Adolescent Flashcards
(49 cards)
Menarche in 95% of adolescents at what age range?
11-14.5
What % of girls are anovulatory in 1st year?
50%
By 3rd year after menarche, what percentage are ovulatory?
95%
How much blood loss
30ml/month
Define primary amenorrhea
No menarche by 16
No menarche if Tanner 5 for >1year
No menarche by 5yrs after breast development
Absence of menses
amenorrhea
Infrequent bleeding >45 day interval
Oligomenorrhea
Prolonged >7days excessive bleeding (80ml) bleeding at regular intervals
Menorrhagia
Bleeding at irregular but frequent intervals
Metorrhagia
Prolonged bleeding at irregular intervals
Menometrorrhagia
Define characteristics of abnormal vaginal bleeding
> 80cc loss, >frequent than 20 days, associated with anemia, if at menarche –> leads to transfusion, hospitalization or if other signs of bleeding, need to work up for bleeding
How do you work up abnormal vaginal bleeding
assess blood loss, evaluate need for surgical intervention/hospitalization, determine etiology and CBC, preg test, PT/PTT
Causes of dysmenorrhea?
endometriosis, chronic pelvic pain, DUB, painful defecation, dysparneuim, PID, benign uterine tumors, polyps, fibroids, IUD, abormality in anatomy.
What is dysmenorrhea and Rx for it
Painful period, NSAIDS, oral contraceptives
Rx of anorexia nervosa
Target co-morbid symptoms of depression/anxiety; may not be as effective in severely malnourished patients, maybe neuroleptics
Rx bulimia nervosa
SSRI, SNRI, TCAs, topiramte, aim for 50% BMI
What are the weight and diet based criteria for hospital admission for anorexia nervosa?
- 75% ideal body weight or ongoing loss
- Refusal to eat
- Body fat <10%
What are the vital sign based criteria for hospital admission for anorexia nervosa?
- HR <50 beats/min daytime; <45 beats/min nighttime
- Systolic bp <90mm Hg
- Orthostatic changes in pulse 30 beats/min or bp drop in systolic >10mm Hg
- Arrhythmia
- Temp <36.3 day and 36 at night
What are symptoms of bulimia that are criteria for hospital admission?
Syncope Esophageal tears Cardiac arrhythmias Hypothermia HR >110 supine Hematemesis Intractable vomiting Not responding to outpt therapy Suicide risk
What are lab work based criteria for hospital admission?
K <3.2mmol/L
Cl 88mmol/L
Hypophosphatemia
Emergency contraceptive can be given up to how many days
5 days
What is depa-provera made of
Progesterone only
What can estrogen cause
hypercoag, seizure, headaches
Screening of chlamydia/gonorrhea
screen for all high risk teens
