Adolescents -Guenther

Question 1

At what average age does sexual development in a male begin? What is the first sign of puberty?

Answer 1

• 12 yo

- testicular enlargement

Question 2

What is the average age for puberty to begin in females? What is the first sign of puberty?

Answer 2

• 11 years old

- breast enlargement (thelarche)

Question 3

What percentage of boys get gynecomastia?

Answer 3

70% –> rarely due to underlying conditions

obese boys get pseudogynecomastia

Question 4

What is the most common gynecologic complaint among adolescent females?

Answer 4

-dysmenorrhea

Question 5

What life-threatening and fertility-threatening conditions have to be ruled out in an adolescent teenager with acute pelvic pain?

Answer 5

• life-threatening: exotic pregnancy, appendicitis, ruptured ovarian cyst
• fertility-threatening: PID, ovarian torsion

Question 6

What are the CRAFFT questions? What can score can indicate a serious problem?

Answer 6

• Have you ever ridden in a CAR driven by someone (including yourself) who had been using alcohol or drugs?
• Do you ever use alcohol or drugs to RELAX?
• Do you ever use alcohol or drugs while ALONE?
• Do you FORGET things you did while using?
• Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
• Have you ever gotten into TROUBLE while you were using alcohol or drugs?

-2+ indicates a serious problem

Question 7

What percentage of sexually active adolescent women will get pregnant in a 1 year period if they are sexually active and not using contraception?

Answer 7

90%

Question 8

What is the median ages for the onset of eating disorders?

Answer 8

12-13 years old

Question 9

What are the symptoms of anorexia nervosa?

Answer 9

• Extremely low body weight
• Severe food restriction
• Distorted body image and self-esteem
• Lack of menstruation among girls
• thinning of bones
• brittle hair and nails
• growth of fine hair over body
• severe constipation
• dec BP and HR
• lethargy
• electrolyte imbalances

Question 10

What are the symptoms of Bulimia Nervosa?

Answer 10

• Recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control weekly for > 3 months
• Followed by behavior that compensates for the overeating (Forced vomiting, Excessive use of laxatives or diuretics, Fasting, Excessive exercise)
• Usually maintain a healthy or normal weight
• Abnormal electrolytes
• Russell’s signs

Question 11

What are the symptoms of Bulimia Nervosa?

Answer 11

• Recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control weekly for > 3 months
• Followed by behavior that compensates for the overeating (Forced vomiting, Excessive use of laxatives or diuretics, Fasting, Excessive exercise)
• Usually maintain a healthy or normal weight
• Abnormal electrolytes
• Russell’s signs

Question 12

What medications should be avoided in eating disorders?

Answer 12

• drugs that prolong QT interval (TCAs, some neuroleptics) –> fatal arrhythmias
• drugs that are renal excreted (lithium) –> electrolyte disturbances
• Buproprion–> inc risk of seizures

Question 13

What are the symptoms of Bulimia Nervosa?

Answer 13

• Recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control weekly for > 3 months
• Followed by behavior that compensates for the overeating (Forced vomiting, Excessive use of laxatives or diuretics, Fasting, Excessive exercise)
• Usually maintain a healthy or normal weight
• Abnormal electrolytes
• Russell’s signs (on fingers)