adolescent

Question 1

hodgkin’s lymphoma

Answer 1

most common cancer in teens

cervical and suprcalvicur lymphadenopathy
severe pain on malignant areas after drinking alcohol

Question 2

testicular cancer

Answer 2

scrotal mass, tender
“heaviness” to testiticle

• risk factor is cryptoorchidism

Question 3

testicular torsion

Answer 3

PAINFUL testicle
90% have n/v
scrotal edema, induration,
** Ipsilateral ( same side) ABSENT CREMASTERIC REFLEX

doppler, emergency!

Question 4

stage 3 for boys/girls

Answer 4

boys: penis elongates
girls: one mound (breast/areola)

Question 5

delayed puberty girl/boy

Answer 5

girl: (stage 2) no breast bud development (stage 2) by 12 yo
boy: (stage 2) no testicular/scrotal growth by 14 yo

Question 6

all college freshmen should receive which vaccine?

Answer 6

MCV4 ( meniogoccal)

Question 7

which labs increase in adolescents

Answer 7

alp (alkaline phosphatase) due to growing bones ( same for pregnant women)

Question 8

emancipated minor criteria ( can give full consent as an adult)

Answer 8

married

active duty

Question 9

what stage does puberty start

Answer 9

tanner 2 (breast bud/scrotal rugation/color darker)

Question 10

female athlete triad

Answer 10

anorexia, amenorrhea, osteoporosis

educate about increasing calories
calcium 1200-1500mg
with vitamin D 400 IU

Question 11

primary amenorrhea

Answer 11

no period by 15 yo (50% due chromosomal disorder)

Question 12

secondary amenorrhea

Answer 12

no menses for 3 cycles or 6 months if previously had menses
due to pregnancy, stress, pcos

check hog, bone density

Question 13

anorexia s/s

Answer 13

lanugo, peripheral edema!, weight loss >10%

avoid Depo provera (progesterone only) since it can cause bone loss

Question 14

gynecomastia vs pseudogynecomastia

Answer 14

gynecomastia- disc like mobile MOUND, round, rubbery.
pseudo- due to adipose ( obese), soft and not tender. no breast bud

if mass irregular, fixed, rapid growth refer

Question 15

scoliosis

Answer 15

“rapid” worsening- r/o marfan or ehlers danlos syndome
check forward bend (cobbs angle)
20, brace (milwaukee)
>40, surgery (harrington rod)

x ray to measure cobb
refer ALL scoliosis to orthopedic specialist

Question 16

osgood schlader

Answer 16

knee pain in young athletes, esp boys during growth spurt

“rice”, can continue based on comfort

Question 17

delayed puberty definition

Answer 17

absence of secondary sexual characterists (males by 14 yo, females by 13).

primary amenorrhea: no period by 15 yo

Question 18

what to r/o if no period by 15 yo (primary amenorrhea)

Answer 18

hypogonadism by checking estrogen/progestoeron, rhea, csh, tsh
r/o chromosomal disorders
absence of uterus
refer to endocrinologist