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Own peds boards > Adolescent > Flashcards

Adolescent Flashcards

1
Q

Menarche in 95% of adolescents at what age range?

A

11-14.5

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2
Q

What % of girls are anovulatory in 1st year?

A

50%

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3
Q

By 3rd year after menarche, what percentage are ovulatory?

A

95%

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4
Q

How much blood loss

A

30ml/month

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5
Q

Define primary amenorrhea

A

No menarche by 16
No menarche if Tanner 5 for >1year
No menarche by 5yrs after breast development

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6
Q

Absence of menses

A

amenorrhea

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7
Q

Infrequent bleeding >45 day interval

A

Oligomenorrhea

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8
Q

Prolonged >7days excessive bleeding (80ml) bleeding at regular intervals

A

Menorrhagia

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9
Q

Bleeding at irregular but frequent intervals

A

Metorrhagia

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10
Q

Prolonged bleeding at irregular intervals

A

Menometrorrhagia

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11
Q

Define characteristics of abnormal vaginal bleeding

A

> 80cc loss, >frequent than 20 days, associated with anemia, if at menarche –> leads to transfusion, hospitalization or if other signs of bleeding, need to work up for bleeding

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12
Q

How do you work up abnormal vaginal bleeding

A

assess blood loss, evaluate need for surgical intervention/hospitalization, determine etiology and CBC, preg test, PT/PTT

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13
Q

Causes of dysmenorrhea?

A

endometriosis, chronic pelvic pain, DUB, painful defecation, dysparneuim, PID, benign uterine tumors, polyps, fibroids, IUD, abormality in anatomy.

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14
Q

What is dysmenorrhea and Rx for it

A

Painful period, NSAIDS, oral contraceptives

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15
Q

Rx of anorexia nervosa

A

Target co-morbid symptoms of depression/anxiety; may not be as effective in severely malnourished patients, maybe neuroleptics

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16
Q

Rx bulimia nervosa

A

SSRI, SNRI, TCAs, topiramte, aim for 50% BMI

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17
Q

What are the weight and diet based criteria for hospital admission for anorexia nervosa?

A
  1. 75% ideal body weight or ongoing loss
  2. Refusal to eat
  3. Body fat <10%
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18
Q

What are the vital sign based criteria for hospital admission for anorexia nervosa?

A
  1. HR <50 beats/min daytime; <45 beats/min nighttime
  2. Systolic bp <90mm Hg
  3. Orthostatic changes in pulse 30 beats/min or bp drop in systolic >10mm Hg
  4. Arrhythmia
  5. Temp <36.3 day and 36 at night
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19
Q

What are symptoms of bulimia that are criteria for hospital admission?

A 
Syncope
Esophageal tears
Cardiac arrhythmias
Hypothermia HR >110 supine
Hematemesis
Intractable vomiting
Not responding to outpt therapy
Suicide risk
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20
Q

What are lab work based criteria for hospital admission?

A

K <3.2mmol/L
Cl 88mmol/L
Hypophosphatemia

21
Q

Emergency contraceptive can be given up to how many days

A

5 days

22
Q

What is depa-provera made of

A

Progesterone only

23
Q

What can estrogen cause

A

hypercoag, seizure, headaches

24
Q

Screening of chlamydia/gonorrhea

A

screen for all high risk teens

25
Q

Pattern: discharge between peiors esp after intercourse, mucopus from Ox, erosion friability, 10-30 WBC on gram stain of cervical os

A

GC/chlam

26
Q

Pattern: bubbly discharge, strawberry cervix, unicellular organism, it moves

A

trichomoniasis

27
Q

What are complications of Trichomoniasis

A

PID, pre-term labor, increased CA risk and infertility, high HIV acquisition

28
Q

Pattern: gray-white homogenous discharge, no vulvar inflammation, odor reported, cheesy, fishy odor when KOH is added, clue cells

A

bacterial vaginoisis

29
Q

Pattern: watery discharge, one joint involvment, pt can walk on joint, knee and elbow most common

A

gonorrhea

30
Q

What does rash look like in gonorrhea versus syphillis

A

Gonorrhea - erythematous papules, pustules, necrotic lesion, acrally located near small joints of hand, feet, <20 lesions
Syphillis - on palm and feet

31
Q

Describe tenosynovitis for gonorrhea

A

extensor tendons of hand, wrist, feet most common

32
Q

Pattern: sudden right upper quadrant pain and liver tenderness, pt on OCP, increased liver enzymes

A

Fit Hugh Curtis

33
Q

Best test for chlamydia/gonorrhea

A

NAATS

34
Q

Cause of Reiter’s syndrome

A

chlamydia

35
Q

Triad of Reiter’s syndrome

A

conjunctivitis, red joints, red urethra

36
Q

What are complications of Reiter’s syndrome?

A

cardiac, pericarditis and/or valve disease, erythema nodosum, carcinate balantis, shallow painless ulcers on glans/shaft

37
Q

Rx for Reiter’s

A

NSAIDs, 50% resolve in 6mo and most in 1 year

38
Q

Rx for chlamydia

A

Azithro or doxy

39
Q

Rx for gonorrhea

A

Ceftriaxone and azithro

40
Q

Rx for bacterial vaginosis

A

Metronidazole or clinda

41
Q

Rx for PID

A

Ceftriaxone, doxy +/- metronidazole oral

or parenteral cefotoxan and doxy

42
Q

Rx for syphillis

A

Benzathine penicllin

43
Q

Rx for chancroid - emophilus ducreyi

A

1 dose azithro

44
Q

Rx for granuloma inguinal calymmatobacterium granulomatis

A

azithro x 3 weeks

45
Q

Rx for chlamydia serovaus L1, L2, L3, lymphogranuloma venerum

A

Azithro x 3 weeks

46
Q

What stage of syphillis: painless chancre

A

primary

47
Q

What stage of syphillis: rash, condymata lata, cheeky rash

A

secondary

48
Q

What stage of syphillis: internal organ involvement

A

tertiary

49
Q

Indication for immediate colposcopy

A

high grade squamous intraepithelial, 3 paps smears with ASCUS or LGSIL, immunocompromised with LSIL

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