CLPP 5

Question 1

this symptom of depression is more common in adults than teens

Answer 1

early morning waking more common in adults than depressed adolescents

Question 2

anorexia progression

Answer 2

BMI drops to postural hypotension), electrolyte imbalance (hypogly, hypo alb, hyponatremia due to high water intake, arrhythmia, circa collapse and death
-can also have low Mg and Cal that lead to increased reflex tone, neuro changes

Question 3

subtle bulemia signs

Answer 3

finger callousses, dental decay

Question 4

impact of hypothyroidism on menstrual cycle

Answer 4

short menstrual cycles + menorrhagia

Question 5

puberty ages in boys vs girls

Answer 5

10-15, 8-13

Question 6

Breast buds appear

Answer 6

10-11

Question 7

pubic hair girls

Answer 7

10-11

Question 8

growth spurt girls

Answer 8

12

Question 9

periods/menarche

Answer 9

12-13

Question 10

adult height in girls

Answer 10

15

Question 11

Growth of testicles

Answer 11

12

Question 12

Pubic hair appears in males

Answer 12

12

Question 13

penis and scrotum growth

Answer 13

13-14

Question 14

first ejacaulation

Answer 14

13-14

Question 15

male growth spurt

Answer 15

14

Question 16

Attainment of adult height

Answer 16

17

Question 17

constitutional late bloomer

Answer 17

short / late blooming in puberty but ultimately reaches normal adult height just at a later age

Question 18

generalizations of tanner staging of pubic hair

Answer 18

1 - no hair
2- thin fine straight hairs
3-curly hairs
4-adult but limited distribution
5-adult

Question 19

bleeding disorder blood tests

Answer 19

Complete blood count (CBC) with platelets, red blood cell indices, and a smear
Reticulocyte count
Prothrombin time (PT) and partial thromboplastin time (PTT)
Platelet function test (which has largely replaced the bleeding time in most centers)
Factor VIII activity
von Willebrand factor antigen
von Willebrand factor activity (also known as Ristocetin cofactor)

Question 20

most common bleeding disorder

Answer 20

vw disease

Question 21

common genetics of vw dz

Answer 21

AD w/ variable penetrance (tho type 3 = recessive)

-most common is type 1

Question 22

vw dz sx

Answer 22

Ecchymoses (small hematomas in areas of trauma)

Epistaxis
Menorrhagia (why vWD is diagnosed more often in women than men)
Bleeding post-tonsillectomy and dental extractions
Gingival bleeds


In the absence of major trauma, bruising in non-exposed areas (buttocks, back, trunk) needs to be thought of as abnormal. (Remember that child abuse can also be the cause of such bruising.

Question 23

dx of vw dz

Answer 23

A careful clinical history is often the most sensitive indicator of the disease.



The laboratory diagnosis of vWD can be challenging:

Many textbooks state that a prolonged platelet function or bleeding time and mild prolongation of the aPTT point to the diagnosis of vWD.
However, the aPTT may be normal and the patient will still have vWD.
To confirm vWD, check the von Willebrand’s factor antigen and/or platelet function analysis and factor VIII levels.

Question 24

tx vw dz

Answer 24



Treatment for most of the bleeding problems most often consists of intranasal or intravenous desmopressin.

Sometimes human plasma-derived, virally inactivated von Willibrand’s factor concentrate may be administered.

For menorrhagia, combination contraceptive pills, or levonorgestrel intrauterine device would be the treatment of choice.

Question 25

cryoprecipitate

Answer 25

blood product containing fibrinogen, factor VIII, factor XIII, and von Willebrand factor. It is most commonly used to replace fibrinogen. It may also be used in certain scenarios for patients with von Willebrand’s disease. However, it is not as good as desmopressin as a first choice

Question 26

desmopressin

Answer 26

relesaes VWF from endothelial cells

Question 27

general female puberty sequence w/ ages

Answer 27

breast buds are the first sign (10–11 years), followed by pubic hair (10–11 years), then a growth spurt (12 years), and then menarche (12–13 years). Most girls reach adult height by approximately 15 years.

Question 28

boys sequences of puberty

Answer 28

testicular enlargement, pubic hair, penis and scrotal enlargement, ejeaculations, growth spurt,