Complications of adolescence Flashcards
What is PCOS?
Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.
What are common features of PCOS?
Raised testosterone levels (increase in bone and muscle strength)
Raised LH levels (increased facial hair anad breast tissue)
Increased insulin resistance (present in up to 70% of cases)
What are the symptoms of PCOS?
-Missed periods, irregular periods, or very light periods
-Ovaries that are large or have many cysts
-Excess body hair, including the chest, stomach, and back (hirsutism)
-Weight gain, especially around the belly (abdomen)
-Acne or oily skin
-Male-pattern baldness or thinning hair
-Infertility
-Small pieces of excess skin on the neck or armpits (skin tags)
-Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts
What are patients with PCOS at an increased risk of?
Obesity
Diabetes
Ruptured cysts
Cardiovascular diseas and hypertension later in life
What is CDGP?
Constitutional Delay of Growth in Puberty i.e. delayed puberty
What can cause CDGP?
50-70% of cases are hereditary (and usually self resolving)
Can also be caused by:
Chronic illness (CKD, Crohn’s)
Malnutrition
Excessive exercise
CNS abnormalities
Is CDGP more common in males or females?
Males
What is precocious puberty?
Early puberty, before age 8 in females or age 9 in males
Who is more likely to develop precocious puberty, males or females?
Females are 5x more likely
What proportion of cases of precocious puberty are idiopathic?
80% in females, 40% in males
What can cause precocious puberty?
Usually CNS abnormalities
More serious causes include tumors and trauma (but much less common)
What is gynecomastia?
An increase in the amount of breast gland tissue in boys or men caused by an imbalance of the hormones estrogen and testosterone. In adolescence is usually self limiting and resolves after 1-2 years.
What is Klinefelter’s syndrome?
A colection of symptoms caused by an extra X chromosome in men and boys.
What are the symptoms of Klinefeter’s syndrome?
Female pattern fat and muscle distribution
Longer than normal legs and arms
Small testes/penis
Gynecomastia
Osteoporosis
Signs and symptoms of Klinefelter syndrome vary widely among males with the disorder. Many boys with Klinefelter syndrome show few or only mild signs. The condition may go undiagnosed until adulthood or it may never be diagnosed. For others, the condition has a noticeable effect on growth or appearance.
What can cause gynecomastia?
Hormonal changes
Klinefelter’s syndrome
Malnourishment
Obesity
Tumors
Synthetic androgens
What is metabolic syndrome?
A cluster of cardiovascular risk factors:
Hypertension
Altered glucose metabolism
Dyslipidaemia
Abdominal obesity
How does obesity cause T2DM?
Obesity, particularly when associated with increased abdominal and intra-abdominal fat distribution and increased intrahepatic and intramuscular triglyceride content, is a major risk factor for prediabetes and type 2 diabetes because it causes both insulin resistance and β-cell dysfunction.
Why might some adolescents develop SoB and exercise intolerance?
The muscles and bones can grow in size before the heart and the lungs
What is hypertrophic cardiomyopathy?
A thickening of the heart wall(s) - usually hereditary
What complications can occur from hypertrophic cardiomyopathy?
Arrythmias
Syncope
Heart failure
Cardiac arrest
What are the symptoms of hypertrophic cardiomyopathy?
Exercise induced SoB and chest pain
Fits, faints, funny turns (3F’s)
Palpitations
Which spinal abnormality can compromise lung expansion and vetilation?
Kyphosis
What is the difference between scoliosis, kyphosis amd lordosis?
Scoliosis:
-Lateral curvature
-Thoracic, Lumbar or combined
-Structural/primary (idiopathic, congenital) or
functional/secondary (trauma, muscular dystrophy, CP, spinal tumours)
Kyphosis:
-Usually postural in adolescence
-Lung expansion and ventilation are affected
Lordosis
-Also postural
-Can be caused by obesity, changed centre of gravity
What is osteomyelitis?
An infection of bone tissue occuring after minor trauma or soft tissue injury
Why can children and adolescents be prone to osteomyelitis?
Their growing bones have hight blood supplies making it easy for infection to get in. Infection most commonly occurs at the growth plates as they are the last portions to develop and remain ‘soft’.
How does osteomyelitis progress causing sequestrum, new bone formation, local and systemic infection?
-Initial infection caused by a variety of mechanisms. (e.g. bacteria from nearby infected tissue or an open wound, sometimes fungus or other germ)
-Purulent exudate builds up causing pressure on bone and damage to periosteum.
-Blood supply is interupted causing sequestrum (a piece of necrotic bone)
-Ossification occurs around the injured site which can cause soft tissue injury.
-Local inflammation occurs which can become systemic if untreated.
What is an EDNOS?
Eating Disorder No Origin Specified
What causes eating disorders?
Primarily psycological but this is under investigation, it is now thought hormonal changes and brain function can contribute.
What is NSSI?
Non Suicidal Self Injury
