Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Royal College Studying > Adolescent Medicine > Flashcards

Adolescent Medicine Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What is the average age of first intercourse in Canadian Teens

A

16.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Age of sexual consent in Canada

A

16
14-15 can consent with someone 5 years older
12-13 with 2 years old
( Must not be position of authority)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is recommended first line contraception

A

Long acting reversable contraception (IUDS!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the typical use failure rate for IUDS

A

0.2% for hormonal, 0.8% for copper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Typical use failure rate for OCP, depo

A

6% of depo, 9% for combined and progesterone only pill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Typical use failure rate for male condoms and withdrawal

A

21% for condoms, 22% for withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the failure rate for OCP plus condom

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does progrestin cause contraception

A

Thickens cervical mucus
alter tubal transport time
inhibit ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are drugs that CAUSE contraception to fail

A

anticonvulsants- carbamazepine, phenobarb, phenytoin, topiramate
antivirals
antifungal
RIFAMPIN
st jonhs wart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are drugs that fail due to OCPs

A

lamotrigine
salicylic acid
parecetamol
morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drugs that dont interact with OCP

A

valproic acid
ethosuximide
keppra
clonazepam
pregabalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Absolute CI to OCP

A

uncontrolled HTN (systolic > 160 and diastolic>100
current or past history of VTE (stroke, PE, MI)
ishcemic heart disease
complicated valuvalr heart disease
migraine headache with aura
breast cancer (current)
diabets WITH complications
severe cirrhosis
liver tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Absolute contraindication to progestin only pill

A

Breast cancer within the last 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What to do if you mised 1 birht control pll

A

Take as soon as remember, no back up needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What to do you if you miss 2 birth contorl in a row

A

Use back up
Take 2 pills the day you remember

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What to do you if you miss 3 birth contrl pills in a row

A

Start a new pack, use back up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What dose of estradiol do you recommend for OCP

A

30-35 mcg because below 30 associated with poorer bone mineralization in youth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is a preg test mandatory before emergency contraception

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Whats the most frequently reported STI in Canada

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fitz hugh Curts syndrome

A

RUQ pain
fever
nausea
vomiting
Usually caused by chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Reiter Syndrome

A

sexually acquired reactive arthritis
chlamydia
male
1mo post chlamydia infection
arthritis, rash on soles and penis, conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

STI risk factors

A

under 25
no condom use
contact with someone known to ahve sti
new partern
over 2 partners in last year
serial monogamy
IVDU
any drug use
previous TI
sex workers
survival sex
street involvement
anonymous sex
sexual assault

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Who should you screen for C + G

A

all sexually active under 25 regardless of rf
once er year, more often if risk factors
every 6mo if previous infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What all should you screen for in a sexually active youtih with no other risk factors

A

C and G
syphyllis
HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When to collect NAAT for test of cure

A

wait 2-3 weeks agter treatmnet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how to treat a patient with STI symptoms

A

empirically
ceftriaxone 250mg IM single dose plus azithromycin 1g PO single dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

preferred chlamydia treatment

A

azithro 1g PO once
OR
Doxy 100mg PO BID for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Gonorrhea treatment

A

Have to treat for chlamydia too
Ceftriaxone 250mg IM once PLUS azithro 1g ONCE
Cefixime 800mg po once pLUS azithro 1g ONCE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When to do follow up testing for C and G

A

C- NAAT 3-4 weeks post treatment, recommended when compliance is uncertain, second-line treatmen twas used, re-expsure risk is high, pregnant
G- culture 3-7 days post treatmnet or NAAT 2-3 weeks post treatmnet IF complicance uncertain, second line, high re-exposure risk, pregnant, antimicrobial resisttance is a concern, previous treatmnet failure, pharyngeal or rectal infection, infection isdisseminated, persistent signs and symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is more likely to have resistnace C or G

A

C- rare
G- resistance emerging

31
Q

Partner notification for C and G

A

All parterns withint 60 days priro to symptoms onset or if no symptoms then from time of specimen collection

32
Q

How long to abstain from sexual activity after treatmnet for C and G

A

C: once symptoms have resolved
7 days post single therapy or after completion of multiple dose treatment

G: 3 days after single treatment and after symptoms have resolved

33
Q

What percent of PID is due to STIs

A

80%

34
Q

RF for PID

A

young adults (20-24), cervicits with C/G, high risk sexual behaviors (unprotected, frequent, multiple, during menses, smoking/alc/drug use, before age 15-16), previous PID, black, BV, menses

35
Q

Do contraceptives increase risk for PID

A

NO
oral OCP increases risk for C possibly G not PID
IUD risk following insertion is low even if they have cervicitis, generally restricted to first 3 weeks after insertion

36
Q

Diagnostic criteria for PID

A

sexually active adolescents with pelvic/lower abdo pain, no other cause for illness identified, one or more of cervical motion tenderness, uterine tenderness, adnexal tendnerness

NOT required but supportive
fever, abnormal discharge, abundant WBC in vaginal secretions (absence has NPV of 95%), elevated serum WBC, ESR, CRP, positive STI culture

37
Q

Gold standard for PID diagnosis

A

laparoscopy abnormality consistent with PID +/- endometrial niopsy with evidence of endometritis

38
Q

Does a normal US rule out PID

A

no

39
Q

When to do an US in PID work -up

A

Not routinely indicated
Can do if the patient refuses gyne exam, adnexla mass is felt, adnexal pain and markedly elevated inflam markers, high fever, elevated WBC, other diagnosis suspected, positive BHCG, hospitalization

40
Q

When to admit PID

A

surgical emergency cannot be xcluded
pregnnacy
no response to outpatient treatment after 48-72h
patient unable to tolerate oral regimen
severe illness, nausea, hgih fever
UOA
immunosuppression

41
Q

Recommended outpatient treatmnet for PID

A

ALWAYS 14 days of antibiotics
Ceftriaxone 250mg IM in a single dose
OR other third gen cephalosporin
PLUS
dox 100mg BID for 14 days
+/- flagyl 500mg BID for 14 days

42
Q

Inpatient treatment for PID

A

Cefoxitin 2gIV every 6 hours
Doxy 100mf oral or IV q12h for 4 days

OR

clinda 9000mg IV every 8 hours + gent

43
Q

What are acute complications of PID

A

peritonitis
perihepatitis (fitx hugh curtis)
TOA
adhesions

44
Q

What are longterm complications of PID

A

recurrent PID
infertility
ectopic
chronic pelvic pain

45
Q

Does BV cause PID

A

NO- it is a risk factor but is not causative

46
Q

Risk factors for dysmenorrhea

A

age < 30
smoking
low BMI
earlier menarche
longer cycles
hevy flow
psych symptoms
ovulatory cycles
higher levels of prostaglanding in endmetrium
family history ?

47
Q

1 cause of school absenteeism

A

dysmenorrhea

48
Q

What is first line treatment for dysmenorrhea

A

NSAIDs
80% respond

49
Q

What of OCP helps with dysmenorrhea

A

estrogen component

50
Q

effective treatments for endometriosis

A

OCP
depo
IUD hormonal
gnrh agonists

51
Q

Definition of primary amenorrhea

A

no menses by age 14 without secondary sex characterisitics
No menses by age 16 with secondary sex characterisitics

52
Q

Ddx for amenorrhea with withdrawal bleed after progesterone admin

A

PCOS or hypothalamic/pit dysfunction
Do prolactin/TSH
Androgen levels

53
Q

Ddx negative withdrawal bleed

A

Ovarian insuffiency or hypothalamic
DO LH and FSH
If high- thinking OI
if normal or low- mRI brain

54
Q

Complications of PCOS

A

infertliy
metabolic syndroem (independent of BMI)
unopposed estrogen increased risk for endometrial cancer (x3) and breast cancer (x3)

55
Q

Who is at incrased risk for refeeding

A

Low weight on admission (>70% median BMI)
rapid weight loss
young age

56
Q

treatment for anorexia

A

family based therapy

57
Q

What is treatment for bulimia

A

fluoxetine is the onyl medication approved
antidepressant and CBT superior to either alone

58
Q

indications for admission in eating disorder

A

severe malnutrition (<75% median BMI), dehydration, electrolyte abn, ecg abn, severe vrady <50, hypotension, hypothermia (<35.5), orthostatic changes, failure of otpatient treatment, syncope, seizures, acute food reguslal, uncontrollabel binging nad purging, psych ermgencies

59
Q

What percent of kids have tried alcihol by end of high school and drugs

A

70% alcohol
50% illicit drug
25% drug other than weed

60
Q

RF for smoking

A

low education aspirations
low self esteem
risk taking
minimized perceived hazards of smoking
favourable attitude towards smokiing
peer, parent, sibling smoking
lower SES or parents educational attainmnet
history of abuse
exposure to tobacco media
accessibility and price of tobacco products
girls: weight control
boy: sense of adventure/daring

61
Q

Are e cigarettes effective to help quite smoking

A

no

62
Q

best evidence for smoking cessation

A

brief counselling
CBY
phone or distance counselling

63
Q

risk factors for alcohol use

A

early puberty in girls
parental alcoholism (4-10x)
parental drinling standards
early onset etoh (<14y)
media of alcohol
social norms
societal provision of alcohol

64
Q

CRAFT screening for alchol

A

CAR
RELAX
ALONE
FORGET
FRIEND
TROUBLE

65
Q

AE of anabolic steroids

A

psych- psychosis, mood swings, aggressive, violence, neurotixicity, body dysmorphia
CV_ low HDL, high LDL, HTN, MI, death
endo- premature epihpyseal closure, short, female virilization and hypogonadism, decreased libido, infertility, testiuclar atrophy, gynecomastia and high voice
acne, prostate enlargement, hepatocellular carcinoma, other illict drugs, hemolysis

66
Q

Acute AE of marijuana use

A

anxiety/panic, psychotic symptoms, high risk behavior (MVA)
increased hR< dry mouth, orthostatic hypotension, supine hypertension, red eyes, CI, processing difficultieis

67
Q

physiologic effects of chronic cannabis use

A

chronic bronchitis
i,paired resp function
res cancers
gynecomastia

68
Q

Cannabis withdrawl syndrome

A

at least 2 of : irritability, anxiety, depression mood, sleep disturbance, appetite changes
at least 1 physical symptoms: abdo pain, shaking, fever, chills, headache

symptoms occur 24072h after cessation of heavy cannabis use, duration 1-2 weeks

Treatment: no meds, cognitive and behavioral skills to manage withdrawal and avoid relapse

69
Q

Factors that protect against suicide

A

reasons for staying alive
postivie relationship with at least one parent
cultural or religious beliefs
adequate parental monitoring and supervision
proscoial peer group
strong connection to school

70
Q

what medical conditions are associated with suicide

A

insomnia
pain
CNS conditions- migraine, epilepsy
infalmmatory- IBD, asthma, obesity
TBI- esp in military populations

71
Q

RF for depression

A

female, older, parent/fam hx, comorbid chronic illness (ADHD, DM, anxiety), past history of depression, learning disorder, genetics, certain medications (steroids, isotretinoin), substance use

famly or peer conflict, childhood neglect or abuse, poverty, recent loss, academic difficulties or school failure, discrimination and socal exclusion, poo home school relationships, poor quality neighbourhoods

72
Q

Common SSRI AEs

A

GI symptoms
sleep disturbance
restlessness
headaches
appetite changes
sexual dysfunction

73
Q

Does presence of substance use do preculude SSRI treatment

A

no

74
Q

ECG findings in ANR

A

Bradycardia
Low voltage changes
Prolonged QTc interval
T-wave inversion
ST segment depression

Royal College Studying (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions