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adolescents Flashcards

1
Q

what is the most common cause of morbidity in males ages 15-19

A

unintentional Injury 28.3/100000

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2
Q

what is the most common cause of morbidity in females ages 15-19

A

unintentional Injury 12.4/100000

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3
Q

what is the second common cause of morbidity is males ages 15-19

A

homicide 14.0/1000000

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4
Q

what is the third common cause of morbidity in males ages 15-19

A

suicide 11.7/1000000

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5
Q

what is the 4th common cause of morbidity in males ages 15-19

A

cancer 3.2/1000000

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6
Q

what is the 5h common cause of morbidity in males ages 15-19

A

heart disease 2.1/1000000

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7
Q

what is the second common cause of morbidity in females ages 15-19

A

suicide 3.1/1000000

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8
Q

what is the third common cause of morbidity in females ages 15-19

A

homicide 2.3/1000000

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9
Q

what is the 4th common cause of morbidity in females ages 15-19

A

cancer 2.2/1000000

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10
Q

what is the 5th common cause of morbidity in females ages 15-19

A

heart disease 0.9/1000000

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11
Q

What is the Number one youth risk behavior

A

Texting while driving

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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

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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

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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

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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

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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

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17
Q

when does the growth spurt start in males?

A

starts ~12Yo

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18
Q

when does the growth spurt peaks in males?

A

peak ~13-

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19
Q

when does the growth spurt ends in males?

A

Ends ~17 yo

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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

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21
Q

at what age there is a testicular volume changes?
~7-9
~5.4-20
~10.5-17

A

~10.5-17

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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

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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

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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

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25
Q 
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
A

~14

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26
Q

Pubic Hair changes in males. Tanner 2 occurs at what age?
2-10
3-6
11-12.5

A

11-12.5

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27
Q

Pubic Hair changes in males. Tanner 3 occurs at what age?
9-10
11-12
12.5-13 yo

A

12.5-13 yo

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28
Q

Pubic Hair changes in males. Tanner 4 occurs at what age?
10-11
11-12
13-13.5

A

13-13.5

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29
Q

Pubic Hair changes in males. Tanner 5 occurs at what age?
11-12
13-13.8
~14

A

~14

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30
Q

Changes in body shape in males. occurs at what age?
13-14
10-11
~12-17

A

~12-17 yo

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31
Q

Growth of facial and underarm hair in males. occurs at what age?
9-10
2-3
~13-18 yo

A

~13-18

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32
Q

Growth Spurt in females. STARTS at what age?
~10
~14
~9.5

A

~9.5

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33
Q

Growth Spurt in females. PEAKS at what age?
~20-23
~9-10
~11-13.5

A

~11.13.5

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34
Q

Growth Spurt in females. ENDS at what age?
~10
~20
~14.5

A

~14.5

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35
Q

what age does menarche happens ?
10-20
9-10
10-16

A

10-16

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36
Q 
Breast changes in females.
Budding happens at what age?
5-6
7-7.5
8-13
A

8-13

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37
Q 
Breast changes in females.
TANNER 2 happens at what age?
10&11
7&8
5&6
A

10&11

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38
Q 
Breast changes in females.
TANNER 3 happens at what age?
2&3
4&6
11&12
A

11&12

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39
Q 
Breast changes in females.
TANNER 4 happens at what age?
9&10
3&4
12&13.5
A

12&13.5

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40
Q 
Breast changes in females.
TANNER 5 happens at what age?
10-10.5
9-10.3
12.5-16.5
A

12.5-16.5

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41
Q

growth of underarm hair in females?
~9.5-12
~13-14
~10.5-16.5

A

~10.5-16.5

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42
Q

Change in body shape in females?
~9-10
~2-3
~11-15.5

A

~11-15.5

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43
Q

Pubic hair changes in females.Growth STARTS?
~2
~3
~8

A

~8

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44
Q

Pubic hair changes in females.Growth ENDS?
~20
~30
~14

A

~14

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45
Q

Pubic hair changes in females. TANNER 2 happens at what age?
10&21
10.5&23
11&11.5

A

11&11.5

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46
Q

Pubic hair changes in females. TANNER 3 happens at what age?
10.5&20
5&6
11.5&12

A

11.5&12

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47
Q

Pubic hair changes in females. TANNER 4 happens at what age?
10&23
9&10
12&13

A

12&13

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48
Q

Pubic hair changes in females. TANNER 5 happens at what age?
9
10
3

A

13

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49
Q

Describe TANNER 1 -PREPUBESCENT in males

A

Precocious puberty= before 9y more ominous in boys-shaken baby, intracranial hemorrhage , trauma

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50
Q

Describe TANNER 2 in males

A

enlargement of scrotum and testes , fine and straight pubic hair chiefly at the base of the penis

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51
Q

Describe TANNER 3 in males

A

elongation of penis , darker , coarser, curlier hair spreading sparsely over the pubis symphysis

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52
Q

Describe TANNER 4 in males

A

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

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53
Q

Describe TANNER 5 in males

A

adult genitalia

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54
Q

Describe TANNER 1-PREPUBESCENT in females

A

Precocious puberty=before age 8y

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55
Q

Describe TANNER 2 in females

A

breast buds, fine and straight pubic hair

56
Q

Describe TANNER 3 in females

A

enlargement of breast, including areola, more fine and straight pubic hair

57
Q

Describe TANNER 4 in females

A

enlargement of breast, coarser and thicker pubic hair (inverted triangle)

58
Q

Describe TANNER 5 in females

A

adult genitalia

59
Q

name the 5 Normal pubertal variants

A 
breast asymmetry
male gynecomastia
physiologic leukorrhea
irregular menses
primary dysmenorrhea
60
Q

Male gynecomastia is a

A

normal pubertal variant

61
Q

male gynecomastia occurs in what

A

40-65 percent of population

62
Q

what are the 3 characteristics of physiologic leukorrhea

A

normal
perienarchal
clear discharge

63
Q

irregular menses is a what

A

normal pubertal variant

64
Q

2 characteristic of irregular menses

A

normal

may last several years

65
Q

Primary dysmenorrhea is a what

A

normal pubertal variant

66
Q

2 characteristics of primary dysmenorrhea:

A

normal

with increasing ovulation

67
Q

Describe 3 things to help with patient-provider relationship

A

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
Q

name the 4 health services that may be provided to the minor without parental consent

A

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
Q

can you in the state of WA provide Birth control services at any age?

70
Q

can you in the state of WA provide Mental health, substance abuse care for older than 13 yo?

71
Q

can you int the state of WA provide STI screening /treatment for older than 14 yo?

72
Q

Provide health care services for emancipated minor: medially ( childbirth)

73
Q

Provide health care services for emancipated minor: Legally( financially)

74
Q

Provide health care services for emancipated minor: Married

75
Q

Provide health care services for emancipated minor: Military

76
Q

what does HEADSS assessment stand for

A 
Home
Education
Activities
Drugs
Sexually
Suicide
77
Q

HEADSS

H:ome assessment questions

A

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
Q

adolescent-parent dynamic would be a question to ask in what part of the HEADSS assessment

79
Q

House hold members, neighbors. adults , children , stability of home.
would be a question to ask in what part of the HEADSS assessment

80
Q

type of friends.

would be a question to ask in what part of the HEADSS assessment

81
Q

support, guidance, communication, decision making
time together
privacy.
would be a question to ask in what part of the HEADSS assessment

82
Q

HEADSS

E: Education/ Employment questions

A 
1) grades
performance , homework
behavior
2) learning disabilities
3)Hours and type of work
4)goals for the future
83
Q

grades
performance , homework
behavior. would a question for what part of the HEADSS assessment

A

Education/employment

84
Q

learning disabilities.

would a question for what part of the HEADSS assessment

A

Education/employment

85
Q

Hours and type of work.

would a question for what part of the HEADSS assessment

A

Education/employment

86
Q

goals for the future .

would a question for what part of the HEADSS assessment

A

Education/employment

87
Q

HEADSS

A:ctivities assessment questions

A

1) physical activity/sports
2) clubs , church, community service
3) screen time, reading
4) interests/hobbies/music

88
Q

physical activity/sports.

would a question for what part of the HEADSS assessment

A

Activities

89
Q

clubs , church, community service.

would a question for what part of the HEADSS

A

Activities

90
Q

screen time, reading.

would a question for what part of the HEADSS

A

Activities

91
Q

Interests/hobbies/music.

would a question for what part of the HEADSS

A

Activities

92
Q

HEADSS

D:rugs , drinking questions

A

1) Drugs/alcohol/tobacco use
2) friends using
3) family use
4) craft: substance abuse screening tool

93
Q

Drugs/alcohol/tobacco use.

would a question for what part of the HEADSS

A

D:rugs , drinking questions

94
Q 
friends using (drugs).
would a question for what part of the HEADSS
A

D:rugs , drinking questions

95
Q 
family use (drugs).
would a question for what part of the HEADSS
A

D:rugs , drinking questions

96
Q

craft: substance abuse screening tool.

would a question for what part of the HEADSS

A

D:rugs , drinking questions

97
Q

HEADSS

S:exuality questions

A

1) sexual development /identity/activity
2) dating/partner
3) contraception/safe sex
4) Sexually transmitted infections/pregancy
5) abuse/rape

98
Q

sexual development /identity/activity.

would be a question to ask in what part of the HEADSS assessment

99
Q

dating/partner.

would be a question to ask in what part of the HEADSS assessment

100
Q

contraception/safe sex.

would be a question to ask in what part of the HEADSS assessment

101
Q

Sexually transmitted infections/pregnancy.

would be a question to ask in what part of the HEADSS assessment

102
Q

abuse/rape.

would be a question to ask in what part of the HEADSS assessment

103
Q

HEADSS

S:uicide Questions

A

1) mood swings
2) self-image
3) DEPRESSION-screen yearly (12 yo older) with a standardized tool

104
Q

mood swings

would be a question to ask in what part of the HEADSS assessment

105
Q

self-image

would be a question to ask in what part of the HEADSS assessment

106
Q

DEPRESSION-screen yearly (12 yo older) with a standardized tool.
would be a question to ask in what part of the HEADSS assessment

107
Q

How often you do depression screening?

108
Q

what age you do depression screening?

A

12 yo older

109
Q

what are the 5 screenings you do for adolescents

A

1) depression
2) anemia
3) dyslipidemia
4) sexually transmitted infections
5) Hearing

110
Q

anemia screening definition:

A

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
Q

what test you do to screen for dyslipidemia?

A

Universal lipid panel @ 9-11 and 18-21

112
Q

test for HIV at what age ?

113
Q

when do you do universal audiometry to test for hearing ?

A

1) 11-14
2) 15-17
3) 18-21

114
Q

what are the 6 anticipatory guidance we must give to patients

A

1) motor vehicle safety
2) violence prevention
3) nutrition
4) drugs (substance abuse)
5) sexually
6) suicide/depression

115
Q

ROS for physical sports physical

A

1) vision
2) cardiac
3) respiratory
4) nuerologic
5) musculoskeletal

116
Q

Medical conditions that warrant further evaluation. doing sports physical

A

1) epilepsy
2) down syndrome
3) type 1 DM
4) Temperature conditions

117
Q

SPORTS PHYSICAL

Vision

A

get eye correction if the vision is worse than 20/40

118
Q

SPORTS PHYSICAL

Cardiac 3 things:

A

1) HX
2) fam HX
3) Physical exam

119
Q

SPORTS PHYSICAL

Cardiac HX: questions

A

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
Q

SPORTS PHYSICAL

Cardiac Fam HX: questions

A

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
Q

SPORTS PHYSICAL

Cardiac Physical exam:

A

1) marfan syndrome
2) HTN
3) murmur that is unlikely bening
4) delayed femoral pulses

122
Q

SPORTS PHYSICAL

Respiratory 2 things :

A

1) HX

2) Physical exam

123
Q

SPORTS PHYSICAL

Respiratory HX: questions

A

1) exercise- induced bronchospasm-may need multiple inhalers
2) astha or EIB not controlled with bronchodilator
3) vocal cord dysfuntion

124
Q

SPORTS PHYSICAL

Respiratory Physical Exam

A

1) ausculate for wheezing

2) palpate for enlarged spleen

125
Q

SPORTS PHYSICAL

Neurologic HX questions:

A

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
Q

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?

A

Neurologic HX

127
Q

braxial plexus, cervical nerve root injury.

should be a questiona asked in what part of the sports physical?

A

Neurologic HX

128
Q

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?

A

Neurologic HX

129
Q

SPORTS PHYSICAL

Muscoloskeletal 2 things must one do

A

1) HX

2) physical exam

130
Q

SPORTS PHYSICAL

Musculoskeletal HX questions:

A

1) current injuries

2) past injuries that needed eval, brancing, casting, surgery or resulted in lost of practice

131
Q

SPORTS PHYSICAL

Musculoskeletal Physical exam:

A

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
Q

if a patient has epilepsy what must happen for the pt to plays sports

A

epilepsy must be controlled for 3-6 months prior to participation

133
Q

if a patient has Down syndrome can they play contact sports

A

no contact sports

134
Q

if a patient has type 1 DM what must happen

A

further evaluation prior to play sports

135
Q

is pt has febrile illness can they play sports

A

needs further evaluation prior to play sports

136
Q

is pt has acute injury can they play sports

A

needs further evaluation prior to play sports

137
Q

is pt has contagious infections such as impetigo can they play sports

A

needs further evaluation prior to play sports

Adolescent (2 decks)

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