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Peds I > Exam 3 - Adolescents > Flashcards

Exam 3 - Adolescents Flashcards

1
Q

What age range is defined by adolescents?

A

11-21

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2
Q

What classification is use to determine stage of sexual maturity and secondary sexual characteristics?

A

Tanner staging

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3
Q

During examination you appreciate no palpable breast tissue and no pubic hair. What tanner stage is the patient in?

A

Stage 1

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4
Q

During examination you appreciate breast elevated as a small mound and sparse, slightly pigmented pubic hair along the medial border of the labia. What tanner stage is the patient in?

A

Stage 2

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5
Q

During examination you appreciate enlarged breasts and aureoles, but no contour separation and dark, slightly curly pubic hair. What tanner stage is the patient in?

A

Stage 3

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6
Q

During examination you appreciate enlarged breasts and the aureoles and papilla form a secondary mound. As well as dark, course, curly pubic hair. What tanner stage is the patient in?

A

Stage 4

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7
Q

During examination you appreciate enlarged breast tissue, nipple projections with the aureoles apart of the general breast contour. As well as dark, course, curly pubic hair that spreads to the medial surface of the thigh. What tanner stage is the patient in?

A

Stage 5

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8
Q

During examination you appreciate scantly, long, slightly pigmented pubic har, minimally enlarged penis, and enlarged scrotum that is pink. What tanner stage is the patient in?

A

Stage 2

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9
Q

During examination you appreciate a small amount of dark pubic hair that is starting to curl, lengthened penis, and enlarged testes. What tanner stage is the patient in?

A

Stage 3

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10
Q

During examination you appreciate a moderate amount of dark curly pubic hair, larger penis with increased glans and breadth, and enlarged testes with a dark scrotum. What tanner stage is the patient in?

A

Stage 4

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11
Q

During examination you appreciate dark curly pubic hair that spreads to the medial surface of the thighs, adult sized penis and testes. What tanner stage is the patient in?

A

Stage 5

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12
Q

What is the sequence of puberty in girls?

A 
Thelarche
Pubic hair growth
Peak height velocity
Menarche
Completion
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13
Q

What is the sequence of puberty in boys?

A 
Increased testicular volume
Penile and pubic hair growth
Peak height velocity
Nocturnal sperm emission, sperm in the urine
Completion
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14
Q

When should you worry about precocious puberty?

A

Pubertal onset at an age 2 to 3 standard deviations below the mean age of onset of puberty

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15
Q

When should you worry about delayed puberty?

A

If the patient has absence of signs of puberty at an age 2 to 3 standard deviations above the mean age of onset of puberty

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16
Q

What defines precocious puberty in girls and boys?

A

Girls- breast development before the age of 8

Boys- testicular enlargement before the age of 9

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17
Q

What is defined as the upper limit of puberty development in girls and boys?

A

Girls- 12 to 13 for breast development

Boys - 13 to 14 for testicular enlargement

18
Q

What is the last cognitive function to develop in adolescence?

A

Weighing long term consequences and controlling impulses

19
Q

Are males or females more likely to die during adolescence? What do death rates increase with?

A

Males 2-3x more likely to die than females

Death rates increase with every yr of age

20
Q

What are the leading causes or morbidity in adolescence?

A 
Pregnancy
STIs
Drug and alcohol use
Obesity
Tobacco use (delayed morbidity)
21
Q

Does parents involvement and attitudes have an affect on health outcomes?

A

Yes

22
Q

What is the one health-risk behavior that parent/family connectedness is not protective against?

A

Pregnancy

23
Q

What immunizations should adolescences have by age 11-12?

A 
Hep A and B
MMR
HPV
Meningococcal 
Pneumococcal 
Varicella
Influenza
Tdap

“Having A Buddy Makes Me Realize How Much Puberty Varies In Teens”

24
Q

What can be a good way to gather information and identify problems?

A

Questionnaires

25
Q

What is the HEEADSSS questionnaire used for?

A

Psychosocial

26
Q

What is the CRAFFT questionnaire used for?

A

Substance abuse

27
Q

What is the PHQ-2 questionnaire used for?

A

Depression

28
Q

Should you tell your adolescent patient what information is confidential and what information is not?

A

Yes, it’s important to discuss with patients and parents at initial visit

29
Q

What is the term used to describe explicitly defined circumstances in which confidentiality must be broken?

A

Conditional confidentiality

30
Q

What are some exceptions to confidentiality?

A 
Child abuse or neglect
Suicidal ideation or attempt
Homicidal ideation
Violent injuries
STIs
Consensual sexual activity 
Mental health care
Parental notification
31
Q

Is unconditional confidentiality protected by law the way conditional confidentiality is?

A

No, unconditional confidentiality is not protected by law and is not endorsed by guidelines of any professional organizations

32
Q

Providers have a legal and ethical duty to obtain what for all patients?

A

Informed consent

33
Q

Who provides consent for medical treatments for unemancipated minors?

A

Parents or legal guardian

34
Q

Who provides consent for medical treatments for emancipated minors?

A

Provide their own consent

35
Q

Who provides consent for medical treatments for homeless minors?

A

Provide their own consent (must lack regular night time residence or live in supervised temporary accommodations)

36
Q

What is the role of mature minor regarding consent?

A

May be able to consent to routine care and low risk treatments
Must be at least 14 yrs old
Able to understand risks and benefits of proposed treatment

37
Q

Are mature minors legally recognized in AZ state laws?

A

No

38
Q

What are some exceptions to minor consent?

A 
Mental health services 
Pregnancy and contraceptive services
Testing or treatment for HIV
STI testing or treatment
Drug and alcohol addiction treatment
39
Q

In Arizona, minors may consent for care in what types of conditions?

A 
Emancipated, homeless, or married 
Emergencies 
STIs/HIV testing
Sexual assault and the patient is older than 12 (only if legal guardian cannot be contacted)
Substance abuse and the patient is older than 12 (g
Pregnancy care
Family planning services
Emergency contraception
40
Q

In Arizona, minors may not consent for care in what types of conditions?

A

Mental health screening or treatment

Abortion

Peds I (5 decks)

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