Pediatric / Adolescent Medicine Flashcards
Adolescent mortality statistics
72% of all adolescent mortality is from preventable causes; of those:
45% are accidents
15% are homicides
11% are suicides
Stages of adolescence
Early (12 - 14 years)
Middle (15 - 17 years)
Late (18 - 21 years)
Adolescent Screening - Components
HEEEADSSS
Home Education / Employment Eating Activity Drugs Suicide Sexuality Safety
Social Smile
6 - 8 weeks
Reaching
3 months
Rolling over
4 months
Sitting
6 - 7 months
Crawling
8 - 10 months
Standing
10 - 12 months
Walking
~12 months
First words
9 - 12 months
2-3 word sentences
24 months
Toilet training
2 - 3 years
Child abuse statistics
Total prevalence = 25 / 1,000 US Children
78% neglect, 18% physical, 10% sexual
Radiologic findings suspicious for child abuse
Metaphyseal “corner” or “bucket handle” fractures of long bones
Bilateral skull fractures
Spiral fractures of extremities in non-ambulatory infants
Rib fractures
Spinous process fractures
Subdural hemorrhage
STI prophylaxis following sexual assault
Ceftriaxone + Metronidazole + Azithromycin or Doxycycline
+/- HBV vaccine
+/- HIV prophylaxis
Neurobiological findings in pedophiles
Amygdala volume 50% normal
Long-term sequelae of childhood abuse
Increased rates of childhood and adult health problems
Adolescent suicide, alcoholism, and drug abuse
Anxiety and depression
Criminality and violence
Genetics associated with increased resiliency to cope with childhood abuse
Increased levels of MAOA gene activity
Tin ear syndrome
Bruising of the pinna + ipsilateral subdural and retinal hemorrhages in an infant
Prevention of physical abuse
Parent education
Public Health Nurse home visitation
Public Health nurse home visititation outcomes
PHN visitation during last 2 trimesters of pregnancy and first 2 years of child’s life can reduce physical abuse by 87% over the lifespan
