Adolescent Medicine Flashcards
Adolescent Development
Medical complications of eating disorders
- brain atrophy
- neuropathy
- hypercortisol
- hypothermia
- low pituitary hormones
- sick euthyroid
- xerosis
- lanugo
- acrocyanosis
- livedo reticularis
- GERD
- gastroparesis
- constipation
- elevated transaminases
- bone loss
- pathologic stress fracture
- low BP/HR (orthostatic changes)
- prolonged QT
- amenorrhea
- MV prolapse
- myocardial atrophy
- anemia > leukopenia > thrombocytopenia
Electrolyte changes in purging methods
Vomiting
- low K
- low Cl
- high HCO3
- basic pH
- any Na
Laxatives
- low K
- low or high Cl
- low or high HCO3
- low or high pH
- any Na
Admission criteria for eating disorders
- BMI < 75th %ile median weight
- dehydration
- electrolyte abnormalities
- HR < 40 awake/< 45 asleep
- BP < 90/45
- Temp < 35.6
- orthostatic vitals
- arrested growth/development
- outpatient failure
- acute food refusal
- uncontrollable binging
- medical complications (syncope, pancreatitis)
Nicotine Toxicity
- headaches
- intense abdominal pain
- N/V
- palpitations/arrhythmias
- hand tremors
- difficulty concentrating
- seizures
Nicotine replacement
- long acting patch + breakthrough (gum or lozenge - 1-4mg q1-2 hr)
- 0-25mg nicotine = 7mg patch, 25-50mg = 14mg patch, 50-100mg = 21mg patch
Cannabis Withdrawal Syndrome
- 2/5 (irritability, anxiety, depressed mood, sleep disturbance, appetite change)
- 1/6 (abdominal pain, shaking, fever, chills, headache, diaphoresis)
- start within 24-72 hours and can last 1-2 weeks (insomnia last to go)
Risk Factors for Dieting
Individual factors
○ Female
○ Overweight and obesity
○ Body image dissatisfaction and distortion
○ Low self-esteem
○ Low sense of control over life
○ Psychiatric symptoms: depression and anxiety (more likely to engage in extreme dieting)
○ Vegetarianism (some positive health factors, but more likely to endorse dieting, emesis and laxative use)
○ Early puberty
Family factors
○ Low family connectedness
○ Absence of positive adult role models
○ Parental dieting
○ Parental endorsement or encouragement to diet
○ Parental criticism of child’s weight
Environmental factors
○ Weight-related teasing (body dissatisfaction, weight loss attempts and eating disturbance)
○ Poor involvement in school
○ Peer group endorsement of dieting
○ Involvement in weight-related sports (dance, gymnastics)
Other factors
○ Certain chronic illnesses, especially diabetes (also asthma, ADHD, epilepsy)
○ Presence of other risk behaviors: smoking, substance use, unprotected sex
7P’s of sexual health assessment
- partners
- practices
- protection from STIs
- past history of STIs
- prevention of pregnancy
- permission
- personal (gender) identity
Factors impacting smoking cessation
Sexual Maturity Rating
Vaginitis
Treatment of Vaginitis
