Adolescent

Question 1

HEADSSSS assessment

Answer 1

H: home environment

E: Education, employment, exercise, eating

A: Activities and peer relationships

D: Drugs, cigarettes, alcohol

S: Sexuality

S: Suicide/depression/mood screen

S: Safety

S: Spirituality

Question 2

How is HTN determined in adolescents?

Answer 2

based on gender, age and height chart

Question 3

What are the cut offs for Stage 1 and Stage 2 HTN in adolescents?

Answer 3

• Stage 1 HTN – Systolic and/or diastolic BP between the 95th percentile to 5 mmHg above the 99th percentile.
• Stage 2 HTN – Systolic and/or diastolic BP levels that are > 5mm Hg above the ≥99th.

Question 4

Hypertrophic Cardiomyopathy

Answer 4

Genetic heart condition causes thickening of the myocardium

LVH with Left ventricular outflow tract obstruction

Mitral Regurgitation

Play low impact sports if asymptomatic, and no sports if symptomatic

Question 5

Hypertrophic Cardiomyopathy symptoms

Answer 5

Fatigue
Dyspnea
Chest Pain
Palpitations
Presyncope or syncope

Question 6

Uncontrolled stage 2 HTN: definition and can they play sports?

Answer 6

Systolic and or diastolic BP > 99th percentile plus 5 mmHg

Increased risk for sudden death

Hold until eval by cardiologist

Question 7

Marfan’s Syndrome

Answer 7

Inherited autosomal dominant connective tissue disorder

Aortic root disease

Mitral Valve Prolapse

Myopia

Kyphoscoliosis

Refer to cardiologist

Restricted from vigorous activity

Some level of low impact maybe allowed on an individual basis

Question 8

Marfan’s syndrome presentation

Answer 8

Tall, thin

Pectus carinatum(pigeon chested)*

Has been seen with pectus excavatum (funnel chested)

Arm span > height (>1.05)

Question 9

What is prolonged QT syndrome?

Answer 9

Congenital or Acquired disorder that causes prolonged QT

This may lead to polymorphic ventricular tachycardia, know as Torsades de Pointes

Question 10

Brugata Syndrome

Answer 10

Autosomal dominant genetic disorder

Variable expression

Lead to ventricular tachyarrhythmia

Sudden death

Abnormal EKG: Prolonged PR, ST segment increased, and RBBB

ST elevation V1 V3

Question 11

What is the Brugada Pattern?

Answer 11

EKG findings absent of symptoms

Syncope, palpitations

Question 12

How long do kids wait to play sports after mono?

Answer 12

4-6 weeks after onset of symptoms, to avoid splenic rupture

Question 13

What is the female athlete triad?

Answer 13

1. Disordered Eating/Reduced Energy: Dietary intake does not meet exercise/energy expenditure
2. Menstrual Dysfunction => amenorrhea
3. Impaired Bone Health: low bone density, increased risk of stress fractures