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Senoir 21-2 > Teens > Flashcards

Teens Flashcards

1
Q

What is the exception to confidentiality in teens

A

harm to self or others

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2
Q

HEADSS exam

A

Home/Friends
(What do you do for fun)

Education
(How’s school going? )

Alcohol
(Are any of your friends drinking)

Drugs
“Are any of your friends doing drugs? )

Diet
(Are you trying dieting?”)

Sex
(Are you dating anyone? )

Suicide
(Have you felt so bad you’ve wanted to hurt yourself? .)

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3
Q

Ave age of puberty

A

11 (8-13 NML)

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4
Q

What is the threshold for precocious puberty

A

Precocious puberty: pubertal changes prior to age 6 in African Americans and age 7 in Caucasian

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5
Q

If a mass is found in puberty breasts

What is the next step

A 
Breast cancer is rare in this age group
Ultrasound eval (better for young, dense breasts)

Usually benign fibroademona or cyst

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6
Q

vaginal dc in tanner stage III

Think

A

Vaginal discharge -> Clear, no odor, no
Pruritus

Due to ovarian estrogen stimulation of uterus & vagina

If needed, obtain vaginal culture without speculum

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7
Q

What is the w/u for premature thelarche

A

Rule out early central precocious puberty, functional ovarian cysts, ovarian tumor

Refer to Endo if necessary

Run estrogen, LH/FSH labs and bone age

R/o tumor, pelvic US or MRI

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8
Q

What is the threshold for premature adrenarche

A

<8yo females or < 9yo males

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9
Q

W/u for premature adrenarche

A

Differential diagnosis—rule out excessive androgens

Congenital adrenal hyperplasia, Tumor (adrenal/gonadal), Cushing syndrome, environmental exposure

Refer to Endo if necessary

Labs: DHEAS< Andro/ Test, 17OH progesterone, bone age

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10
Q

If testes start to grow before what age? It’s abNML

A

Age 9

Endocrine emergency consult and get MRI - brain tumor

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11
Q

What is an Rx for Gynecomastia

A

Bromocriptine

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12
Q

What is the approach to severe or prolonged menstrual bleeding

A

Adolescent GI referral

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13
Q

What is the typical ovulation cycle for 1st time menses

A

A ovulatory

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14
Q

Primamry amenorhhea

A

No menses by age 16

Or 14 if no secondary characteristics

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15
Q

What is the most common cause of AUB in peds

A

Anovulation

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16
Q

What is the criteria for PCOS

A

Diagnosed w/ 2 of the following:
-Infrequent menstrual bleeding or secondary amenorrhea

  • Clinical or biochemical hyperandrogenism
  • Polycystic morphology of ovaries on ultrasound
17
Q

Treatment for AUB

A

Treatment is indicated for heavy menses

Lab: CBC

Iron therapy if has iron deficiency anemia

Combo estrogen/progesterone tx

18
Q

What is the mainstay tx for heavy bleeding is pts with bleeding d/o

A

Combo estrogen/progesterone

19
Q

What is the approach to primary dysmenorrhea

A

First line NSAIDS

If NSAIDS fail then OCPS

If longer than 4 months on tx and no resolution consider alt dx

20
Q

If a pt has HTN/poorly controlled on sports physical

What is the recommendation

A

Stage II HTN/poorly controlled: Disqualify until Nephrology evaluation

21
Q

What is the sports restriction with mono

A

Mononucleosis: restrict for at least 28 days (increased risk splenic injury/rupture)

22
Q

Approach to childhood obesity

A

Children <7 yo
-Goal is weight maintenance, not loss; let linear growth (height) catch up to weight

Children >7 yo
-Goal is 1lb/month until BMI <85%

SMART goals
Specific, Measurable, Attainable, Realistic, Timely

23
Q

SIGECAPS

A 
Sleep 
Interests 
Guilt 
Energy 
Concentration 
Appetite 
Psychomotor 
SI/HI
24
Q

What is the greatest risk factor for successful suicide

A

Previous attempts

25
Q

Screening tool for depression

A

PHQ-2

If score greater than 3= PHQ-9

26
Q

PHQ-9 Scoring

A 
0-4: minimal 
5-9: mild 
10-14: mod 
15-19: mod/ severe 
20-27: severe
27
Q

Treatment approach to depression in adolece cents

A

Fluoxetine and escitalopram are the only meds approved for use for depression in children

28
Q

What is the screening tool for Anxiety

A

SCARED

29
Q

What is the mgmt for anxiety

A

Consider co-morbid conditions (ADHD)

Consider thyroid, substance abuse, meds

Mild-moderate:
-CBT + SSRI (fluoxetine, sertraline)

Mod-severe: refer to Psychiatry

30
Q

What is the screening tool for adolescent substance abuse

A

CRAFT

Car -drugs and driving 
Relax -drugs to relax 
Alone - drugs alone 
Forgetting - forgetting from drugs
Family/Friends - asked to stop 
Trouble -getting into 2.2 drugs

Senoir 21-2 (77 decks)

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