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MCQ by topic > Adolescent med > Flashcards

Adolescent med Flashcards

1
Q

What arrhythmia are anorexics at risk for?

A

prolonged QT

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2
Q

Lab abnormalities found in AN

A

Low WBC, normal hub and dif
mildly elevated liver enzymes, cholesterol and cortisol
low gonadotropins and blood glucose

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3
Q

electrolyte disturbance with laxatives

A

hyperchloremic metabolic acidosis

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4
Q

electrolyte abnormality with vomiting, laxative or diuretics

A

hypokalemia, hypophosphatemia

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5
Q

lab abnormality with vomiting in AN

A

hypochloremic hypokalemic metabolic alkalosis

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6
Q

symptoms of referring syndrome

A

acute tachycardia, heart failure, neurologic symptoms with rapid drop of phos, mag, and potassium

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7
Q

best way to restore bone mineral density in AN

A

weight gain and restoration of menstrual cycles, +vitamin D and calcium

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8
Q

2 most common causes of death in AN

A

1) suicide
2) tachyarythmias

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9
Q

9 indications for hospitalization in AN

A

1) severe malnutrition: weight 75-80% average for sex, height, and age
2)Dehydration
3) electrolyte disturbance
4)Arrhythmia/bradycardia <50bmp daytime, <45bmp nighttime
5) Hypotension (<80/50)
6) Hypothermia
7) Orthostatic changes in HR (>20bpm) or BP (>10mmg)
8) acute food refusal, bingeing purging etc
9) SI

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10
Q

Time frame for buliemia

A

weekly x 3 months

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11
Q

most common cause of secondary dysmenorrhea

A

endometriosis

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12
Q

3 treatments for menorrhagia

A

high dose combined OCP, IV estrogen, TXA

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13
Q

What are 3 features of Rotterdam criteria for PCOS. How many features do you need to have?

A

need 2/3 of
1) oligo-ovulation or anovulation (irregular periods)
2) hyperandrogenism–clinical or biochemical
3) polycystic ovaries on ultrasound

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14
Q

How should impaired glucose tolerance in PCOS be evaluated?

A

2 hour glucose tolerance test

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15
Q

when can you have contraception after abortion?

A

immediately

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16
Q

at what age is a Pap smear recommended?

A

age 21 then q 3 yr once sexually active (changing to starting at 25 yrs)

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17
Q

If you vomit within what time frame should you take another plan B?

A

1 hr

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18
Q

up to what time after sex can you use copper IUD for emergency contraception?

A

7 days

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19
Q

levonorgestrel (plan B) can be used up to how many days after intercourse?

A

5 days (120 hrs), efficacy decreases with time and increasing body weight

20
Q

Within what time frame can ulipristal acetate be used? (Ella)

A

5 days, efficacy dose not decrease with increasing body weight, 2nd most effective emergency contraception after copper IUD

21
Q

Within what time frame should Yuzpe be used?

A

72 hrs

22
Q

within what time frame should pt have a period after emergency contraception

A

3 weeks

23
Q

which types of OCPs may exacerbate acne?

A

progestin only

24
Q

how long does someone need to experience gender dysphoria for to meet DSM criteria?

A

6 months

25
Q

how long should someone obstain from sex after chlamydia treatment?

A

7 days

26
Q

treatment options for gonorrhoea?

A

Ceftriaxone 250mg IM x 1 and azithromycin 1 g PO (2 mechanisms to slow resistance (synergy)
OR
cefizime PO once with azithro PO one
OR
??doxycycline 100mg PO BID x 7 days

Alternative treatment as per nelsons is Cefixime

27
Q

when testing for G&C, who should get urine and who should get swabs?

A

sexual assault of boys, non-vaginal symptoms of girls, treatment failure should do culture otherwise can do urine for screen and diagnosis

28
Q

which adolescents should get HIV screening?

A

all sexually active >=15 yrs or those <15 yrs with risk factors (essentially everything is a risk factor ex. unprotected sex)

29
Q

acute and chronic side effects of anabolic steroids

A

Acute: Increased muscle mass/strength, gynecomastia, acne, small testes, low sperm density, behaviour changes (irritability, depression, aggression),
Long term: cholestasis/liver tumors, cardiomyopathy & HTN, lipoprotein changes, hair loss/male pattern baldness, brain remodeling in adolescents, premature growth plate closure

30
Q

Growth hormone acute and chronic effects

A

Acute effects: headaches/IIH, inc intraocular pressure, SCFE, scoliosis exacerbation,
Rare: transient gynecomastia, pancreatitis, insulin & glucose intolerance, growth & pigmentation of nevi, decreased efficacy (due to neutralizing antibodies)

31
Q

side effects of taking creatine

A

weight gain (water retention), reduced joint mobility, muscle cramping

32
Q

features making teens more (7) or less (10) likely to quit smoking

A
33
Q

who is nicotine replacement recommended for in pediatrics?

A

regular smokers age 12-18
-side effects: local mucosal irritation, increased HR and higher BP readings

34
Q

contraindication for bupropion for smoking cessation in adolescents?

A

seizures, eating disorders

35
Q

differentiate between fibroadenoma and fibrocystic change in breasts

A
36
Q

toxidrome wet and dilated

A

sympathomimetic

37
Q

toxidrome wet and pinpoint

A

cholinergic

38
Q

toxidrome dry and dilated

A

anticholinergic

39
Q

toxidrome dry and pinpoint

A

opioid

40
Q

treatment for chlamydia?

A

azithromycin 1g PO once OR doxy 100mg PO BID x 7 days
(NB dont need ceftriaxone)

Test of cure
3-4 weeks later if NAAT
3-7 days later if culture
Repeat screening in 6 months or sooner

41
Q

how often should you screen for G&C in adolescents?

A

yearly

42
Q

treatment for genital herpes?

A
43
Q

2 treatment options for PID

A
44
Q

who can 12/13 yo consent to have sex with?
14/15 year old?
16+ year old?
18+?

A

less than 12 never
12&13 –> 2 yrs
14&15 –> 5 yrs
16+ –> consent to anyone as long as not in position of trust/authority, not dependent on person for care/support, sex trafficking/pornography
18+ pornography, sex work etc

45
Q

3 elements of informed consent

A

understand appropriate information, capacity, voluntariness

46
Q

4 reasons to break confidentiality

A

risk of serious harm to self
risk of serious harm to other
abuse of any child
reportable illness

47
Q

which antibiotic used to treat chlamydia is contraindicated in pregnancy?

A

doxycycline

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