HLTH 2501: diseases associated with adolescence Flashcards
what do the biological chances typical of adolescence result from?
the hormonal activity stimulated by the hypothalamus and the pituitary gland
GnRh
gonadotropin-releasing hormone; this is released from the hypothalamus and stimulates the release of gonadotropins from the pituitary (LH and FSH)
gonadotropins
are LH and FSH
why does linear growth occur for longer in males?
because the epiphyseal closure is delayed in males
why do males develop more muscle mass than females?
because of the anabolic action of male sex hormones (androgens and testosterone)
in what stages does adolescence growth occur in?
first limb growth, then hip and shoulder, then and increase in muscle maass
what nutrients are important during adolescence development?
Ca+ and vitamin D
how is the cardiovascular system impacted during adolescence growth?
the BV is increased as well as the strength of cardiac contractions, although pulse rate decreases
burning fat and adolescence
is begins to decrease after puberty due to metabolic changes; thus obesity can be common in younger individuals
what can obesity as an adolescent lead to?
increased risk for diabetes type 2, cardiovascular disease (due to increased blood cholesterol and elevated BP), strokes and permanent joint damage (due to musculoskeletal problems)
overweight vs obese
overweight refers to an excess of muscle, bone, fat or water whereas obese is an excess of fat
how is obesity determined?
BMI (body mass index); this is calculated based on age, height, and weight
when is an adolescent considered obese?
when the BMI is at the 95th percentile or greater for their age; 85th-94th percentile is at risk for obesity
metabolic syndrome
may be defined in various ways but includes three factors: presence of significant abdominal fat, changes in glucose metabolism, and changes in lipoprotein metabolism
how prevalent is metabolic syndrome?
present in 1-4% of children and adolescents and 49% of those who are clinically obese young people
primary cause of metabolic syndrome?
obesity
what is the underlying cause of metabolic syndrome?
is the release of insulin antagonists by adipose tissue, thus more body fat results in more insulin resistance
why are musculoskeletal disorders common in adolescents?
because muscular development lags behind skeletal growth, thus, less support is available for the weight-bearing areas
kyphosis
aka hunchback and is an increase in the convexity of the thoracic spine; a milder form may develop in adolescents
what is commonly the cause of kyphosis in adults?
secondary to osteoporosis or tuberculosis
what do teens often present kyphosis?
because they are taller than their peers, insecure about this breasts, or muscle support is inadequate
what are complications of kyphosis?
it can interfere with lung expansion and ventilation
lordosis
is an exaggerated concave lumbar curvature or swayback
causes of lordosis in adolescents
poor posture and obesity (because the center of gravity for the body is altered and can cause changes in vertebral alignment)
scoliosis
is a lateral curvature of the spine affecting both the thoracic or lumbar area, and may be accompanied by rotation of the vertebrae
scoliosis and adolescence
may become greater during growth sprouts
2 classifications of scoliosis
structural or functional
structural scoliosis
is a primary spinal deformity, of which 80% are idiopathic and genetic factors play a role; females are impacted much more; 2 subgroups are congenital and degenerative
congenital scoliosis
is part of structural group and includes developmental defects such as hemivertebrae and urinary tract disorders
degenerative scoliosis
may develop in older individuals with osteoporosis and osteoarthritis which create an unstable vertebral column
functional scoliosis
develops secondary to another problems such as unequal leg length, spinal nerve compression, or unequal spinal muscle support
what are possible results of unequal spinal muscle support?
loss of the normal curvature which can result from partial paralysis, trauma, MD, cerebral palsy, or spinal tumors
signs of abnormal spinal curvature of scolosis
loss of alignment of the hip and shoulder and rotation of the vertebrae which affects the pelvis and thorax
treatment of scoliosis
exercise, braces, but most often surgery is required using instrumentation and fusion of the vertebrae
osteomyelitis
is an infection of the bone and is associated with minor trauma such as fractures and soft tissue injury
who is osteomyelitis common in?
younger males
why may osteomyelitis develop?
because a bruise or sprain leaves the area vulnerable to blood-borne organisms from another site such as a skin boil, an abscess, or sinusitis
most common organism causing osteomyelitis
S. aureus
most common site of infection for osteomyelitis
the metaphysis of the femur or tibia
what is a predisposing condition to osteomyelitis?
sickle cell anemia
phases occurring in osteomyelitis
a local accumulation of pus creates pressure on the bone, periosteum, and nerves; new bone grows around the infected site; the pressure may tear the periosteum and create a sinus or passage through the soft tissue, spreading the infection; and joint involvement and inflammation may occur
signs of osteomyelitis
inflammation signs and systemic signs of infections (fever, leukocytosis, malaise, and irritability)
treatment for osteomyelitis
aggressive antimicrobials that can penetrate the bone and surgery if the infection persists
juvenile rheumatoid arthritis
is a group of autoimmune diseases that cause chronic inflammation in the CT areas such as joints; this is often marked by remissions and exacerbations
how is JRA different from adult RA?
the onset is more marked, large joints are frequently affected, systemic effects are more present, and RF is absent
three subgroups of JRA
are based on the joints affected, the types of antibodies in the blood, and the other effects
still disease
is a type of JRA that is distinguished by systemic effects that cause a high fever, skin rash, and enlarged spleen
causes of JRA
not known but is linked to a genetic factor, environmental agents, or infectious agents
who is JRA common in?
children aged 2-5 or 9-12
what happens in JRA?
the synovial membrane is inflamed and the cartilage erodes, causing red, swollen, and tender joints with impaired mobility and not too severe pain; adhesions may form is persists for long
serum levels of those with JRA
high WBCs and antinuclear antibodies
complications of JRA
hip involvement or inflammation of the eye (iridocyclitis)
treatment for JRA
NSAIDS, glucocorticoids, disease-modifying antirheumatic drugs, PT, and exercise (particularly swimming)
example of a disease-modifying antirheumatic drug
methotrexate
general medical concern with eating disorders
poor nutrition on growth and development
anorexia nervosa
is an extreme loss of weight because of self-starvation in the absence of another disease
what are factors driving individuals to anorexia nervosa?
perfectionists, high achievers, family conflict, confused perception of sexulaity, and a fear of fatness
word for thin and wasted
emaciated
signs of anorexia nervosa
emaciation, amenorrhea, low body temperature, cold intolerance, low BP, slow HR, dry skin, brittle nails, and development of fine body hair (lanugo)
lanugo
fine body hair
lack of menstrual cycle word
amenorrhea
complications for anorexia nervosa
low Ca+ intake can lead to osteoporosis, impaired kidney function, impaired cardiovascular function, hypokalemia hyponatremia can cause cardiac arrhythmias or arrest
bulimia nervosa
is characterized by binge eating followed by purging
complications of bulimia nervosa
anemia, menstrual irregularities, electrolyte imbalance causing cardiac arrhythmias, tetany, severe abdominal pain, and oral cavity problems
tetany
involuntary muscle contractions and overstimulated PNS nerves
how is the oral cavity impacted with bulimia?
erosion of tooth enamel, increased dental caries, tears and ulcers in the oral mucosa, enlarged parotid and submandibular glands and chronic esophagitis
binge eating disorder
is characterized by the frequent intake of large amounts of food but lacks purging
acne vulgaris
is a common skin infection that occurs in adolescence and teen years and is associated with sebaceous glands and hair follicles on the face, neck, and upper trunk
why does acne increase during puberty?
because the sebaceous glands increase in activity, resulting in plugged pores and infection
two types of lesions in acne vulgaris
comedones or inflammatory
name for whiteheads
comedones and inflammatory acne
comedones
are noninflammatory collections of sebum, sloughed epithelial cells, and bacteria that clog the gland and prevent normal drainage
inflammatory acne
occurs when infection causes the hair follicles swell and rupture by the propionibacterium acne; the bacterium breaks down into the sebum, breaking down the sebum into irritating fatty acids; after this, the staphylococcal organisms invade and create a pustule
2 microorganisms involved in inflammatory acne
propionibacterium acne and staphylococcus
risk factors for acne
genetic factors, increased androgen levels, premenstrual hormonal fluctuations, oily creams, certain drugs, heavy or irritating clothing, backpacks, helmets, and heat or humidity
medical treatment for acne
involves benzoyl peroxide, tretinoin, isotretinoin or antibacterial agents like tetracycline
full name for mono
infectious mononucleosis
infectious mononucleosis
is an acute infection affecting lymphocytes (B) through invading epithelial cells in the nasopharynx or oropharynx and penetrating to the lymphoid tissue
what causes infectious mononucleosis?
epstein-barr virus (part of the herpes group)
how is infectious mononucleosis transmitted?
infected saliva (hence kissing), airborne droplets, and blood
incubation period for infectious mononucleosis
4-6 weeks
signs of infectious mononucleosis
sore throat, headache, fever, fatigue, enlarged lymph nodes, enlarged spleen, and rash on trunk
testing for infectious mononucleosis
blood test demonstrating an increase in atypical T lymphocytes and heterophil antibodies
possible complications of infectious mononucleosis
hepatitis, ruptured spleen or meningitis
3 types of disorders affecting sexual development
chromosomal disorders, tumors, or menstrual abnormalities
klinefelter syndrome
affects males owing to the presence of an additional X chromosome (XXY instead of XY)
signs of klinefelter syndrome
mental retardation is common, small testes, no sperm, and secondary male characteristics do not develop
turner syndrome
is a monosomy X in which one X chromosome is missing and this affects sexual development in females
testicular tumors
not common in adolescents but can affect men in their 20s and 30s; the tumor is usually malignant and is a unilateral hard mass on the testes; fertility can resume after surgical removal if one is still present
what is the absence of menstruation called?
delayed menarche or primary amenorrhea and this occurs after age 17
what is delayed menarche caused by?
an abnormality in the reproductive organs, abnormality in the pituitary gland or hypothalamus, lots of exercise, or systemic disorders like hypothyroid or diabetes
dysmenorrhea
refers to the discomfort that occurs in varying degrees during the first or second day of menstruation
what is period cramping due to?
the secretion of prostaglandins from the uterus
serious effects of dysmenorrhea
vomiting or fainting
treatment for dysmenorrhea
hormones, NSAIDs like advil, midol that contains aspirin, caffeine, or cinnamedrine
cinnamedrine
is a uterine relaxant
secondary dysmenorrhea
is usually related to infection or other pathologies
