puberty and adolescence Flashcards
regarding early adolescence
biological changes
male 2
males
-testicular enlargement
-start of genital growth
regarding mid adolescence
biological changes
male 3
male
-sperm production
-voice breaks
-start of growth spurt
regarding early adolescence
biological changes
female 3
females
-breast buds
-pubic hair development
start of growth spurt
regarding mid adolescence
biological changes
female 3
end of growth spurt
menarche
change in body shape
regarding mid adolescence
biological changes
both 3
acne
blushing
need more sleep
regarding late adolescence
biological changes
male 2
end of puberty
continued growth in height
regarding early adolescence
psychological changes 3
concrete thinking
begin devleopping moral concepts
start developing awarenses of sexual identity
regarding mid adolescence
psychological changes 4
abstract thinking
belive themselves to be immortal
increased verbal dexterity
may develop fervent ideology
regarding late adolescence
psychological changes 3
complex absrtract thinking
increased impulse control
further development of personal identity
regarding early adolescence
social changes 3
early emotional separtion from paretns
strat of strong peer identification
early exploratory behvaoirs eg smoking
regarding mid adolescence
social changes 3
continuing parental separtion
heterosexual peer interest
early vocational plans
regarding late adolescence
social changes 3
social automny
develop intimate relationships
begin developing financial independence
how to optimise consultations with adolescents 5
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
describe the aspects of a psychosocial history 9
HEADS
home life
education
activities
drinking
driving
drugs
sex
smoking
suicide
overview of female puberty sequence
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
overview of male puberty
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
how is delayed puberty defined by age in both genders
*important point about delayed puberty
girls -by age 14
boys- by age 15
*mainly affects boys and is usually benign
-females more likely to be pathological
how can causes of delayed puberty by classified 3
constiutional delay
hypogonadotrophic hypogonadism
hypergonadotropic hypogonadism
how can hypogonadoptophic hyogonadism cuases of delayed puberty be split
hypothalamo-pituitarty disorders
systemic disease
hypothalamo-pituitary disorders causes of delayed puberty 3
panhypopituitarism
intrcranial tumours
Kallmans syndrome
systemic cuases of delayed puberty 3
anoerexia nervosa
crohns disease
cystic fibrosis
how can hypergonadotrophic hypogonadism causes of delayed puberty be classified 3
chromosomal abnormalities
steroid hormone enzyme deficiencies
gonadal trauma
chromosomal abnormalites causing delayed puberty 2
Klinefelters (XXY)
Turnes (XO)
gonadal truama causes of delayed puberty 4
direct trauma
post surgery
post chemo
torted testicle
assessment in delayed puberty in males 3
pubertal staging
growth parameters
exclude chornic systemic disease
assessment in delayed puberty in females 5
pubertal staging
growth parameters
karyotype
thyroid hormones
sex hormones
treatment for constitutinoal delayed puberty 4
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
concerning features of a adolescent sexual history 5
age<13yo
power imbalcne in relationship
evidence of coercion
substance misuse
whether the behaviour places them at risk
risk factors for STIs 4
avoidance of barrier contraception
multiple partners
mental illness
substance misuse
risk factors for substnace missue 5
conduct disordr
poor parenting
early expierience of substance abuse
peer group pressure
poor social environment
areas of health promoitn
antisocial behvaiour
health risk behaviours
mental health
physical health
parental relation
goal setting tips in chronic disease with adolescents 5
include them in discussion
keep goals short term
use simple regime
tailor plan to their daily routine
consider social effects of actions
opitimiings transisiton for adolscent to adult services
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
