adolescents Flashcards
1
Q
what is the most common cause of morbidity in males ages 15-19
A
unintentional Injury 28.3/100000
2
Q
what is the most common cause of morbidity in females ages 15-19
A
unintentional Injury 12.4/100000
3
Q
what is the second common cause of morbidity is males ages 15-19
A
homicide 14.0/1000000
4
Q
what is the third common cause of morbidity in males ages 15-19
A
suicide 11.7/1000000
5
Q
what is the 4th common cause of morbidity in males ages 15-19
A
cancer 3.2/1000000
6
Q
what is the 5h common cause of morbidity in males ages 15-19
A
heart disease 2.1/1000000
7
Q
what is the second common cause of morbidity in females ages 15-19
A
suicide 3.1/1000000
8
Q
what is the third common cause of morbidity in females ages 15-19
A
homicide 2.3/1000000
9
Q
what is the 4th common cause of morbidity in females ages 15-19
A
cancer 2.2/1000000
10
Q
what is the 5th common cause of morbidity in females ages 15-19
A
heart disease 0.9/1000000
11
Q
What is the Number one youth risk behavior
A
Texting while driving
12
Q
all of the following are considered youth risk behavior BUT one is not which one: Tobacco alcohol marijuana texting while driving condom use more than 4 sex partners going to church
A
going to church
13
Q
Name the 3 reasons of decreased onset of females and males:
A
1) improved nutrition
2) exogenous chemicals
3) varies depending on race and family HX
14
Q
which of the following is considered to be a reason for onset decreasing in both genders:
riding bike
going to church
improved nutrition
A
improved nutrition
15
Q
which of the following is considered to be a reason for onset decreasing in both genders:
running every morning
getting an A on a test
exogenous chemicals
A
exogenous chemicals
16
Q
which of the following is considered to be a reason for onset decreasing in both genders:
coloring a book
yelling at your mom
varies depending on race and family HX
A
varies depending on race and family HX
17
Q
when does the growth spurt start in males?
A
starts ~12Yo
18
Q
when does the growth spurt peaks in males?
A
peak ~13-
19
Q
when does the growth spurt ends in males?
A
Ends ~17 yo
20
Q
at what age there is a change in voice in males?
~12-15yo
~13.3-19 yo
~10.5-18 yo
A
~10.5-18 yo
21
Q
at what age there is a testicular volume changes?
~7-9
~5.4-20
~10.5-17
A
~10.5-17
22
Q
Genitalia size which is enlargement of penis, increase in volume of testis . Tanner 2 in males occurs at what age? 11.2-23 11.5-12.5 13-16
A
11.5-12.5
23
Q
Genitalia size which is enlargement of penis, increase in volume of testis .
Tanner 3 in males occurs at what age?
A
12.5-13 yo
24
Q
Genitalia size which is enlargement of penis, increase in volume of testis . Tanner 4 in males occurs at what age? 11.2-23 11.5-12.5 13-13.5 yo
A
13-13.5
25
```
Genitalia size which is enlargement of penis, increase in volume of testis .
Tanner 5 in males occurs at what age?
11.2-23
11.5-12.5
~14
```
~14
26
Pubic Hair changes in males. Tanner 2 occurs at what age?
2-10
3-6
11-12.5
11-12.5
27
Pubic Hair changes in males. Tanner 3 occurs at what age?
9-10
11-12
12.5-13 yo
12.5-13 yo
28
Pubic Hair changes in males. Tanner 4 occurs at what age?
10-11
11-12
13-13.5
13-13.5
29
Pubic Hair changes in males. Tanner 5 occurs at what age?
11-12
13-13.8
~14
~14
30
Changes in body shape in males. occurs at what age?
13-14
10-11
~12-17
~12-17 yo
31
Growth of facial and underarm hair in males. occurs at what age?
9-10
2-3
~13-18 yo
~13-18
32
Growth Spurt in females. STARTS at what age?
~10
~14
~9.5
~9.5
33
Growth Spurt in females. PEAKS at what age?
~20-23
~9-10
~11-13.5
~11.13.5
34
Growth Spurt in females. ENDS at what age?
~10
~20
~14.5
~14.5
35
what age does menarche happens ?
10-20
9-10
10-16
10-16
36
```
Breast changes in females.
Budding happens at what age?
5-6
7-7.5
8-13
```
8-13
37
```
Breast changes in females.
TANNER 2 happens at what age?
10&11
7&8
5&6
```
10&11
38
```
Breast changes in females.
TANNER 3 happens at what age?
2&3
4&6
11&12
```
11&12
39
```
Breast changes in females.
TANNER 4 happens at what age?
9&10
3&4
12&13.5
```
12&13.5
40
```
Breast changes in females.
TANNER 5 happens at what age?
10-10.5
9-10.3
12.5-16.5
```
12.5-16.5
41
growth of underarm hair in females?
~9.5-12
~13-14
~10.5-16.5
~10.5-16.5
42
Change in body shape in females?
~9-10
~2-3
~11-15.5
~11-15.5
43
Pubic hair changes in females.Growth STARTS?
~2
~3
~8
~8
44
Pubic hair changes in females.Growth ENDS?
~20
~30
~14
~14
45
Pubic hair changes in females. TANNER 2 happens at what age?
10&21
10.5&23
11&11.5
11&11.5
46
Pubic hair changes in females. TANNER 3 happens at what age?
10.5&20
5&6
11.5&12
11.5&12
47
Pubic hair changes in females. TANNER 4 happens at what age?
10&23
9&10
12&13
12&13
48
Pubic hair changes in females. TANNER 5 happens at what age?
9
10
3
13
49
Describe TANNER 1 -PREPUBESCENT in males
Precocious puberty= before 9y more ominous in boys-shaken baby, intracranial hemorrhage , trauma
50
Describe TANNER 2 in males
enlargement of scrotum and testes , fine and straight pubic hair chiefly at the base of the penis
51
Describe TANNER 3 in males
elongation of penis , darker , coarser, curlier hair spreading sparsely over the pubis symphysis
52
Describe TANNER 4 in males
increase the breadth of penis and darkening of scrotal skin, development of the glans, coarser and thicker pubic hair covering more area then stage 3
53
Describe TANNER 5 in males
adult genitalia
54
Describe TANNER 1-PREPUBESCENT in females
Precocious puberty=before age 8y
55
Describe TANNER 2 in females
breast buds, fine and straight pubic hair
56
Describe TANNER 3 in females
enlargement of breast, including areola, more fine and straight pubic hair
57
Describe TANNER 4 in females
enlargement of breast, coarser and thicker pubic hair (inverted triangle)
58
Describe TANNER 5 in females
adult genitalia
59
name the 5 Normal pubertal variants
```
breast asymmetry
male gynecomastia
physiologic leukorrhea
irregular menses
primary dysmenorrhea
```
60
Male gynecomastia is a
normal pubertal variant
61
male gynecomastia occurs in what
40-65 percent of population
62
what are the 3 characteristics of physiologic leukorrhea
normal
perienarchal
clear discharge
63
irregular menses is a what
normal pubertal variant
64
2 characteristic of irregular menses
normal
| may last several years
65
Primary dysmenorrhea is a what
normal pubertal variant
66
2 characteristics of primary dysmenorrhea:
normal
| with increasing ovulation
67
Describe 3 things to help with patient-provider relationship
1) greater portion of the history will be gathered from the adolescent
2) increasing portion of visit without a parent in the room
3) confidentiality- introduce the concept and reassure your patient
68
name the 4 health services that may be provided to the minor without parental consent
1) birth control services at any age
2)mental health , substance abuse more than 13 yo
3) STI screening /treatment older than 14 yo
4) emancipated minor : medically (childbirth)
legally( financially)
Married
military
69
can you in the state of WA provide Birth control services at any age?
Yes
70
can you in the state of WA provide Mental health, substance abuse care for older than 13 yo?
yes
71
can you int the state of WA provide STI screening /treatment for older than 14 yo?
Yes
72
Provide health care services for emancipated minor: medially ( childbirth)
yes
73
Provide health care services for emancipated minor: Legally( financially)
yes
74
Provide health care services for emancipated minor: Married
yes
75
Provide health care services for emancipated minor: Military
yes
76
what does HEADSS assessment stand for
```
Home
Education
Activities
Drugs
Sexually
Suicide
```
77
HEADSS
| H:ome assessment questions
House hold members, neighbors. adults , children , stability of home.
adolescent-parent dynamic
support, guidance, communication, decision making
time together
privacy
and type of friends
78
adolescent-parent dynamic would be a question to ask in what part of the HEADSS assessment
Home
79
House hold members, neighbors. adults , children , stability of home.
would be a question to ask in what part of the HEADSS assessment
Home
80
type of friends.
| would be a question to ask in what part of the HEADSS assessment
Home
81
support, guidance, communication, decision making
time together
privacy.
would be a question to ask in what part of the HEADSS assessment
Home
82
HEADSS
| E: Education/ Employment questions
```
1) grades
performance , homework
behavior
2) learning disabilities
3)Hours and type of work
4)goals for the future
```
83
grades
performance , homework
behavior. would a question for what part of the HEADSS assessment
Education/employment
84
learning disabilities.
| would a question for what part of the HEADSS assessment
Education/employment
85
Hours and type of work.
| would a question for what part of the HEADSS assessment
Education/employment
86
goals for the future .
| would a question for what part of the HEADSS assessment
Education/employment
87
HEADSS
| A:ctivities assessment questions
1) physical activity/sports
2) clubs , church, community service
3) screen time, reading
4) interests/hobbies/music
88
physical activity/sports.
| would a question for what part of the HEADSS assessment
Activities
89
clubs , church, community service.
| would a question for what part of the HEADSS
Activities
90
screen time, reading.
| would a question for what part of the HEADSS
Activities
91
Interests/hobbies/music.
| would a question for what part of the HEADSS
Activities
92
HEADSS
| D:rugs , drinking questions
1) Drugs/alcohol/tobacco use
2) friends using
3) family use
4) craft: substance abuse screening tool
93
Drugs/alcohol/tobacco use.
| would a question for what part of the HEADSS
D:rugs , drinking questions
94
```
friends using (drugs).
would a question for what part of the HEADSS
```
D:rugs , drinking questions
95
```
family use (drugs).
would a question for what part of the HEADSS
```
D:rugs , drinking questions
96
craft: substance abuse screening tool.
| would a question for what part of the HEADSS
D:rugs , drinking questions
97
HEADSS
| S:exuality questions
1) sexual development /identity/activity
2) dating/partner
3) contraception/safe sex
4) Sexually transmitted infections/pregancy
5) abuse/rape
98
sexual development /identity/activity.
| would be a question to ask in what part of the HEADSS assessment
Sexuality
99
dating/partner.
| would be a question to ask in what part of the HEADSS assessment
Sexuality
100
contraception/safe sex.
| would be a question to ask in what part of the HEADSS assessment
Sexuality
101
Sexually transmitted infections/pregnancy.
| would be a question to ask in what part of the HEADSS assessment
Sexuality
102
abuse/rape.
| would be a question to ask in what part of the HEADSS assessment
Sexuality
103
HEADSS
| S:uicide Questions
1) mood swings
2) self-image
3) DEPRESSION-screen yearly (12 yo older) with a standardized tool
104
mood swings
| would be a question to ask in what part of the HEADSS assessment
Suicide
105
self-image
| would be a question to ask in what part of the HEADSS assessment
Suicide
106
DEPRESSION-screen yearly (12 yo older) with a standardized tool.
would be a question to ask in what part of the HEADSS assessment
Suicide
107
How often you do depression screening?
yearly
108
what age you do depression screening?
12 yo older
109
what are the 5 screenings you do for adolescents
1) depression
2) anemia
3) dyslipidemia
4) sexually transmitted infections
5) Hearing
110
anemia screening definition:
hematocrit ( % of RBC in blood by volume)
| make sure to order a CBC at least once after menarche to assess for iron deficiency anemia
111
what test you do to screen for dyslipidemia?
Universal lipid panel @ 9-11 and 18-21
112
test for HIV at what age ?
15- 18 yo
113
when do you do universal audiometry to test for hearing ?
1) 11-14
2) 15-17
3) 18-21
114
what are the 6 anticipatory guidance we must give to patients
1) motor vehicle safety
2) violence prevention
3) nutrition
4) drugs (substance abuse)
5) sexually
6) suicide/depression
115
ROS for physical sports physical
1) vision
2) cardiac
3) respiratory
4) nuerologic
5) musculoskeletal
116
Medical conditions that warrant further evaluation. doing sports physical
1) epilepsy
2) down syndrome
3) type 1 DM
4) Temperature conditions
117
SPORTS PHYSICAL
| Vision
get eye correction if the vision is worse than 20/40
118
SPORTS PHYSICAL
| Cardiac 3 things:
1) HX
2) fam HX
3) Physical exam
119
SPORTS PHYSICAL
| Cardiac HX: questions
1) chest pain/ disconfort on exertion
2) unexplained syncope/ near-syncope associate w/exertion
3) excessive dyspnea/fatigue during exertion
4) Hx of heart murmur
5) elevated BP
120
SPORTS PHYSICAL
| Cardiac Fam HX: questions
1) sudden cardiac death before age 50 in greater than one relative
2) close relative w/cardiac disability before age 50
3) cardiomyophathy/arrythmia, long QT syndrome/other ion channel-opathies
4) marfan syndrome
121
SPORTS PHYSICAL
| Cardiac Physical exam:
1) marfan syndrome
2) HTN
3) murmur that is unlikely bening
4) delayed femoral pulses
122
SPORTS PHYSICAL
| Respiratory 2 things :
1) HX
| 2) Physical exam
123
SPORTS PHYSICAL
| Respiratory HX: questions
1) exercise- induced bronchospasm-may need multiple inhalers
2) astha or EIB not controlled with bronchodilator
3) vocal cord dysfuntion
124
SPORTS PHYSICAL
| Respiratory Physical Exam
1) ausculate for wheezing
| 2) palpate for enlarged spleen
125
SPORTS PHYSICAL
| Neurologic HX questions:
1) concusion or head injury
eval frequency, duration of symptoms, type of trauma
should get baseline eval to comprare to should athlete sustain another concussion
2) braxial plexus, cervical nerve root injury
3) cervical spine stenoiss can lead to transsient quadriplegia from forced hypertension, hyperflexion or compression
126
cervical spine stenoiss can lead to transsient quadriplegia from forced hypertension, hyperflexion or compression.
should be a questiona asked in what part of the sports physical?
Neurologic HX
127
braxial plexus, cervical nerve root injury.
| should be a questiona asked in what part of the sports physical?
Neurologic HX
128
concusion or head injury
eval frequency, duration of symptoms, type of trauma
should get baseline eval to comprare to should athlete sustain another concussion.
should be a questiona asked in what part of the sports physical?
Neurologic HX
129
SPORTS PHYSICAL
| Muscoloskeletal 2 things must one do
1) HX
| 2) physical exam
130
SPORTS PHYSICAL
| Musculoskeletal HX questions:
1) current injuries
| 2) past injuries that needed eval, brancing, casting, surgery or resulted in lost of practice
131
SPORTS PHYSICAL
| Musculoskeletal Physical exam:
1) obeserve standing feet together
2) neck ROM
2) shoulder ROM
3) elbow ROM
4) Wrist ROM
5) Finger ROM
6) duck walk
7) behind foward to eval for scoli
132
if a patient has epilepsy what must happen for the pt to plays sports
epilepsy must be controlled for 3-6 months prior to participation
133
if a patient has Down syndrome can they play contact sports
no contact sports
134
if a patient has type 1 DM what must happen
further evaluation prior to play sports
135
is pt has febrile illness can they play sports
needs further evaluation prior to play sports
136
is pt has acute injury can they play sports
needs further evaluation prior to play sports
137
is pt has contagious infections such as impetigo can they play sports
needs further evaluation prior to play sports
