Adolescent Health Flashcards

1
Q

What is the first stage for intervention when taking a life course approach?

A

Pre-conception

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2
Q

What is the most prevalent STI according to NATSAL?

A

HPV

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3
Q

In which group is non-volitional sex more common?

A

Women

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4
Q

Why is there an importance placed on addressing sexual health?

A
  • Improves physical health outcomes
  • Improves mental health outcomes
  • Positively influences social and emotional wellbeing
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5
Q

What are the four main methods of prevention of poor sexual health?

A

1) Contraception
2) HPV immunisation
3) HIV prevention
4) Education/health literacy

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6
Q

Outline the role of clinician in patient’s contraception options? (3 points)

A
  • Provide information around contraception options
  • Educate patients about risks and consequences of unprotected sex
  • Facilitate prompt access to contraception and sexual health services
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7
Q

What is the most common form of contraception and protection against STIs?

A

Barrier protection

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8
Q

What are the circumstances around unplanned pregnancies?

A

1/6 pregnancies are unplanned
More common in young, single women
Smoking, drug use and depression more common in women who report unplanned pregnancy

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9
Q

What impact does conception under the age of 18 have on babies?

A

Low birth weight babies
Higher infant mortality rate
Higher risk of poor antenatal health

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10
Q

What diseases does the HPV vaccine protect against?

A

Cervical cancer
Some mouth and throat (Head and neck) cancers
Some cancers of the anal and genital areas
Protection against genital warts

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11
Q

What is pre-exposure prophylaxis (PrEP)?

A

Course of HIV drugs taken by a HIV negative person to lower the chance of becoming infected with HIV in the future

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12
Q

What is post-exposure prophylaxis (PEP)?

A

Anti-HIV medication that is prescribed to a HIV negative person after a potential HIV exposure to protect them from being infected with HIV

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13
Q

What are the two major types of drug used for HIV prevention?

A

PrEP and PEP

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14
Q

What are the four most common types of commonly diagnosed STI’s in England as of 2018?

A
  • Chlamydia: 49%
  • Gonorrhoea: 15%
  • First episode genital warts: 11%
  • First episode genital herpes: 7%
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15
Q

How does breast milk influence the microbiome in infants?

A

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.

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16
Q

What is the microbiome?

A

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.

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17
Q

What is the difference between microbiome and microbiota?

A

Refers to all microbes and their genetic material found in the gut, whereas ‘gut microbiota’ refers to the micro-organisms in the gut only.

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18
Q

How does the method of delivery influence an infants microbiome?

A

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

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19
Q

Babies delivered by vaginal birth are exposed to which types of organisms?

A

Colonised by organisms from the maternal vagina

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20
Q

Babies delivered by C-section are exposed to which types of organisms?

A

Maternal skin flora and tend to have significantly less diverse and fewer bacteria in their gut in early life

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21
Q

What properties are exhibited by the microbioma?

A

Immunomodulatory properties
The microbiome curbs the growth of pathological microorganisms and has a role in balancing proinflammatory and anti-inflammatory signals.

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22
Q

What is the risk of folate deficiency during pregnancy?

A

Neural tube defects including spina bifida

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23
Q

What is the importance of vitamin D in pregnancy?

A

To promote bone health of the foetus and reduce the risk of rickets

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24
Q

What are some folate rich foods?

A
  • Green leafy vegetables
  • Peas
  • Kidney beans
  • Chickpeas
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25
What conditions is physical activity during pregnancy associated with a decreased risk?
Hypertension in pregnancy Pre-eclampsia Gestational diabetes Reduced severity of depressive symptoms
26
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
27
What major factors influence diversity and health of the microbiome?
``` Genes Age Environment Diet Pharmaceuticals Geography Lifestyle changes Birthing process stress Infant feeding method ```
28
What are the two main phyla present in the gut microbiome?
Firmicutes and bacteriodetes
29
What are temporal differences in the distribution of species throughout the GI tract?
Oesophagus to colon
30
What are the spatial differences in the distribution of species throughout the GI tract?
Luminal v mucosal
31
How does the GI tract microbiome derive its nutrition?
Host dietary intake | Shed epithelial cells
32
What class of metabolites are produced by the gut microbiome?
Secondary metabolites by breaking down luminal compounds to more useful metabolites
33
How does the microbiome provide protection against pathogens and toxins?
Reactions can detoxify ingested toxins | Release of antimicrobial peptides
34
How can dietary fibre and resistance starches be broken down?
Fermented by enzymes from the gut microbiome in the colon
35
Which bacteria is predominantly responsible for fermentation?
Firmicutes
36
What is released by firmicutes and dictates the pH of the colon?
Short chain fatty acids (SCFAs)
37
What is the purpose of SCFAs?
Rich source of energy and lower the pH in the colon
38
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
39
What is the most pivotal form of SCFAs?
Butyrate
40
What roles does SCFAs have on immunity?
Maintaining local and systemic immune homeostasis
41
Which cells detect pathogens within the gut?
Dendritic cells
42
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
43
What molecule arising from the outer coat of bacteria can enter circulation through a permeable gastrointestinal lumen?
Lipopolysaccharides
44
Which parasympathetic fibre is responsible for neural communication between the gastrointestinal tract and the central nervous system?
Vagus nerve
45
Which essential precursor amino acid is metabolised by the microbiome, and implicated in the production of serotonin?
Tryptophan
46
What influence does serotonin have on the gastrointestinal tract?
Regulates gut motility
47
Which screening technique does the clinician use for the physical barriers to exercise?
The Scot-PASQ | GPPAQ
48
Why are women at an increased risk of dementia?
Oestrogen is protective to brain cells, and reduces in women post-menopause
49
Which hormone is protective of dementia?
Oestrogen
50
What are the some common barriers to females being physically active?
Fear of judgement Lacking confidence Lacking time
51
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)
52
What term describes the impact on mothers in comparison to mothers regarding unemployment?
Motherhood penalty
53
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
54
Which hormone is associated with social connection, sex, labour and childbirth?
Oxytocin
55
What does oxytocin promote?
Social bonding, prosocial behaviour, empathy, elevated mood and stress reduction.
56
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.
57
Which groups of women are more likely impacted by negative aspects of close relationships?
Women arising from lower socioeconomic status
58
Domestic abuse is a combination of what?
Sexual, emotional, psychological or financial abuse
59
What are the risks associated with domestic abuse during pregnancy?
Miscarriage infection Premature birth Injury or death of the baby following birth
60
What is the probability of women experiencing domestic abuse or violence during their life?
1 in 4 women
61
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
62
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