Adolescents

Question 1

What is the primary physical development occurring in adolescents?

Answer 1

Transition from sexual immaturity to sexual maturity

Question 2

What is the first apparent sign of puberty in girls?

Answer 2

Breast development

Question 3

What is the first apparent sign of puberty in boys?

Answer 3

Testicular enlargement

Question 4

What is the mean age of puberty in girls?

Answer 4

10.5 years old (range 8-12)

Question 5

What is the mean age of puberty in boys?

Answer 5

11.5 years old (9-13)

Question 6

What is precocious puberty?

Answer 6

Onset of puberty 2-3 SD before the mean

Girls: breast development before age 8
Boys: testicular enlargement before age of 9

Question 7

What age would be considered delayed puberty in girls?

Answer 7

After 12 years of age in girls

Question 8

What stage of breast development does the breast bud elevate and there is enlargement of areola?

Answer 8

Stage 2

Question 9

What stage of breast development is defined as areola and nipple form a secondary mound above the level of the breast?

Answer 9

Stage 4

Question 10

In breast development, what is the mature stage?

Answer 10

Stage 5, projection of the nipple

Question 11

How many stages are in pubic hair development?

Answer 11

5

Question 12

What is a prader orchidometer?

Answer 12

Medical tool used to measure the volume and size of the testicle

Question 13

What is measurement size of the adult testicle with a prader orchidometer?

Answer 13

12-25 ml

Question 14

Is puberty synchronized with cognitive, social, and emotional development?

Answer 14

No, not necessarily synchronized

Question 15

What are the health issues in adolescence?

Answer 15

Tobacco, alcohol, drug use
Depression
Obesity

Question 16

What are the major causes of morbidity and mortality in adolescence?

Answer 16

Car accidents
Homicide and suicide
Alcohol and drug use
Unintended pregnancy and STI’s
Obesity

Question 17

Should unconditional confidentiality be promised to the adolescent patient?

Answer 17

No, certain information must be reported.

• Suicidal, homicidal, physical and sexual abuse
• Behaviors involving self-harm
• Reportable STI’s

Question 18

In most states what is the age of a legal adult?

Answer 18

18

Question 19

What should be brought up at every adolescent visit?

Answer 19

HEADSS

Home
Education/employment
Activities
Drugs
Sexuality
Suicide/mental health

Question 20

How many kids have tried alcohol before age 13?

Answer 20

16%

Question 21

What is included in the physical exam of the adolscent?

Answer 21

Same order as adults, assess sexual maturity stage (Tanner stage) with chaperone present

Question 22

Who should perform the first pelvic exam?

Answer 22

An experienced provider

Question 23

When does ACOG recommend that speculum exams begin?

Answer 23

21

Question 24

What is an important element to the MSK exam in the adolescent?

Answer 24

Assess for scoliosis

Question 25

What are the routine immunizations in adolescent years?

Answer 25

Annual flu Meningococcal vaccine (2-doses) Tdap booster (11-12 years old) HPV series

Question 26

What are the universal screening should be done in adolescents?

Answer 26

Depression screening Tobacco, Alcohol, and Drug screening Hearing Vision HIV screening Lipids (once between 17-21)

Question 27

What depression screen should be done in adolescents?

Answer 27

PHQ-2

Question 28

Within the Pre-Participation Physical what is an important component?

Answer 28

Cardiovascular history

Question 29

What are some potential cardiac findings suggestive of Marfan syndrome?

Answer 29

Associated with aortic root dilation, dissection, and aneurysm

Question 30

Should ECG's be done routinely in student athletes with no cardiovascular concerns?

Answer 30

No, only recommended if there are concerns