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Nephrology > Adolescent > Flashcards

Adolescent Flashcards

1
Q

The adolescent period is considered by most to be what age range?

A

11-19 years of age

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2
Q

What is the main cause of death in adolescents?

A

Unintentional injuries (MVA, discharge of firearm, drowning, or poisoning)

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3
Q

What is the major cause of hospitalizations among adolescents?

A

Pregnancy and related conditions

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4
Q

What is the main age for puberty in Caucasian girls? African American girls?

A

10 years, 8-9 years

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5
Q

True or false? Boys have their pubescent growth spurt before girls.

A

False.

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6
Q

What is the average age of peak height velocity in boys? in girls?

A

13.5 years; 11.5 years

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7
Q

Define an emancipated minor.

A
  • Moved outside of the home and financially independent

- Married or members of the military

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8
Q

What are the medical exceptions for notifying parents against an adolescent’s wishes?

A

Physical or sexual abuse, nonadherence with treatment of a chronic disease, threat of harm to self or others

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9
Q

How often should adolescents see a medical professional for health supervision and guidance?

A

Annually; at minimum at each stage (early, middle, late)

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10
Q

Starting at what age should adolescents be seen alone for at least part of the visit?

A

12-14 years old

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11
Q

What parts of the physical examination are important to focus on in an adolescent boy or girl?

A

Questions about peer and family relationships, depression, sexual relationships, substance use, and eating disorders.

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12
Q

How many MMR and Varicella inoculations should an adolescent have?

A

2

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13
Q

How common is AN in girls? What is the ratio of girls to boys diagnosed with an eating disorder?

A

Lifetime Prevalence 0.5%; 10:1

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14
Q

What are the DSM-5 Diagnostic criteria for AN?

A
  • Significantly low body weight
  • intense fear of gaining weight or of becoming “fat”
  • Disturbance in the way in which one’s body weight or shape is experienced
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15
Q

In patients with AN, and ECG changes suggest increased risk for ventricular arrhythmia?

A

Prolonged QTc intervals or ST-segment depression on exercise stress testing

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16
Q

Under what conditions should you hospitalize an adolescent with AN?

A
  • Marked cachexia
  • Refusal to eat; binging/purging; dehydration
  • ECG changes
  • Acute medical complications of malnutrition
  • Hypotension
  • Orthostatic changes
  • Hypothermia
  • Severe electrolyte disturbances
  • Seizures
  • Comorbidity that prevents adequate outpatient care
  • SI or other psychiatric emergency
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17
Q

True or false? Patients with BN are commonly underweight.

A

False.

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18
Q

What type of breast mass is the most common in an adolescent girl?

A

Fibroadenoma

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19
Q

When should you further investigate a breast mass?

A

Persistent, larger, or suspicious lesions

20
Q

What organism is the most common cause of acute mastitis?

A

S. aureus

21
Q

What is the most common cause of secondary amenorrhea?

A

Pregnancy

22
Q

Amenorrhea and anosmia should make you consider what syndrome?

A

Kallman Syndrome

23
Q

List 2 physical signs of androgen excess in patients with amenorrhea.

A

Acne, hirsutism

24
Q

What is the most common cause of dysmenorrhea?

A

Prostaglandin production from secretory endometrium before menses, which causes vasoconstriction and muscular contractions.

25
Q

A girl presents with her 1st menses and hemorrhages to a hemoglobin of 9%. What is the likely etiology for her excessive blood loss?

A

von Willebrand disease

26
Q

What type of cancer is seen in daughters of mothers who took DES?

A

Clear cell adenocarcinoma

27
Q

True or False? Gynecomastia in boys is always symmetric.

A

False, typically asymmetric

28
Q

Characterize hydroceles, spermatoceles, and varicoceles.

A

Hydroceles: soft, fluctuant, non-tender, transilluminates
Spermatoceles: Smooth cystic mobile nodule above and posterior to the testes
Varicoceles: p/w sensation of pressure, heaviness, or engorgements; “bag of worms”

29
Q

True or False? Torsion of the spermatic cord is a surgical emergency. Describe expected clinical findings.

A

True

30
Q

Describe typical clinical findings of epididymitis in an adolescent male.

A

swollen and tender, cremasteric reflex is present, pain is relieved with elevation of testis

31
Q

What is the 1st line birth control method recommend for teens by the AAP?

A

LARC (long-acting reversible contraception)

32
Q

Which form of contraception, besides abstinence, is the most effective method for preventing STIs?

A

Males - condoms

Females - LARC

33
Q

Name the conditions in which estrogen-containing OCPs are contraindicated.

A 
Current breast cancer
Severe cirrhosis, malignant liver tumor, hepatocellular adenoma
Acute DVT
Known thrombogenic mutations
Major surgery with prolonged immobilization 
HTN 
Ischemic heart disease
Complicated valular heart disease
Peripartum cardiomyopathy 
Postpartum <21 days
Breastfeeding <12 days postpartum 
SLE with antiphospholipid antibody 
Migraine with aura
34
Q

You are told that a 4-yo child is masturbating in the bathtub. What is the appropriate parental approach for this behavior?

A

Advise parents to counsel children to keep this behavior private. With religious prohibition, advise parents to provide simple teaching and to redirect behavior, avoid negative reactions or punishments

35
Q

A 5-yo girl shows her mother how her 2 dolls “Barb” and “Kyle” kiss each other. The mother is upset that the child shows barb kissing Kyle’s genital area. Is this normal behavior for a 5yo?

A

No.

36
Q

Define gender nonconformity.

A

Variation from the cultural norms of gender behavior or expression.

37
Q

True or False? Most tomboys have gender nonconformity.

A

False

38
Q

True or False? LGBTQ youth make up large percentage of youth who are homeless.

A

True; 25-40%

39
Q

How common is sex among adolescents?

A
40
Q

What are the “reportable” STIs in every state in the US?

A
41
Q

What screening lab tests should be done on a pregnant adolescent?

A
42
Q

For which viral infection is prophylactic cesarean delivery indicated? Under what conditions?

A

*

43
Q

Describe acute retroviral syndrome.

A

*

44
Q

Differentiate the genital lesions of HSV, sphilis, and chancroid.

A

*

45
Q

What defines a positive Tzanck prep?

A

*

Nephrology (2 decks)

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