage

38
Q

Dental erosion, parotid enlargement, soft palate petechiae

What is going on?

A

Bulimia nervosa

39
Q

Nausea, shaking chills, severe right upper quadrant pain, adnexal and cervical motion tenderness

What is going on?

A

Fitz-Hugh-Curtis syndrome (perihepatitis) - inflammation of the hepatic capsule and right diaphragm from PID (Chlamydia or Gonnorhea)

40
Q

Rod-shaped oval organisms within cytoplasm of mononuclear phagocytes

What is the finding called? Organism?

A

Donovan bodies

Klebsiella granulomatous (cause of granuloma inguinale)

41
Q

What is the definition for delayed puberty in adolescent males

A

Lack of testicular enlargement by 14 years of age

42
Q

Nausea, vomiting, “heart racing”, confused, skin flush … after drinking alcohol with a medication

What is going on ? What is the medication?

A

Disulfiram-like reaction

The medication is metronidazole

43
Q

When does peak height velocity (PHV) usually occurs in girls ? During which SMRs

A

Mean age 11.5
SMR 2-3

44
Q

When does peak height velocity (PHV) usually occurs in boys ? During which SMRs

A

Meaen age 13.5
SMR 3-4

45
Q

Teenager, sexually active, with testicular pain, scrotal edema

What is going on ? Treatment?

A

Epididymis (from gonorrhea or chlamydia)

Ceftriaxone + Doxycycline

46
Q

What are the electrolyte abnormalities in patients with bulimia nervosa purging type?

A

HYPOkalemia and HYPOchloremia metabolic alkalosis

47
Q

Definitions of an emancipated minor

A

1 - Age >= 18
2 - Married
3 - On active duy status in the military
4 - Obtained a court order
5 - Living separately from their parents or legal guardians AND independently managing their own financial affairs

GEN PEDS (16 decks)

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