Adolescent Health Flashcards
What is the first stage for intervention when taking a life course approach?
Pre-conception
What is the most prevalent STI according to NATSAL?
HPV
In which group is non-volitional sex more common?
Women
Why is there an importance placed on addressing sexual health?
- Improves physical health outcomes
- Improves mental health outcomes
- Positively influences social and emotional wellbeing
What are the four main methods of prevention of poor sexual health?
1) Contraception
2) HPV immunisation
3) HIV prevention
4) Education/health literacy
Outline the role of clinician in patient’s contraception options? (3 points)
- Provide information around contraception options
- Educate patients about risks and consequences of unprotected sex
- Facilitate prompt access to contraception and sexual health services
What is the most common form of contraception and protection against STIs?
Barrier protection
What are the circumstances around unplanned pregnancies?
1/6 pregnancies are unplanned
More common in young, single women
Smoking, drug use and depression more common in women who report unplanned pregnancy
What impact does conception under the age of 18 have on babies?
Low birth weight babies
Higher infant mortality rate
Higher risk of poor antenatal health
What diseases does the HPV vaccine protect against?
Cervical cancer
Some mouth and throat (Head and neck) cancers
Some cancers of the anal and genital areas
Protection against genital warts
What is pre-exposure prophylaxis (PrEP)?
Course of HIV drugs taken by a HIV negative person to lower the chance of becoming infected with HIV in the future
What is post-exposure prophylaxis (PEP)?
Anti-HIV medication that is prescribed to a HIV negative person after a potential HIV exposure to protect them from being infected with HIV
What are the two major types of drug used for HIV prevention?
PrEP and PEP
What are the four most common types of commonly diagnosed STI’s in England as of 2018?
- Chlamydia: 49%
- Gonorrhoea: 15%
- First episode genital warts: 11%
- First episode genital herpes: 7%
How does breast milk influence the microbiome in infants?
Significant differences in the gut microbiome between breast fed and formula fed babies have been found. This is thought to result from breast feeding exposing the baby to the microbiome of the breast skin, nipple and ducts, and milk contents compared to less exposure for formula fed babies. Diet is also thought to impact on the health of the microbiome later in life.
What is the microbiome?
The microbiome consists of bacteria, fungi, parasites and viruses including their genes found co-existing throughout the human body. This can also be found within and on all multicellular organisms, not just in the GI tract of humans. Microbiota is the term usually used for a group of micro-organisms found within a certain environment. For example, the ‘gut microbiome’ refers to all microbes and their genetic material found in the gut, whereas ‘gut microbiota’ refers to the micro-organisms in the gut only.
What is the difference between microbiome and microbiota?
Refers to all microbes and their genetic material found in the gut, whereas ‘gut microbiota’ refers to the micro-organisms in the gut only.
How does the method of delivery influence an infants microbiome?
Babies born vaginally are initially colonised by organisms from the maternal vagina to which they are exposed during delivery. Babies delivered via caesarean section are mostly colonised by maternal skin flora and tend to have significantly less diverse and fewer bacteria in their gut in early life compared with those delivered vaginally
Babies delivered by vaginal birth are exposed to which types of organisms?
Colonised by organisms from the maternal vagina
Babies delivered by C-section are exposed to which types of organisms?
Maternal skin flora and tend to have significantly less diverse and fewer bacteria in their gut in early life
What properties are exhibited by the microbioma?
Immunomodulatory properties
The microbiome curbs the growth of pathological microorganisms and has a role in balancing proinflammatory and anti-inflammatory signals.
What is the risk of folate deficiency during pregnancy?
Neural tube defects including spina bifida
What is the importance of vitamin D in pregnancy?
To promote bone health of the foetus and reduce the risk of rickets
What are some folate rich foods?
- Green leafy vegetables
- Peas
- Kidney beans
- Chickpeas
What conditions is physical activity during pregnancy associated with a decreased risk?
Hypertension in pregnancy
Pre-eclampsia
Gestational diabetes
Reduced severity of depressive symptoms
What are the characteristics of foetal alcohol syndrome?
- Small stature
- Facial features (microcephaly, a flat elongated philtrum, a thin upper lip, a small chin)
- Cardiac defects
- Abnormal palmar creases
- Cognitive defects
What major factors influence diversity and health of the microbiome?
Genes Age Environment Diet Pharmaceuticals Geography Lifestyle changes Birthing process stress Infant feeding method
What are the two main phyla present in the gut microbiome?
Firmicutes and bacteriodetes
What are temporal differences in the distribution of species throughout the GI tract?
Oesophagus to colon
What are the spatial differences in the distribution of species throughout the GI tract?
Luminal v mucosal
How does the GI tract microbiome derive its nutrition?
Host dietary intake
Shed epithelial cells
What class of metabolites are produced by the gut microbiome?
Secondary metabolites by breaking down luminal compounds to more useful metabolites
How does the microbiome provide protection against pathogens and toxins?
Reactions can detoxify ingested toxins
Release of antimicrobial peptides
How can dietary fibre and resistance starches be broken down?
Fermented by enzymes from the gut microbiome in the colon
Which bacteria is predominantly responsible for fermentation?
Firmicutes
What is released by firmicutes and dictates the pH of the colon?
Short chain fatty acids (SCFAs)
What is the purpose of SCFAs?
Rich source of energy and lower the pH in the colon
What does the pH in the colon determine?
The type of micro-organisms capable of surviving there, and also interacts with both the immune and nervous system
What is the most pivotal form of SCFAs?
Butyrate
What roles does SCFAs have on immunity?
Maintaining local and systemic immune homeostasis
Which cells detect pathogens within the gut?
Dendritic cells
What impact does the exposure to lower level harms common in modern day life have on the gut microbiome?
Chronic inflammatory state can occur which is detrimental to health and associated with chronic disease
What molecule arising from the outer coat of bacteria can enter circulation through a permeable gastrointestinal lumen?
Lipopolysaccharides
Which parasympathetic fibre is responsible for neural communication between the gastrointestinal tract and the central nervous system?
Vagus nerve
Which essential precursor amino acid is metabolised by the microbiome, and implicated in the production of serotonin?
Tryptophan
What influence does serotonin have on the gastrointestinal tract?
Regulates gut motility
Which screening technique does the clinician use for the physical barriers to exercise?
The Scot-PASQ
GPPAQ
Why are women at an increased risk of dementia?
Oestrogen is protective to brain cells, and reduces in women post-menopause
Which hormone is protective of dementia?
Oestrogen
What are the some common barriers to females being physically active?
Fear of judgement
Lacking confidence
Lacking time
Outline some health inequalities seen specifically in females?
Women are at a higher risk of initial misdiagnosis following MI
Women not always been represented equally in research (Thalidomide)
What term describes the impact on mothers in comparison to mothers regarding unemployment?
Motherhood penalty
What is motherhood penalty?
Mothers more likely than fathers to lose their jobs – “motherhood penalty”:
• Quit their job
• Lost their job
• Been furloughed
• Contribute to childcare
• Contribute to household responsibilities
Which hormone is associated with social connection, sex, labour and childbirth?
Oxytocin
What does oxytocin promote?
Social bonding, prosocial behaviour, empathy, elevated mood and stress reduction.
Compare relationship experiences between females and males
Females are more likely to have broader and more intimate friendships than men
-Women are more likely to discuss personal matters and feel more supported during times of stress
Women report higher psychological distress and negative interactions, despite having broader and more intimate relationships.
Which groups of women are more likely impacted by negative aspects of close relationships?
Women arising from lower socioeconomic status
Domestic abuse is a combination of what?
Sexual, emotional, psychological or financial abuse
What are the risks associated with domestic abuse during pregnancy?
Miscarriage
infection
Premature birth
Injury or death of the baby following birth
What is the probability of women experiencing domestic abuse or violence during their life?
1 in 4 women
How can health professionals aid women suffering from domestic abuse?
- Elicit information in a sensitive and empathetic manner
- Signpost to appropriate sources for guidance and safety
- Plan follow-up care with flexible appointments as needed, and refer to appropriate professionals, such as a domestic abuse support worker
- Address their fear of involvement of social or child protection services and reassure confidentiality where appropriate]
- Allow the patient to have autonomy over their decisions, without feeling pressured
- Respect their decisions and remain non-judgemental]
- Remind them that they are not alone in their experience and that there is always help available
Summarise what inputs/outputs are seen when food enters the body
• Metabolism:
o Food broken down to useable compounds
o Hormone regulation
• Gut Microbiome: Interacts with CNS + ENS, Immune system, Vitamin and metabolite production, plays a role in appetite
• Gut-brain axis:
o Bi-directional communication between CNS and ENS
o Stress-mediated responses in gut physiology, epithelial function and motility (via vagus nerve and cytokine in the bloodstream
o Mood and mental state also alters the above
• Intestinal permeability:
o Increased with poor diet and stress
o Lipopolysaccharides into blood stream
