adolescent medicine

Question 1

Tanner stages - boys

Answer 1

Stage 1 - no pubic hair, preadolescent
Stage 2 - testes larger, sparse long downy hair
Stage 3 - testes further enlarged, penis length enlarged, darker coarser and curlier hair
Stage 4 - scrotal skin darkening, penish length and width increased, coarse curly pubic hair
Stage 5 - testes and penis adult in size and shape, spreads to medial surface of thighs

Question 2

Tanner stages - girls

Answer 2

Stage 1 - no pubic hair, preadolescent
Stage 2 - elevation of breast and nipple, sparse long downy hair along labia
Stage 3 - breast enlargement, areola enlarges, darker coarser and curlier hair
Stage 4 - areola and nipple project to form secondary mound above breast, coarse and curly adult type hair
Stage 5 - nipple projects, areola recedes, adult hair onto medial surface of thighs

Question 3

vaginalis

Answer 3

Sx: malodorous, profuse yellow green discharge, strawberry cervix, vulvar inflammation and itching, dyspareunia
Dx: pH > 4.5, wet mouth microscopy
Tx: metronidazole

Question 4

Gardnerella vaginalis

Answer 4

Sx: gray-white thin vaginal discharge, fishy odor,
Dx: positive whiff test, clue cells, pH > 4.5
Tx: metronidazole

Question 5

candida albicans

Answer 5

Sx: severe itching, white curdlike discharge
Dx: pH < 4.5, fungal hyphae on wet mouth saline
Tx: fluconazole

Question 6

C trachomatis/N gonorrhoeae

Answer 6

Sx: purulent discharge, friable edematous red cx, dysuria, urinary frequency
Dx: gold standard is culture
Tx: doxy/ erythro/ azithro and IM ceftriaxone