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Peds Boards > Adolescent/GYN > Flashcards

Adolescent/GYN Flashcards

1
Q
  • absent pubic hair
  • childlike phallus
  • testicular volume <2.5mL
A

SMR 1 (prepubertal)

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2
Q
  • fine pubic hair
  • childlike phallus
  • inrceased testicular size and volume
  • scrotum more textured
A

SMR 2 (beginning of puberty)

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3
Q
  • coarse, curly, and pigmented pubic hair
  • increased phallus size
  • increased testicular size
A

SMR 3

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4
Q
  • denser and curled pubic hair, but less abundant than adult

- phallus size closer to adult male

A

SMR 4

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5
Q
  • pubic hair extends to the inner thigh, adult like
  • adult size phallus
  • adult size testicles
A

SMR 5

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6
Q
  • absent pubic hair

- no glandular breast tissue

A

SMR 1 (prepubertal)

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7
Q
  • hair along the labia

- small breast buds, with glandular tissue

A

SMR 2 (beginning of puberty)

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8
Q
  • coarse, curly and pigmented pubic hair

- breast tissue extends beyond the areola

A

SMR 3

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9
Q
  • pubic hair denser and curled but less abundant than adult

- enlarged areola and papilla form a secondary mound

A

SMR 4

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10
Q
  • pubic hair extends to the inner thigh, adult like

- no longer a separate projection of the areola from the remainder of the breast

A

SMR 5

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11
Q

pre-puberty height velocity

A

5-6 cm/yr

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12
Q

peak adolescent height velocity

A

9-10 cm/yr

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13
Q

-no pubertal development by 14 in a girl, 13 in a boy

A

Delayed Puberty

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14
Q

-what the female growth spurts begins and ends with

A

Breast development, menarche

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15
Q

-first sign of puberty in males

A

Testicular enlargement

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16
Q

-2 labs that increase with growth spurt

A

Alk Phos and Hematocrit

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17
Q

-sequence of male pubertal development

A

Testicular growth->pubarche->penile growth->peak height velocity

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18
Q
  • MC for delayed puberty in males

- bone age < constitutional age

A

Constitutional Growth Delay

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19
Q

-sequence of female sexual development

A

Breast buds (thelarche)->pubarche->peak height velocity->menarche

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20
Q
  • when thelarche occurs without pubarche

- breast tissue without pubic hair

A

Androgen insensitivity

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21
Q
  • pubarche without thelarche

- pubic hair without breast development

A

low estrogen or excess androgens

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22
Q
  • white, odorless, mucoid discharge that precedes menarche by 3-6 months and can continue for several years
  • requires no intervention
A

Physiologic leukorrhea

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23
Q

-when secondary sexual characteristics appear before age 9 in males and 8 in females

A

Precocious Puberty

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24
Q 
Breast cancer
Coronary Artery Disease
Hepatic disease
Elevated
Lipids
Pregnancy
A

Absolute contraindications for OCPs

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25
Q
  • amenorrhea, obesity, hirsutism, and acne
  • LH:FSH >2.5, elevated androgens
  • Tx: wt loss, OCPs, spironolactone, metformin
A

Polycystic Ovary Disease

26
Q

-best study to order in a girl with breast development but no pubic hair

A

Karyotype

27
Q
  • female involved in heavy athletic training
  • menstrual cycles gradually become lighter then stop
  • low serum estradiol
  • increased risk for low bone density and osteoporosis
  • Tx: reduce training, stop smoking, calcium, increase calories
A

Female athlete triad

28
Q
  • crampy lower abdominal pain and pelvic pain that occurs with menses and is not due to other pelvic etiology
  • due to prostaglandins produced during the ovulatory cycle
  • Tx: NSAIDs
A

Primary Dysmenorrhea

29
Q
  • pelvic pain that occurs other times besides menstruation

- due to underlying pelvic pathology

A

Secondary dysmenorrhea

30
Q
  • recurrent nightmares, fear of being alone, diminished interest in school, decreased appetite
  • lower abdominal pain and vaginal discharge
A

PTSD

31
Q

-top 3 leading causes of death in teens

A
  1. MVA/accidents
  2. Homicide
  3. Suicide
32
Q
  • distorted body perception
  • weight 15% below expected
  • intense fear of gaining weight
  • absence of 3 consecutive menstrual cycles
  • excessive exercise, use of diuretics, depression
A

Anorexia Nervosa

33
Q
  • binging and purging
  • salivary gland enlargement
  • dental enamel erosion
  • calluses over knuckles
  • low K, Cl, metabolic alkalosis
A

Bulimia Nervosa

34
Q
  • failure of outpt Tx
  • dehydration
  • EKG abnl
  • Mallory Weiss tears
  • Suicidal ideation
A

Indications for hospital admission for eating disorders

35
Q

-which electrolyte abnl are eating disorder pts at risk for during refeeding

A

hypophosphatermia

36
Q

-tx for trichomoniasis

A

Metronidazole 2g po x1

37
Q
  • rash, joint/tendon involvement, meningitis, endocarditis
  • Dx: gram stain with intracellular gram negative diplococci
  • Tx: CTX and Azithro
A

Disseminated gonococcal infection

38
Q
  • lower abd or pelvic pain
  • uterine or adenexal tenderness or CMT
  • WBC in vaginal secretions
  • temp >101F
  • elevated ESR or CRP
  • lab evidence of GC/CTT at cervix
  • vaginal discharge
A

PID

39
Q

-outpatient treatment for PID

A

Ceftriaxone 250mg IM x1 and

Azithromycin 1g po x1

40
Q

-if pain persists after treatment for PID, must obtain an US to look for this complication

A

Tubo-ovarian abscess

41
Q

-what size ovarian cyst would need laproscopic aspiration

A

6mm or causing significant discomfort

42
Q
  • RUQ pain that radiates to the right shoulder, nausea
  • US will be negative
  • Dx: pelvic exam
  • Tx: same as for PID
  • pain should resolve 2 days after treatment
A

Fitz Hugh Curtis

43
Q

-when is parental consent not needed?

A
  • life threatening emergencies
  • sexual assault services
  • medical care during pregnancy and family planning
  • std treatment and testing
  • substance abuse treatment
44
Q

-a person under legal age who is no longer under their parent’s control and regulation who is allowed to give informed consent instead of the parent

A

Emancipated minor

45
Q
  • low self esteem and coping skills
  • alienation from conventional norms
  • homosexuality
  • use of performance enhancing drugs
A

Risk factors for drug abuse

46
Q

How long can marijuana can be detected in the urine?

A

5 days for single use
10 days for chronic use
1 month for daily use

47
Q

How long can short acting and long acting barbituates be detected in the urine?

A

24 hours

1 week or longer

48
Q
  • causes drowsiness, decreased inhibition, and light-headedness, ataxia, and disorientation
  • muscle weakness, nystagmus, and loss of coordination
  • asphyxia, cardiac arrhythmia, and aspiration, leading to death
  • chronic use leads to encephalopathy
  • MC in lower SEC groups and Hispanic and Native Americans
A

Inhaled hydrocarbons

49
Q
  • tachycardia
  • tremulousness
  • HTN
  • mydriasis
  • euphoria and overconfidence
  • agressive and violent behavior at high doses
A

Cocaine

50
Q
  • combative behavior and agitation

- tremulousness is not common

A

Alcohol

51
Q
  • characterized as a “quick drunk” with disinhibition and agitation
  • hallucinations, generalized muscle weakness and nystagmus
A

Volatile hydrocarbons

52
Q
  • agitation w/o tremulousness or tachycardia
  • depressed sensorium, resp depression, miosis, indifference to pain, euphoria
  • hypotension, low temp, constipation, urinary retention
A

Opiates

53
Q
  • combative, tachycardia, mydriasis

- NO nystagmus

A

Amphetamines

54
Q
  • combative
  • vertical and horizontal nystagmus
  • muscle rigidity
  • normal pupils
  • distortion of body image, paranoia, hallucinations
  • tachycardia, HTN, increased DTRs
  • miosis, flushing, and diaphoresis
  • can lead to rhabdo, then renal failure
  • Tx: do not acidify urine or use physical restraints
  • Tx: cooling blanket, chemical restraints
A

PCP

55
Q

-memory loss, decreased reading comprehension, and poor interpersonal skills

A

Behavioral consequences of marijuana use

56
Q
  • dry mouth
  • dilated pupils
  • drowsiness
  • distortion of time
A

Acute effects of marijuana use

57
Q
  • ataxia, slurred speech, visual disturbance, vomiting, nausea, sluggish pupils, excessive sweating, flushed skin, hypoglycemia
  • irritability, stupor, and coma
A

Alcohol intoxication

58
Q
  • circulatory collapse
  • coma
  • hypertensive crisis
  • seizure
  • elevated temp
  • cerebral hemorrhage
  • arrhythmias
A

Amphetamine abuse

59
Q

-anxiety, poor school performance, rhinorrhea, insomnia, stomach cramps

A

Opiate withdrawal

60
Q
  • sleepiness and sedation

- pupils are slow to react but normal size

A

Benzo abuse

61
Q

-alertness, muscle relaxation, enhanced memory and alertness, decreased appetitie, decreased irritability

A

Physiologic effects of nicotine

62
Q
  • giggling, slurred speech, and ataxia

- death from asphyxia or arrhythmia

A

Organic solvent abuse

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