Physical Development ✅

Question 1

What is the physical hallmark of development in adolescence?

Answer 1

Puberty

Question 2

How does the timing of the growth spurt differ in girls and boys?

Answer 2

In girls, the growth spurt occurs before the onset of genesis, whereas in boys it occurs later

Question 3

What condition is the difference in timing of the growth spurt important in?

Answer 3

Eating disorders

Question 4

What is the significance of the difference in timing of the growth spurt between girls and boys in eating disorders?

Answer 4

Te peak onset of eating disorders in males tends to occur before or during the growth spurt, whereas in females onset is typically after the growth spurt, so risk of growth stunting following eating disorders is higher in males

Question 5

What is the clinical relevance of the rapid growth seen in adolescence?

Answer 5

Can increase the risk of some symptoms

Question 6

What symptoms can be worsened by rapid growth seen in adolescence?

Answer 6

Back pain

Question 7

Who is adolescent back pain seen more commonly in

Answer 7

Those with increased truncal length

Question 8

What % of adolescents are affected by back pain by 18-20 years?

Answer 8

50%

Question 9

What is the underlying cause of back pain in adolescence?

Answer 9

Underlying cause not identified in most children

Question 10

What should be considered as a potential underlying cause for back pain in adolescents?

Answer 10

Spondylolysis and spondylolisthesis

Question 11

Who is at particular risk of spondylolysis and spondylolisthesis?

Answer 11

Active and rapidly growing adolescents

Question 12

What is spondylolysis?

Answer 12

Fracture of the pars interarticularis or pedicle

Question 13

Where is spondylolysis most likely to affect?

Answer 13

The lower lumbar vertebrae

Question 14

What can cause spondylolysis?

Answer 14

Injury or repetitive activity

Question 15

What movements are most likely to cause spondylolysis?

Answer 15

• Extension (bending backwards)

- Rotation

Question 16

Does spondylolysis only affect adolescents?

Answer 16

No, it can also cause back pain in children and adults

Question 17

What % of children can develop spondylolysis by the age of 6?

Answer 17

4-5%

Question 18

Which children are at higher risk of spondylolysis?

Answer 18

Those active in sports

Question 19

What % of adults develop spondylolysis?

Answer 19

6%

Question 20

Is spondylolysis more common in girls or boys?

Answer 20

Boys

Question 21

Why might spondylolysis be more common in boys?

Answer 21

• Growth spurt

- Involvement in contact sports

Question 22

How does spondylolysis present?

Answer 22

• Pain in particular spot of low back
• Spasm of muscles along spine
• Pain into buttocks or thighs

Question 23

What investigations can be done in spondylolysis?

Answer 23

• Plain spine x-rays

- MRI scanning of spine

Question 24

What is the limitation of plain spine x-rays in spondylolysis?

Answer 24

It may not show a fracture

Question 25

How is spondylolysis managed?

Answer 25

• Conservative management

- Bracing

Question 26

What is involved in conservative management of spondylolysis?

Answer 26

• Change in activity
• Rest
• Avoiding hyperextension and rotation

Question 27

When might bracing be needed in spondylolysis?

Answer 27

If symptoms are not improving with conservative management

Question 28

What should be considered if symptoms of spondylolysis aren’t improving with treatment?

Answer 28

May have forward displacement of one vertebra on another

Question 29

What can cause premature fusion of epiphyses?

Answer 29

Inflammatory arthritis

Question 30

What can premature fusion of epiphyses in adolescence cause?

Answer 30

Asymmetrical growth

Question 31

What is the implication of adolescence on the action of drugs?

Answer 31

Distribution of drugs can be affected by the change in body size and composition characteristic of puberty

Question 32

How does the increase in lean body mass during adolescence compare between boys and girls?

Answer 32

It is usually greater in boys

Question 33

What is the result of the increase in lean body mass during puberty being greater in boys?

Answer 33

Girls have relatively more body fat than boys in late puberty

Question 34

What is the significance of girls having relatively more body fat in late puberty than boys?

Answer 34

This can have implications for the volume of distribution for some drugs

Question 35

What can be used for pubertal assessment?

Answer 35

Pubertal self-assessment tools

Question 36

What is good about pubertal self-assessment tools?

Answer 36

They are useful in clinical consultation and provide a means of facilitating discussions in this area with individual young people

Question 37

Why might adolescents develop bone problems?

Answer 37

• Significant period of bone mass development

- Reduction in observed vitamin D levels

Question 38

What % of adult bone mass is accrued in the adolescent period?

Answer 38

40%

Question 39

What can increased bone mass development and low vitamin D levels in adolescent lead to?

Answer 39

• Suboptimal bone mineralisation
• Increased fracture risk
• Bone pain

Question 40

What happens to the proportion of children with vitamin D deficiency with age?

Answer 40

It increases

Question 41

What % of adolescents have vitamin D deficiency?

Answer 41

11-16%