puberty and adolescence

Question 1

regarding early adolescence
biological changes
male 2

Answer 1

males
-testicular enlargement
-start of genital growth

Question 2

regarding mid adolescence
biological changes
male 3

Answer 2

male
-sperm production
-voice breaks
-start of growth spurt

Question 3

regarding early adolescence
biological changes

female 3

Answer 3

females
-breast buds
-pubic hair development
start of growth spurt

Question 4

regarding mid adolescence
biological changes
female 3

Answer 4

end of growth spurt

menarche

change in body shape

Question 5

regarding mid adolescence
biological changes
both 3

Answer 5

acne

blushing

need more sleep

Question 6

regarding late adolescence
biological changes
male 2

Answer 6

end of puberty

continued growth in height

Question 7

regarding early adolescence
psychological changes 3

Answer 7

concrete thinking

begin devleopping moral concepts

start developing awarenses of sexual identity

Question 8

regarding mid adolescence
psychological changes 4

Answer 8

abstract thinking

belive themselves to be immortal

increased verbal dexterity

may develop fervent ideology

Question 9

regarding late adolescence
psychological changes 3

Answer 9

complex absrtract thinking

increased impulse control

further development of personal identity

Question 10

regarding early adolescence
social changes 3

Answer 10

early emotional separtion from paretns

strat of strong peer identification

early exploratory behvaoirs eg smoking

Question 11

regarding mid adolescence
social changes 3

Answer 11

continuing parental separtion

heterosexual peer interest

early vocational plans

Question 12

regarding late adolescence
social changes 3

Answer 12

social automny

develop intimate relationships

begin developing financial independence

Question 13

how to optimise consultations with adolescents 5

Answer 13

explain clearly confidentiality
-unless at risk behaviour

consider family dynamic - who is answering questions and why

alert to proxy presentation - abdo pain

consider full psychosocial hx

for physical examine consider who should be present

Question 14

describe the aspects of a psychosocial history 9

Answer 14

HEADS

home life
education
activities
drinking
driving
drugs
sex
smoking
suicide

Question 15

overview of female puberty sequence

Answer 15

breast development (8-12yo)
-immediatley after-> pubic growth and rapid growth spurt

menrache- occurs around 2.5years after start of puberty
-signals growth is coming to an end

Question 16

overview of male puberty

Answer 16

testicular enlargement-firs sign of puberty
followed by pubic hai growth (10-14yo)

height spurt
-in conjunction w testicular volume of 12-15ml, 18mnths after puberty commences

Question 17

how is delayed puberty defined by age in both genders

*important point about delayed puberty

Answer 17

girls -by age 14

boys- by age 15

*mainly affects boys and is usually benign
-females more likely to be pathological

Question 18

how can causes of delayed puberty by classified 3

Answer 18

constiutional delay

hypogonadotrophic hypogonadism

hypergonadotropic hypogonadism

Question 19

how can hypogonadoptophic hyogonadism cuases of delayed puberty be split

Answer 19

hypothalamo-pituitarty disorders

systemic disease

Question 20

hypothalamo-pituitary disorders causes of delayed puberty 3

Answer 20

panhypopituitarism

intrcranial tumours

Kallmans syndrome

Question 21

systemic cuases of delayed puberty 3

Answer 21

anoerexia nervosa

crohns disease

cystic fibrosis

Question 22

how can hypergonadotrophic hypogonadism causes of delayed puberty be classified 3

Answer 22

chromosomal abnormalities

steroid hormone enzyme deficiencies

gonadal trauma

Question 23

chromosomal abnormalites causing delayed puberty 2

Answer 23

Klinefelters (XXY)

Turnes (XO)

Question 24

gonadal truama causes of delayed puberty 4

Answer 24

direct trauma

post surgery

post chemo

torted testicle

Question 25

assessment in delayed puberty in males 3

Answer 25

pubertal staging

growth parameters

exclude chornic systemic disease

Question 26

assessment in delayed puberty in females 5

Answer 26

pubertal staging

growth parameters

karyotype

thyroid hormones

sex hormones

Question 27

treatment for constitutinoal delayed puberty 4

Answer 27

most no treatment required
-give reassurance

if treatment desired
-oral oxandrolone in young males
-will induce some catch up growth but not influence seocndrary sexual characteristics

older males
-low dose IM testosterone to accelerate growth and induce secondary sexual characteristic

female
-can treat with oestradiol

Question 28

concerning features of a adolescent sexual history 5

Answer 28

age<13yo

power imbalcne in relationship

evidence of coercion

substance misuse

whether the behaviour places them at risk

Question 29

risk factors for STIs 4

Answer 29

avoidance of barrier contraception

multiple partners

mental illness

substance misuse

Question 30

risk factors for substnace missue 5

Answer 30

conduct disordr

poor parenting

early expierience of substance abuse

peer group pressure

poor social environment

Question 31

areas of health promoitn

Answer 31

antisocial behvaiour

health risk behaviours

mental health

physical health

parental relation

Question 32

goal setting tips in chronic disease with adolescents 5

Answer 32

include them in discussion

keep goals short term

use simple regime

tailor plan to their daily routine

consider social effects of actions

Question 33

opitimiings transisiton for adolscent to adult services

Answer 33

inform them and parents early

run specific teenage clinics

involve GP

encourage young person to take control of health interaction/ management

support parents on how to make teenager to be more indepent