Adolescent Health Flashcards
Criteria for hosp assessment in anorexia
- rapid weight loss
- BMI < 15
- bradycardic HR <40
- prolonged QTc > 450
- electrolytes Na <130 or K < 3
- postural hypotension
- SUSS < 2
- core body temp < 35
Cortisol in anorexia
High
Thyroid function in anorexia
low or normal T4
low T3
normal TSH
LH and FSH in anorexia
Low
GH in anorexia
Raised
GnRH in anorexia
Low
Last areas of the brain to mature
Superior temporal cortex & dorsal prefrontal cortex
Subcortical grey or white matter is involved in decision making?
Grey matter
What is the nucleus accumbens
Area of the brain associated with reward, gratification, motivation and fortification of behaviours
Major excitatory neurotransmitter
Glutamate
Major inhibitory neurotransmitter
GABA
Secondary syphilis symptoms
painless rash on palms and soles
viral type illness
swollen lymph nodes
white patches in mouth
Ix for syphilis
DARK field micropscpy
Rx syphilis
IM benpen
Rx gonorrhoea
- IM ceftriazone or cefixime
- azithromycin
What drugs is gonorrhoea highly resistant to
tetracyclines
penicillins
quinolones
IX chlamydia
NAAT testing
Female - vulvovaginal swab
Male - first catch urine
Rx chlamydia
Doxycycline or single dose azithromycin
Organism causing BV
Gardnerella vaginalis
How does metronidazole work in BV
inhibits bacterial nucleic acid synthesis by disrupting DNA
normal vaginal flora
gardnerella vaginalis
haemophilus influenzae
Rx scabies
Permethrin - topical insecticide
Rx public lice
malathion
What type of virus is HSV
double stranded DNA
Most common route of transmission for HIV
unprotected anal or vaginal sex with an infected individual
Ix of a neonate with possible HIV
HIV RNA PCR or DNA PCR
Check at 24-48h, then 6w, then 3-4 months of age
Ix of a child with possible HIV
HIV antibodies
What constitutes a positive HIV diagnosis in a child
HIV antibodies are +ve after 18m in a child born to an infected mother
HIV antibodies are +Ve at any age in a child born to an infected mother
Rx of an infant born to an HIV +ve mother
Start ART ideally within 12h but within 72h
Low risk - zidovudine for 4w
High risk - combination ART zidovudine/lamivudine/nevirapine
Rx of an HIV +ve child
start combination ART
2x NRTI + INI (or) NNRTI (or) PI
NRTIs
zidovudine
lamivudine
tenofovir
abacavir
emtricitabine
NNRTIs
nevirapine
etravirine
efavirenz
rilpivirine
PIs
atazanavir
darunavir
fosamprenavir
ritonavir
indinavir
INIs
raltegravir
dolutegravir
elvitegravir
S/E of efavirenz
new onset psychiatric symps
S/E of tenofovir
GI upset
S/E of emtricitabine
rash and darkening of palms or soles
S/E of lamivudine
insomnia
S/E of rilpivirine
depression (more common if prev MH problems)
F/U for HIV patients
CD4 count and HIV Viral load every 3-6 months
Transmission of Hep A
faecal oral
What type of virus is Hep A
RNA virus
Hep A antibodies and what they mean
Anti HAV IgM
- suggests recent infection
- persists for 4-6m
Anti HAV IgG
- persists lifelong
- confers protection
Most Hep A becomes chronic T or F
False
Most cases self-resolve and don’t require Rx
What type of virus is Hep B
DNA virus
Transmission of Hep B
vertical or by blood or blood products
Hepatitis B surface Antigen (HbsAg)
detected in acute or chronic infection
Hepatitis B core antibody (anti-HbC)
appears at the onset of symptoms
persists for life
indicates previous or ongoing infection
Hepatitis B e Antigen (HBeAg)
indicates replication and high levels of the virus
Hepatitis B e antibody (HBeAb or Anti-HBe)
Seroconversion and spontaneous clearance
Hepatitis B surface antibody (anti-HBs)
recovery and immunity
successful vaccination
Most Hep B becomes chronic T or F
False
Most acute cases self resolve and dont require treatment
When is treatment for Hep B indicated
Evidence of compensated liver disease AND raised ALT/fibrosis
Most Hep C becomes chronic T or F
True
80% develop chronic infection
