Adolescents Flashcards
What is the primary physical development occurring in adolescents?
Transition from sexual immaturity to sexual maturity
What is the first apparent sign of puberty in girls?
Breast development
What is the first apparent sign of puberty in boys?
Testicular enlargement
What is the mean age of puberty in girls?
10.5 years old (range 8-12)
What is the mean age of puberty in boys?
11.5 years old (9-13)
What is precocious puberty?
Onset of puberty 2-3 SD before the mean
Girls: breast development before age 8
Boys: testicular enlargement before age of 9
What age would be considered delayed puberty in girls?
After 12 years of age in girls
What stage of breast development does the breast bud elevate and there is enlargement of areola?
Stage 2
What stage of breast development is defined as areola and nipple form a secondary mound above the level of the breast?
Stage 4
In breast development, what is the mature stage?
Stage 5, projection of the nipple
How many stages are in pubic hair development?
5
What is a prader orchidometer?
Medical tool used to measure the volume and size of the testicle
What is measurement size of the adult testicle with a prader orchidometer?
12-25 ml
Is puberty synchronized with cognitive, social, and emotional development?
No, not necessarily synchronized
What are the health issues in adolescence?
Tobacco, alcohol, drug use
Depression
Obesity
What are the major causes of morbidity and mortality in adolescence?
Car accidents
Homicide and suicide
Alcohol and drug use
Unintended pregnancy and STI’s
Obesity
Should unconditional confidentiality be promised to the adolescent patient?
No, certain information must be reported.
- Suicidal, homicidal, physical and sexual abuse
- Behaviors involving self-harm
- Reportable STI’s
In most states what is the age of a legal adult?
18
What should be brought up at every adolescent visit?
HEADSS
Home
Education/employment
Activities
Drugs
Sexuality
Suicide/mental health
How many kids have tried alcohol before age 13?
16%
What is included in the physical exam of the adolscent?
Same order as adults, assess sexual maturity stage (Tanner stage) with chaperone present
Who should perform the first pelvic exam?
An experienced provider
When does ACOG recommend that speculum exams begin?
21
What is an important element to the MSK exam in the adolescent?
Assess for scoliosis
What are the routine immunizations in adolescent years?
Annual flu
Meningococcal vaccine (2-doses)
Tdap booster (11-12 years old)
HPV series
What are the universal screening should be done in adolescents?
Depression screening
Tobacco, Alcohol, and Drug screening
Hearing
Vision
HIV screening
Lipids (once between 17-21)
What depression screen should be done in adolescents?
PHQ-2
Within the Pre-Participation Physical what is an important component?
Cardiovascular history
What are some potential cardiac findings suggestive of Marfan syndrome?
Associated with aortic root dilation, dissection, and aneurysm
Should ECG’s be done routinely in student athletes with no cardiovascular concerns?
No, only recommended if there are concerns
