Adolescent/GYN Flashcards

1
Q
  • absent pubic hair
  • childlike phallus
  • testicular volume <2.5mL
A

SMR 1 (prepubertal)

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2
Q
  • fine pubic hair
  • childlike phallus
  • inrceased testicular size and volume
  • scrotum more textured
A

SMR 2 (beginning of puberty)

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3
Q
  • coarse, curly, and pigmented pubic hair
  • increased phallus size
  • increased testicular size
A

SMR 3

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4
Q
  • denser and curled pubic hair, but less abundant than adult

- phallus size closer to adult male

A

SMR 4

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5
Q
  • pubic hair extends to the inner thigh, adult like
  • adult size phallus
  • adult size testicles
A

SMR 5

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6
Q
  • absent pubic hair

- no glandular breast tissue

A

SMR 1 (prepubertal)

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7
Q
  • hair along the labia

- small breast buds, with glandular tissue

A

SMR 2 (beginning of puberty)

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8
Q
  • coarse, curly and pigmented pubic hair

- breast tissue extends beyond the areola

A

SMR 3

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9
Q
  • pubic hair denser and curled but less abundant than adult

- enlarged areola and papilla form a secondary mound

A

SMR 4

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10
Q
  • pubic hair extends to the inner thigh, adult like

- no longer a separate projection of the areola from the remainder of the breast

A

SMR 5

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11
Q

pre-puberty height velocity

A

5-6 cm/yr

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12
Q

peak adolescent height velocity

A

9-10 cm/yr

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13
Q

-no pubertal development by 14 in a girl, 13 in a boy

A

Delayed Puberty

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14
Q

-what the female growth spurts begins and ends with

A

Breast development, menarche

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15
Q

-first sign of puberty in males

A

Testicular enlargement

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16
Q

-2 labs that increase with growth spurt

A

Alk Phos and Hematocrit

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17
Q

-sequence of male pubertal development

A

Testicular growth->pubarche->penile growth->peak height velocity

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18
Q
  • MC for delayed puberty in males

- bone age < constitutional age

A

Constitutional Growth Delay

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19
Q

-sequence of female sexual development

A

Breast buds (thelarche)->pubarche->peak height velocity->menarche

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20
Q
  • when thelarche occurs without pubarche

- breast tissue without pubic hair

A

Androgen insensitivity

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21
Q
  • pubarche without thelarche

- pubic hair without breast development

A

low estrogen or excess androgens

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22
Q
  • white, odorless, mucoid discharge that precedes menarche by 3-6 months and can continue for several years
  • requires no intervention
A

Physiologic leukorrhea

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23
Q

-when secondary sexual characteristics appear before age 9 in males and 8 in females

A

Precocious Puberty

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24
Q
Breast cancer
Coronary Artery Disease
Hepatic disease
Elevated
Lipids
Pregnancy
A

Absolute contraindications for OCPs

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25
- amenorrhea, obesity, hirsutism, and acne - LH:FSH >2.5, elevated androgens - Tx: wt loss, OCPs, spironolactone, metformin
Polycystic Ovary Disease
26
-best study to order in a girl with breast development but no pubic hair
Karyotype
27
- female involved in heavy athletic training - menstrual cycles gradually become lighter then stop - low serum estradiol - increased risk for low bone density and osteoporosis - Tx: reduce training, stop smoking, calcium, increase calories
Female athlete triad
28
- crampy lower abdominal pain and pelvic pain that occurs with menses and is not due to other pelvic etiology - due to prostaglandins produced during the ovulatory cycle - Tx: NSAIDs
Primary Dysmenorrhea
29
- pelvic pain that occurs other times besides menstruation | - due to underlying pelvic pathology
Secondary dysmenorrhea
30
- recurrent nightmares, fear of being alone, diminished interest in school, decreased appetite - lower abdominal pain and vaginal discharge
PTSD
31
-top 3 leading causes of death in teens
1. MVA/accidents 2. Homicide 3. Suicide
32
- distorted body perception - weight 15% below expected - intense fear of gaining weight - absence of 3 consecutive menstrual cycles - excessive exercise, use of diuretics, depression
Anorexia Nervosa
33
- binging and purging - salivary gland enlargement - dental enamel erosion - calluses over knuckles - low K, Cl, metabolic alkalosis
Bulimia Nervosa
34
- failure of outpt Tx - dehydration - EKG abnl - Mallory Weiss tears - Suicidal ideation
Indications for hospital admission for eating disorders
35
-which electrolyte abnl are eating disorder pts at risk for during refeeding
hypophosphatermia
36
-tx for trichomoniasis
Metronidazole 2g po x1
37
- rash, joint/tendon involvement, meningitis, endocarditis - Dx: gram stain with intracellular gram negative diplococci - Tx: CTX and Azithro
Disseminated gonococcal infection
38
- lower abd or pelvic pain - uterine or adenexal tenderness or CMT - WBC in vaginal secretions - temp >101F - elevated ESR or CRP - lab evidence of GC/CTT at cervix - vaginal discharge
PID
39
-outpatient treatment for PID
Ceftriaxone 250mg IM x1 and | Azithromycin 1g po x1
40
-if pain persists after treatment for PID, must obtain an US to look for this complication
Tubo-ovarian abscess
41
-what size ovarian cyst would need laproscopic aspiration
6mm or causing significant discomfort
42
- RUQ pain that radiates to the right shoulder, nausea - US will be negative - Dx: pelvic exam - Tx: same as for PID - pain should resolve 2 days after treatment
Fitz Hugh Curtis
43
-when is parental consent not needed?
- life threatening emergencies - sexual assault services - medical care during pregnancy and family planning - std treatment and testing - substance abuse treatment
44
-a person under legal age who is no longer under their parent's control and regulation who is allowed to give informed consent instead of the parent
Emancipated minor
45
- low self esteem and coping skills - alienation from conventional norms - homosexuality - use of performance enhancing drugs
Risk factors for drug abuse
46
How long can marijuana can be detected in the urine?
5 days for single use 10 days for chronic use 1 month for daily use
47
How long can short acting and long acting barbituates be detected in the urine?
24 hours | 1 week or longer
48
- causes drowsiness, decreased inhibition, and light-headedness, ataxia, and disorientation - muscle weakness, nystagmus, and loss of coordination - asphyxia, cardiac arrhythmia, and aspiration, leading to death - chronic use leads to encephalopathy - MC in lower SEC groups and Hispanic and Native Americans
Inhaled hydrocarbons
49
- tachycardia - tremulousness - HTN - mydriasis - euphoria and overconfidence - agressive and violent behavior at high doses
Cocaine
50
- combative behavior and agitation | - tremulousness is not common
Alcohol
51
- characterized as a "quick drunk" with disinhibition and agitation - hallucinations, generalized muscle weakness and nystagmus
Volatile hydrocarbons
52
- agitation w/o tremulousness or tachycardia - depressed sensorium, resp depression, miosis, indifference to pain, euphoria - hypotension, low temp, constipation, urinary retention
Opiates
53
- combative, tachycardia, mydriasis | - NO nystagmus
Amphetamines
54
- combative - vertical and horizontal nystagmus - muscle rigidity - normal pupils - distortion of body image, paranoia, hallucinations - tachycardia, HTN, increased DTRs - miosis, flushing, and diaphoresis - can lead to rhabdo, then renal failure - Tx: do not acidify urine or use physical restraints - Tx: cooling blanket, chemical restraints
PCP
55
-memory loss, decreased reading comprehension, and poor interpersonal skills
Behavioral consequences of marijuana use
56
- dry mouth - dilated pupils - drowsiness - distortion of time
Acute effects of marijuana use
57
- ataxia, slurred speech, visual disturbance, vomiting, nausea, sluggish pupils, excessive sweating, flushed skin, hypoglycemia - irritability, stupor, and coma
Alcohol intoxication
58
- circulatory collapse - coma - hypertensive crisis - seizure - elevated temp - cerebral hemorrhage - arrhythmias
Amphetamine abuse
59
-anxiety, poor school performance, rhinorrhea, insomnia, stomach cramps
Opiate withdrawal
60
- sleepiness and sedation | - pupils are slow to react but normal size
Benzo abuse
61
-alertness, muscle relaxation, enhanced memory and alertness, decreased appetitie, decreased irritability
Physiologic effects of nicotine
62
- giggling, slurred speech, and ataxia | - death from asphyxia or arrhythmia
Organic solvent abuse