keeping people healthy week 4

Question 1

What initiates puberty?

Answer 1

puberty starts with the de-inhibition of the pulse generator of the arcuate nucleus
Leptin levels rise in the body throughout childhood and play a part in allowing the arcuate nucleus to resume operation
release of gonadotropin-releasing hormone from the hypothalamus
Pituitary gland secretes FSH and LH
These signal the start of sexual development

Question 2

Describe puberty in girls

Answer 2

Ages 10-14
ovaries start to produce oestrogen
body matures in preparation for pregnancy
first sign is normally breast development
then hair grows in pubic area and axillae
menstruation usually occurs last

Question 3

Describe puberty in boys

Answer 3

ages 12-16
sperm and hormone production
testosterone responsible for most changes in the body
puberty begins with testicle and penis enlargement
then hair grows in pubic area and axillae
muscles grow, voice deepens, facial hair develops

Question 4

What are the first signs of puberty due to?

Answer 4

increased secretion of adrenal androgens, possibly under the influence of adrenocorticotropin hormone

Question 5

What can cause delayed puberty?

Answer 5

constitutional delay
hypogonadotropin hypogonadism 
chronic illness 
psychological stress
anorexia nervosa
excessive exercise
endocrine disease

Question 6

Describe constitutional delay

Answer 6

most common cause of delayed puberty
affected children are healthy and usually more than 2.5 SDs below the median height for their age throughout childhood
often family history
in constitutional delay bone age will be less than chronological age

Question 7

What effects can delayed puberty have?

Answer 7

in young skeleton oestrogen deficiency leads to increased osteoclast formation and enhanced bone resorption
oestrogen inhibits the differentiation of osteoclasts
the effect is probably mediated by IL1 and IL6

Question 8

what is a risk factor?

Answer 8

an aspect of personal behaviour or lifestyle, an environmental exposure, or inherited characteristics that on basis of scientific evidence, is known to be associated with meaningful health related conditions

Question 9

What are risk factors for cardiovascular disease?

Answer 9

smoking
alcohol
inactivity
inappropriate diet
genetics 
mental health
diabetes

Question 10

What is the life course approach?

Answer 10

the study of long term effects on later health or disease risk of physical or social exposures during gestation, childhood, adolescence, young adulthood or later in adult life

Question 11

What is programming?

Answer 11

the process whereby a stimulus or insult at a sensitive period of time has lasting effect on the structure and function of the body

Question 12

What is the Barker hypothesis?

Answer 12

the impact of poor foetal nutrition across different sensitive periods results in changes in body structure and function which prepare the baby for austerity

Question 13

What are the risk factors in the adverse childhood experiences study?

Answer 13

abuse- emotional, physical or sexual
household challenges- mother treated violently, household substance abuse, mental illness in household, parental operation, criminal household behaviour
neglect - physical or emotional

Question 14

What are the ACE risk factors for?

Answer 14

alcoholism
COPD
depression
foetal death
illicit drug use
liver disease
poor work performance
financial stress
risk of partner violence
STIs
smoking
suicide
unplanned pregnancies
risk of sexual violence 
poor academic achievement

Question 15

What can adverse childhood experience do?

Answer 15

disrupt neurodevelopment, causes social, emotional and cognitive impairment, adoption of health risk behaviours, disease, disability and morbidity, early death

Question 16

What are possible interventions during the life course?

Answer 16

action of socioeconomic status
action on parenting support 
earlier permanency 
intervention at school
intervention through gangs
intervention in prison

Question 17

what is the definition of a drug?

Answer 17

a chemical substance used in the treatment, cure, prevention, diagnosis of disease or used to otherwise enhance physical or mental well being

Question 18

What are the social impacts of drugs and alcohol?

Answer 18

employment
crime
relationships
child care

Question 19

what are the health impacts of drugs and alcohol?

Answer 19

minor symptoms 
GP consultations 
infections
hospitalisations 
affection services
death

Question 20

What are the determinants of drug use?

Answer 20

availability
affordability
social acceptability
promotion

Question 21

What is contained in cigarettes?

Answer 21

nicotine
carbon monoxide
tar
arsenic, cyandie, ammonia, acetone, benzene, formaldehyde, cadmium, hydrogen cyanide etc

Question 22

What is addiction?

Answer 22

compulsive physiological and psychological need for a habit-forming substance
characterised by compulsive drug-seeking and use even in face of negative health consequences

Question 23

What effect does nicotine have?

Answer 23

stimulates adrenal glands - increases heart rate, BP, breathing, release glucose, surpasses insulin
Binds to “nicotinic” ACH receptors - brain creates more receptors, if these are not activated causes cravings
Dopamine is also released in response to nicotine - pleasure pathway - enjoyment and relaxation
tolerance is quickly acquired

Question 24

What is second hand smoke associated with?

Answer 24

SIDs
Asthma
lower respiratory tract infections, pneumonia, bronchitis
glue ear
bacterial meningitis

Question 25

What are examples of oestrogen and progesterone contraceptives?

Answer 25

combined pill
patch
vaginal ring

Question 26

What are examples of progesterone only contraceptives?

Answer 26

progesterone only pill
injectable
implant
progesterone release IUD (mirena coil)

Question 27

What are examples of barrier methods of contraceptives?

Answer 27

condom - male and female

diaphragm and cervical caps

Question 28

What are natural methods of contraception?

Answer 28

billings (mucus)
temperature
rhythm
withdrawal 
persona

Question 29

What types of sterilisation are there?

Answer 29

female - tubal ligation

male - vasectomy

Question 30

What factors influence contraceptive choice?

Answer 30

knowledge and understanding of method
personal features - e.g forgetfulness
method characteristics
lifestyle and occupation
motivation not to be pregnant 
alcohol and drug use
peer / partner pressures
embarrassed to discuss with health professional
concerns re confidentiality
poor access to services
cultural / religious influences

Question 31

Who are at increased risk of STIs?

Answer 31

adolescents
men who have sex with men
people from or who partners from, countries with high rates of STIs
frequent partner change
previous bacterial STI
early onset sexual activity
alcohol or substance abuse

Question 32

What are the fraser guidelines?

Answer 32

the young person understands the professional’s advise
the young person cannot be persuaded to tell their parents
the young person is likely to begin, or to continue having, sexual intercourse with or without contraception
unless the young person receives contraception, their physical or mental health, or both, are likely to suffer
the young person’s best interests require them to receive contraceptive advise or treatment with or without parental consent

Question 33

What shows that a young person has capacity?

Answer 33

they are able to;
understand the treatment, its purpose and nature and why it is being proposed
understand the benefits, risks and alternatives
understand in broader terms what the consequences of treatment will be
retain the information for long enough to use it and weight it up in order to arrive at a decision