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CPS adolescent Flashcards

1
Q

obesity complications

A

depression, low esteem
bullying
major anxiety, depressiove
eating disorders

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2
Q

protective obestity

A 
adequate sleep
regular family meals
siblings
parental limits 
supervision
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3
Q

sleep screen

A 
BEARS
B = bedtime issues
E = excessive somnolence
A = awakenings
R -= regularity
S = snoring/OSA
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4
Q

sleep recommendations

A

sleep hygiene (no caffeine, bedroom, regular schedule avoid hunger/eating prior to sleep
alcohol, nicotine
avoid TV< screen time
encourage reading prior

melatonin - short term use for > 2 year old
only after trial of sleep hygiene intervention. lack of long term studies

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5
Q

two most common sleep problems

A
  1. delayed sleep phase type
    - initiation of sleep significantly later than desired bedtime (ie sleep latency > 30mins)
  2. behavioural insomnia of childhood
    - sleep onset association type (specific conditions)
    - limit setting type (stalls, refuses to go)
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6
Q

top 3 leading causes of injury-related deaths

A

MCV
drowning
threats to breathing

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7
Q

principles of injury prevention

A

Education
enforcement/legislation
engineering

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8
Q

indications for genital exam

A

routine periodic exam
endocrine concerns
sexual assault
request by parents

advise when touch. neve ruse force.

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9
Q

suicide risk factors

A 
previous attempt
substance use
impulsitivity
precipitating factors
family factors
lack of social support
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10
Q

Suicidal intent assessment

A 
Columbia suicide severity scale
- ideation - frequency, intent, quality
- passive/active
intent
plan
attempt itself - impulsive/planned, lethality, anticipated outcome
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11
Q

nutrition for athletes

A

CHO (1g=4kcal) 50% calories for 4-18year old
protein( 1g = 4kcal) 25% calories
fats - needed for VIt ADEK, essential fatty acids, protect organs. 1g=9kcal (< 10%)

micronutrients
Ca (1000mg/day) , vitamin D (600IU), iron

fluids
500mL prior to exercise
consume 200mL q20mins
if > 60min event, consider sport drink

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12
Q

dieting recommendations

A

healthy and overweight - canadian food guide
if overweight - refer multidD
screen diet part of HEADS
screen mental health/eating
promote active living
risk of emesis, laxative, diuretics, diet pills, etc.

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13
Q

emergency contraception C/I

A

known pregnancy

anaphylaxis

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14
Q

Emergency contraception options

A 
Plan B (99%) - ideally < 72hrs, up to 5 days
Yupze regime (97%) ideally < 72hrs, up to 5 days
copper IUD - 120hrs up to 7 days

s/e GI upset, fatigue, headache, dizziness.

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15
Q

tanning facilities

A

UV radiation - dmange DNA and induce mutations
can be carcinogenic without causing sun burn
WHO - class 1 of physical carcinogens

cutaneous malignant melanoma - accounts for 75% deaths although not most common
others: basal cell carcinoma, squamous cell caricnomas

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16
Q

risk factors for cutaneous malignant melanoma

A 
light skin color, freckles, moles, 
personal history
1st degree family history
large number of nevi
red or blonde hair
immuno suppression
17
Q

smoking dangers

A

cancer - lung bladder colorectal, esophgea, kidney, larynx, mouth, throat
resp infections
diabetes
coronary artery disease
hair loss, skin wrinkling, risk of erectile dysfunction

18
Q

smoking prevention

A 
counseling
guidance for families
school based programs
Government - Tobacco act 2008. restrict sales
smoke free places, high tax etc.
19
Q

smoking on specific diseases

A

asthma & CF - inc severity and freq of attacks, CF dec lung function
JIA - greater disease severity, CV disease, exacerbate osteopenia
cancer - resp infections, exacerbated mucositis
SSD - riskof ACS and stroke
DM - accelerated comorbidities. increases M&M in type 1 by 50%

20
Q

Risk factors smoking initiation

A 
low SES
peer and family influence
misinformation to smoking
easy acess
previous experimentation
poor school performance
depression and mental health
substance abuse
family member with substance abuse
parental divorce
21
Q

factors helping success of teems to quit smoking

A 
older teenager
male
teen pregnancy &amp; parenthood
scholastic success
peer and family support
CYP2A6 slow nicotine metabolizer
22
Q

smoking cessation approach

A

individual counselling
motivational interview
CBT
contigency management - alternatives, adaptive

5 A's
ask
advise
assess
- 30 days - preparation
- next 6 months - contemplative
- beyond 6 mo -precontemplative
assist
arrange
23
Q

smoking cessation pharmacology

A

Nicotine replacement for reg use age 12 - 18
nicotine gums, transdermal patches common
(inhaler not recommended)
s/e mouth & skin irritability, inc HR, BP

Bupriopion
C/I seizures, eating disorders
- reduces seizure threshold, causes weight loss

Varenicline
s/e neuropsychiatric and cardivasculr
C/I unstable psych (SI, agression, depression) and active Coronary artery disease

e cigarettes - NOT recommended

24
Q

e-cigarettes controversies

A

battery attached to chamber containing liquid that may or may not have nicotine
variable concentrations
1. product perception - still a nicotine delivery device. Not harmless. Unproven as smokign cessation/harm reduction

  1. emissions/exposure - concentration variable. potential for large boluses with acute cardiac affects. risk battery explosion
  2. public uptake - expanding industry
  3. aggressive marking, weak regulation
    5 accessible to youth, celebrity indorsement
25
Q

LGQT risks

A

higher use of tobacco, alcohol, substance use
club drugs
suicide intent
higher risk STI - more likely to have had sex, more partners, non-consensual

Rx
test gonorrhea, chlamydia, VDR, O&P, HIV testing, etc
contraceptive options +EC
HPV vcacinations

26
Q

adolescent pregnancy

A 
50% end in induced abortion 
if < 17, more likely unplanned
urine bhcg as early as 10-14 after ovulation 
options
- continue pregnancy and keep
- adoption
- medial abortion (t1) MTX and misopristol
- surgical - early T1 to T2
27
Q

teenage pregnancy management

A

prenatal care ASAP
refer to resources - maternal homes, drop in centers, etc
encourage continued education.
contraceptive counseling (35% 2nd bay within 2 years)

medical abortion - bleed, fever, cramps, abnormal d/c, psych

28
Q

adolescent parents implications

A

higher rates of mental health, repeat pregnancy, substance, DV
lower SES, education attainment
higher risk substance abuse, smoking, STI
lower prenatal care
risk of depression, PTSD, stress disorder, anxiety

babies
LBW, prematurity
developmental
accidenta injury and neglect
as adolescent - substance, early sexual activity
29
Q

adolescent mother’s basic health needs

A 
growth and development - Greig health records, BMI
immunization
food security
lactation
psychosocial assessment
sexual health, contraception
STI screening
30
Q

sexual abuse - risk factors

A

dependency - lack of control
education - lack of sexual education
disability specific - ie communicaton impairment, cognitive impairment to give consent

31
Q

sexual abuse prevention in chronic disease

A

institution - screen/monitor employees
chaperones of physical exams
promote patient privacy
proedures to report

32
Q

sexting

A

describe send and reciving sexually explicit messages, or ndue/seminude photograms electronically
40% teens

management - parental awareness
reinforce discussions online NOT private
HCP advocate as public health issue & screen

33
Q

inhalant abuse

A

volatile substance abuse, solvent abuse, huffing, to achieve altered state

gasoline > air fresheners> propane/butane

34
Q

effects inhalant abuse

A

sniffing/snorting - direct inhalation
stimulation then disinhibition, the euphoria,
hallucination
slurred speech, disturbed gait
resp arrest, aspiration
leading cause of death –> cardiac arrhythmias
risky behaviours

35
Q

substance abuse screen

A

2 or more is potential substance abuse problem

C - car driven by someone intoxicated
R - relax - drugs to relax or feel better
A - alone - use alone
F - forget - forget things while intoxicated
F - family or friends tell you to cut back
T - trouble

36
Q

medical cannibis

A

may be benefician for refractory eplipepsy, but need to be evaluated long term

smoking often mode of delievery and inappropriate in children
combustion - also by products and tar carcinogenic effects
case- by case only
at risk for dependence & withdrawal (headaches, sleep disturbance, irritabilty, anxiety)

37
Q

gambling

A

activity that implies element of risk and money or something valuable could be won/lost by participants

higher rates in adolescent than adults worldwide

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