Adolescent Health Flashcards
What should be asked about under the H of the HEADS assessment?
Home life:
relationships
social support
chores
What should be asked about under the E of the HEADS assessment?
Education:
school and exams
work experience
career
university
financial issues
What should be asked about under the A of the HEADS assessment?
Activities:
Exercise, sport, other leisure activities
Social relationships, peers
Who can they rely on
Any bullying
What should be asked about under the D of the HEADS assessment?
Drug use:
drugs, cigarettes, alcohol
how much and how often
Diet:
weight
caffeine
binges/vomits
What should be asked about under the S of the HEADS assessment?
Sexual health:
Concerns, periods, contraception
Sleep:
How much
Any difficulties
Waking often
Suicide/Affect:
Depression
Self harm
Body image
Safety:
Issues around substances, sexual health or internet use
Social media:
What platforms, how often each day
Effects on confidence and imaging
Cyber-bullying
What is the treatment of choice for chlamydia?
Azithromycin or doxycycline
What is the treatment of choice for gonorrhoea?
A macrolide
Which antibiotic should be added in cases of PID
Metronidazole
What is the failure rate of emergency contraception if taken within the first 72hours?
2%
Which area of the brain is responsible for executive functioning?
Frontal lobe
What is the nucleus accumbens associated with and how does it apply in teenage behaviours?
Reward, gratification and motivation and fortification of behaviours
More likely to take bigger risks for rewards
What percentage of HIV infections globally involve a child <15y/o?
5%
Via what 2 methods in HIV transmitted?
Bodily fluids
Vertical transmission
Which type of cell does HIV infect?
CD4 lymphocytes
When does primary HIV occur?
4-8weeks after infection
How does primary HIV present?
With an EBV-like illness
How does stage 1 HIV present?
Asymptomatic or persistent, generalised lymph nodes
How does stage 2 HIV present?
Moderate, unexplained weight loss
Recurrent resp. infections
Seborrhoeic dermatitis
Recurrent oral ulcers
HZV
Angular chelitis
How does stage 3 HIV present?
Severe weight loss (>10%)
Unexplained chronic diarrhoea
Unexplained persistent fever
Oral candida or hairy leukoplakia
Pulm. TB in last 2 years
Severe bacterial infections
Unexplained neutropenia or anaemia
Acute necrotising ulcerative stomatitis, gingivitis or periodontitis
How does stage 4 HIV present?
Kaposi sarcoma
HIV-wasting syndrome
PCP
Oesophageal candidiasis
CNS toxoplasmosis
Recurrent or severe pneumonia
HIV encephalopathy
Thrombocytopenia
Progressive multifocal leukoencephalopathy
CMV retinitis
Cerebral or B-cell NHL
What testing is done to diagnose HIV in neonates?
HIV DNA or RNA PCR checked at 24-48hours, 6 weeks and 3-4months
When do positive HIV antibodies indicate a diagnosis of HIV in a child?
Positive on 2 separate occasions in a child >18months born to an HIV +ve mother or just positive x2 in a child born to an HIV -ve mother
What combination of ARTs are given to children with HIV?
2x NRTIs (nucleoside reverse transcriptase inhibitors)
INI (integrase inhibitor)
NNRTI (non-nucleoside reverse transcriptase inhibitors) or PI (protease inhibitor)
What type of HIV drug is lamivudine?
NRTI
What type of HIV drug is efavirenz?
NNRTI
What type of HIV drug is atazanavir?
PI
What type of HIV drug is doletegravir?
INI
What type of HIV drug is elvitegravir?
INI
What type of HIV drug is darunavir?
PI
What type of HIV drug is nevirapine?
NNRTI
What type of HIV drug is zidovudine?
NRTI
What type of HIV drug is ritonavir?
PI
What type of HIV drug is etravirine?
NNRTI
What type of HIV drug is raltegravir?
INI
What type of HIV drug is tenotovir?
NRTI
What type of HIV drug is rilpivirine?
NNRTI
What type of HIV drug is abacavir?
NRTI
What type of HIV drug is fosamprenavir?
PI
What type of HIV drug is emtricitabine?
NRTI
What ART therapy are low risk infants born to HIV +ve mothers started on?
zidovudine monotherapy for 4 weeks
What ART therapy are high risk infants born to HIV +ve mothers started on?
zidovudine, lamivudine and nevirapine
Which ART drug is most associated with new onset psychiatric symptoms?
Efavirenz
Which ART drug causes a rash and darkening of palms and soles?
Emtricitabine
What disease is caused by treponema pallidum?
Syphilis
What 2 ways can syphilis be transmitted?
Sexual contact
Mother to child during childbirth
How does primary syphilis present?
Chancre at site of infection
What happens in secondary syphilis?
Latent stage with no clinical symptoms
What organ systems can tertiary syphilis affect?
CNS
CVS
Skin
How does congenital syphilis present?
Skin lesions
Bone abnormalities
Hepatosplenomegaly
Developmental issues
What serological testing can be done to confirm syphilis?
Rapid plasma reagin
T.pallidum particle agglutination
Fluorescent treponemal antibody absorption
What pharmacological management is given for early syphilis?
benzathine benzylpenicillin or doxycycline/erythromycin for 14days
What pharmacological management is given for late syphilis?
benzathine benzylpenicillin or doxycycline
What pharmacological management is given for asymptomatic contacts of syphilis?
doxycycline
What STI has a gram stain which would show gram negative diplococci?
Gonorrhoea
How does gonorrhoea typically present?
Purulent urethral discharge typically 7 days after exposure
What is first line treatment for gonorrhoea?
Ceftriaxone or cefixime
Which HPV strains are the most onocogenic?
16&18
How does treponema pallidum appear on microscopy?
Gram -ve spirochetes
What is the mechanism of action of azithromycin?
Inhibition of bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome
What is the first line treatment in chlamydia?
Azithromycin
