Rita's Adolescent Questions

Question 1

What should you advise an adolescent not to take a week before surgery?

a) ibuprofen
b) pseudophedrine
c) dextro morphine
d) cold meds

Answer 1

a) ibuprofen

Question 2

Which of the following should not be kept confidential?

a) “I am having sex with my bf”
b) “I want to get pregnant”
c) “I occasionally use marijuana”
d) “Occasionally I want to end my life”

Answer 2

d) “Occasionally I want to end my life”

Question 3

What is the most common cause of secondary amenorrhea?a) pregnancy

b) polycystic ovarian disease
c) birth control pills
d) brain tumor

Answer 3

a) pregnancy

Question 4

A 14yo has stained teeth; callus knuckles, and is hoarse frequently. Which of the following is on your differential dx?

a) Personality d/o
b) Bulimia nervosa
c) Anorexia nervosa
d) substance abuse

Answer 4

b) Bulimia nervosa

Question 5

You suspect alcohol abuse in a 16yo. Which of the following best supports your clinical suspicion?

a) Liver enzymes
b) the CAGE questionnaire
c) CBC looking at MCV
d) Obtain a serum ferritin

Answer 5

b) the CAGE questionnaire

–on CBC, see macrolytic anemia d/t nutritional deficiencies…macrocytosis is also assoc. w/liver disease

Question 6

The areola is a small mound above the elevation of the breast. What tanner stage is the child?

a) Tanner 2
b) Tanner 3
c) Tanner 4
d) Tanner 5

Answer 6

c) Tanner 4

Question 7

A 17yo is here for assessment of an eating d/o. Which of the following is not a characteristic of eating d/o’s?

a) sense of helplessness and ineffectiveness
b) wt loss giving the child a sense of mastery and control
c) low body temp, pulse rate, and BP
d) excessive eating followed by purging

Answer 7

a) sense of helplessness and ineffectiveness

Question 8

You find a small breast mass in a 16yo. What is the most likely cause?

a) abscess
b) cytosarcoma
c) fibroadenoma
d) carcinoma

Answer 8

c) fibroadenoma

Question 9

What is the 1st line therapy for an adolescent with dysmenorrhea?

a) birth control pills
b) Lupron
c) NSAIDs
d) Tylenol

Answer 9

c) NSAIDs

Question 10

A 12yo male with gynecomastia presents with a freely moveable nodule below the L nipple. What is the best approach to this problem?

a) Consider it a normal variant bc gynecomastia
b) Get a DHEA-S level
c) Get an estrogen level
d) Refer for a biopsy

Answer 10

a) Consider it a normal variant bc gynecomastia

Question 11

What would you want to tell a 15yo pregnant girl?

a) give options non-judgmentally
b) make decision independently
c) have an abortion
d) refer to right to life unit

Answer 11

a) give options non-judgmentally

Question 12

How do you treat labial adhesions that are uncomplicated in early childhood?

a) estrogen cream
b) leave it alone
c) refer to surgery

Answer 12

a) estrogen cream

vs leave it alone…controversial…

Question 13

What should every adolescent female be taking?

a) Folic acid 1 mg
b) Folic acid 400 mcg
c) Folic acid 600 mcg
d) Folic acid 800 mcg

Answer 13

b) Folic acid 400 mpg

–neural tube closes 25 days after gestation…

Question 14

Which theorist explains why an adolescent might dress like their peers?

a) Kohlberg
b) Piaget
c) Erikson
d) Brazelton

Answer 14

c) Erikson

Question 15

An adolescent complains of vaginal d/c. On exam, a thin, malodorous secretion is noted with a pH greater than 4.5. What is the most likely dx?

a) Gonorrhea
b) chlamydia
c) Bacterial vaginosis
d) Trichomonas

Answer 15

c) Bacterial vaginosis

Question 16

A 15yo girl on OCPs wth 2 episodes of bleeding. What is the best tx plan?

a) Give low estrogen pill, high progesterone
b) don’t change pill for 3 cycles
c) stop oral contraception

Answer 16

b) don’t change pill for 3 cycles

Question 17

Male, the testes have enlarged, the penis has started to grow in length but not in width. What tanner stage is the child?

a) Tanner 2
b) Tanner 3
c) Tanner 4
d) Tanner 5

Answer 17

b) Tanner 3

Question 18

During a 16yo well visit, what screening test would NOT be indicated?

a) BP
b) substance abuse screening
c) sexual maturation screening
d) cholesterol

Answer 18

d) cholesterol

Question 19

How often is Depo-Provera given?

a) every 90 days
b) every 4 months
c) every 6 months
d) every 9 months

Answer 19

a) every 90 days

Question 20

When would you teach girl how to do breast exams?

a) menarche
b) when breast buds appear
c) at Tanner V
d) not needed

Answer 20

d) not needed

Question 21

An 11y says that her uncle touches her in places that she doesn’t like. Why should you proceed with care?

a) children do no want to tattle
b) children make things up for attention
c) children feel they may be responsible in part for the abuse
d) they are not yet concrete thinkers in regard to sexual abuse

Answer 21

c) children feel they may be responsible in part for the abuse

..they ARE concrete thinkers at this point!

Question 22

What is the best way to screen for drug and alcohol use?

a) Drug urine screen
b) CRAFFT screening questionnaire
c) asking parents
d) asking the child in a non-standardized way

Answer 22

b) CRAFFT screening questionnaire

Question 23

You are placing a 15yo on Depo-Provera. What side effects do you need to educate the child on?

a) risk of osteoporosis
b) need to return every 30 days
c) risk of blood clots is much higher

Answer 23

a) risk of osteoporosis

–Depo is choice for blood clots! risk is lower

Question 24

At what age does the AAP suggest that you begin to talk with pts about not using tobacco?

a) 4yo
b) 5yo
c) 6yo
d) 7yo

Answer 24

c) 6yo

Question 25

What is the first age to refer a Tanner I female without any signs of puberty?

a) 12
b) 13
c) 14
d) 15

Answer 25

c) 14

Question 26

What is the best approach to manage breakthrough bleeding in the first month in an adolescent on birth control pills?

a) reassurance
b) stop the pills
c) change the pills to a lower formulation of estrogen

Answer 26

a) reassurance

Question 27

A female adolescent is very concerned about her weight. What dx would you consider?

a) anorexia
b) Normal adolescent female development
c) obsessive compulsive d/o

Answer 27

a) anorexia