Female health maintenance Flashcards

1
Q

Adolescent Interview

A
H - home
E - employment/education
E - eating
A - activity/aspiration
D - drugs
S - sexuality
S - safety
S - suicide
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2
Q

Signs of hypothyroidism in adolescents

A
Cold skin
Slowness
Fatigue
Poor school performance
Preferring hot over cold weather
Coarse hair
Myxedema
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3
Q

Menses in adolescents

A

Often light and irregular with more cramping

  • important to distinguish “extra” tampons or soaking through them
  • timing of periods
  • length of periods
  • are they normal
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4
Q

Infectious mono

A

“mono” caused by EBV virus (fatigue, sore throat, lymphadenopathy)
- infection of lymphocytes

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5
Q

Depression in adolescents

A

Mood swings - can be normal
Adjustment reactions - can be normal
- evaluate if indicated
- screen for depression

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6
Q

Symptoms of depression

A
  1. Feeling down and don’t want to do normal acitvities
  2. Crying over small things
  3. Don’t want to hang out with friends
  4. Suicide ideation
  5. Feeling grouchy
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7
Q

Inquiring about eating disorders

A

Most adolescents are honest when asked especially when you express confidentiality
- ask about both anorexia and bullimia

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8
Q

Signs of anorexia

A

Weight loss/failure to gain weight

  • bradycardia (can lead to hypotension)
  • electrolyte abnormalities (malnutrition)
  • arrhythmias
  • death
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9
Q

Signs of bullimia

A

Can be more difficult to diagnose than anorexia b/c in bullimia the weight remains normal
- look for 2nd manifestations –> tooth decay, finger trauma

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10
Q

Treatment of eating disorders

A

need therapists and counselors, nutritionists,

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11
Q

DDx for fatigue in adolescent female

A
  1. Anemia - either bleeding disorder, heavy periods, iron-deficiency
  2. Hypothyroidism - can cause menstrual abnormalities
  3. Depression - fatigue can be sign of depression
  4. Substance use
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12
Q

Discussing confidentiality with adolescents

A

Be honest, talk about absolute and relative confidentiality,

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13
Q

Evaluating a decrease in academic performance

A

Medical : hypothyroidism
Personal: substance abuse, death of loved one, family stressors
Psychosocial: depression

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14
Q

Obtaining sexual history

A

You need to ask specific questions.

  1. Are you sexually active?
  2. Boys? Girls?
  3. How many partners?
  4. Protection? Always?
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15
Q

Adolescent PE

A

Respect their shyness and privacy

- have a chaperone if appropriate or simply wait for physician to conduct the exam

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16
Q

Puberty for girls

A

8-13 y.o.

  1. Breast buds
  2. Pubic hair
  3. Growth spurt
  4. Menarche
  5. Adult height
17
Q

Puberty for boys

A

10-15 y.o.

  1. Growth of testicles
  2. Pubic hair
  3. Growth of penis
  4. First ejaculation (13-14 y.o.)
  5. Growth spurt
  6. Adult height
18
Q

Labs for a suspected bleeding disorder

A
CBC, PT, PTT
vWF (Ristocetin factor)
Factor VIII activity
Platelet function
Reticulocyte count
19
Q

von Willebrand Disease

A

*most common hereditary bleeding disorder
Autosomal dominance with variable penetrance
Sx = ecchymosis, epistaxis, menorrhagia, gingival bleeds, bleeding following minor procedures

20
Q

Diagnosis of vWD

A

Careful history and PE

  • most blood tests can be normal
  • make sure to check vWF antigen and Ristocetin
21
Q

Treatment of vWD

A

intranasal of IV desmopressin

- causes dose dependent increase in vWF which shortens bleeding time and PTT