Pediatric / Adolescent Medicine

Question 1

Adolescent mortality statistics

Answer 1

72% of all adolescent mortality is from preventable causes; of those:

45% are accidents
15% are homicides
11% are suicides

Question 2

Stages of adolescence

Answer 2

Early (12 - 14 years)
Middle (15 - 17 years)
Late (18 - 21 years)

Question 3

Adolescent Screening - Components

Answer 3

HEEEADSSS

Home
Education / Employment
Eating
Activity
Drugs 
Suicide 
Sexuality
Safety

Question 4

Social Smile

Answer 4

6 - 8 weeks

Question 5

Reaching

Answer 5

3 months

Question 6

Rolling over

Answer 6

4 months

Question 7

Sitting

Answer 7

6 - 7 months

Question 8

Crawling

Answer 8

8 - 10 months

Question 9

Standing

Answer 9

10 - 12 months

Question 10

Walking

Answer 10

~12 months

Question 11

First words

Answer 11

9 - 12 months

Question 12

2-3 word sentences

Answer 12

24 months

Question 13

Toilet training

Answer 13

2 - 3 years

Question 14

Child abuse statistics

Answer 14

Total prevalence = 25 / 1,000 US Children

78% neglect, 18% physical, 10% sexual

Question 15

Radiologic findings suspicious for child abuse

Answer 15

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

Question 16

STI prophylaxis following sexual assault

Answer 16

Ceftriaxone + Metronidazole + Azithromycin or Doxycycline

+/- HBV vaccine
+/- HIV prophylaxis

Question 17

Neurobiological findings in pedophiles

Answer 17

Amygdala volume 50% normal

Question 18

Long-term sequelae of childhood abuse

Answer 18

Increased rates of childhood and adult health problems
Adolescent suicide, alcoholism, and drug abuse
Anxiety and depression
Criminality and violence

Question 19

Genetics associated with increased resiliency to cope with childhood abuse

Answer 19

Increased levels of MAOA gene activity

Question 20

Tin ear syndrome

Answer 20

Bruising of the pinna + ipsilateral subdural and retinal hemorrhages in an infant

Question 21

Prevention of physical abuse

Answer 21

Parent education

Public Health Nurse home visitation

Question 22

Public Health nurse home visititation outcomes

Answer 22

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