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Flashcards in CPS Adolescent 2 Deck (62)
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Which of the following dieting behaviours is most common amongst adolescents?
a) fasting, skipping meals, crash diets
b) self induced vomiting
d)diet pills
e) smoking cigarettes

a) is the answer

fasting, skipping meals, crash diets - 22-46%
cigarettes 12-18%
self induced emesis- 5-12%
laxative and diuretic use- 1-4%
diet pill 3-10%

all groups at risk for dieting, 36% of normal weight girl vs. 55/50% for obese/overweight girls


Which of the following is not associated with dieting behaviours in teens?
a) smoking
b)early puberty
c)lower SES

c) SES does not seem to affect, dieting in all groups

other important factors include psych, poor body image, poor family relationships/criticism of weight, certain sports, chronic illness including diabetes, substance use and unprotected sex; teasing, influence of friends, parents who diet.


Which of the following is not a consequence of dieting in teens?
a)reduced growth
b)heavy periods
c)iron and calcium deficiencies

b) menstrual irregularities, especially amenorrhea (secondary), even in absence of significant weight loss.


Which of the following is true of dieting for teens?
a) structured weight loss programs improve self esteem
b) helps with long term weight loss
c) important psychochological consequences
d) unrelated to eating disorders

c) distractilbe, irritable, fatigue

a) false - decreases self esteem
b)the opposite - can actually gain more weight long term
c) can be the antecedent - need to figure out this relationship better.

most teenage dieting no consequences

no evidence that commercial weight loss programs good for kids, paediatric obesity program might be helpful in some cases.


Which of the following statements is true?
a) UV radiation has a wavelength shorter than X rays
b) UV radiation is an invisible form of electromagnetic radiation
c) UVB and UVC contribute to darkening of skin
d) UV radiation is only carcinogenic when causing sunburn
e) Artificial UVR does not have any carcinogenic potential

b) true

a) false - UV is longer than X rays, shorter than visible light
c)false A (immediate darkening) and B (further darkening in the following days, activate melanocytes) contribute to skin darkening
d)false stimulate synthesis of melanin molecules. UVA - 315-400 UVB 280-315 UVC 100-280.
can be carcinogenic without causing sunburn

damages DNA, can cause mutations, erythema and sunburn are acute reactions
e) impossible to remove all carcinogenic potential from UVR


Which of the following does not increase the risk of cutaneous malignant melanoma?
a) light skin, freckles,
b) second degree relative with CMM
c) multiple moles
d)easy to burn skin

b) 1st degree relative increases risk, or personal history of CMM

red or blond hair colour perhaps more associated than skin type
lots of typical/atypical nevi
UVR contributes to immunosuppression, which increases risk of CMM


Which of the following statements is false?
a) CMM is the most common skin cancer
b)CMM incidence rates have increased significantly
c) few treatments for metastatic disease
d) Incidence of CMM is 15.2/100000

a) false, not most common but most deaths (75%)

rest true
increased in past 35 years
some advances in treatment but still not lots of treatment for metastatic disease


Which of the following is least likely to be related to the reason for increased CMM rates?
a) increased sun seeking behaviour
b)decreased ozone layer
c) more tanning beds
d) changes in diagnostic criteria

d) changes in diagnostic criteria is likely less likely to be contributing than increased exposure to UV radiation, since mostly affects certain age and sex


Which of the following is not associated with increased use of tanning facilities?
a) not having a risk for skin cancer
b) extreme risk taking
c)poorer self esteem
d)unhealthy lifestyle choices
e) parental use of tanning facilities

a)even having a known risk factor for skin cancer doesn't influence use of tanning facilities
SES doesn't affect either

the rest ARE associated with increased use of tanning beds
individual sports -

approx 1/4 of kids 13-19 have used tanning beds, doubles by age 14-15 then again at age 17


Which of the following is not linked?
a) ever tanning indoors and CMM
b) early life exposure to tanning indoors and CMM
c) early life exposure and squamous cell carcinoma
d) number of years of tanning and total hours tanning and CMM

c) false - early life exposure and basal cell carcinoma, chronic total exposure is more related to SCC BCC and SCC also linked to UVR, chronic/total exposure linked to SCC
SCC 25% of skin cancer deaths, non melanocytic
tanning beds increase SCC chance by 2.5 and BCC by 1.5

the rest are true

begin indoor tanning before age 35, 75% increased risk of CMM
WHO lists as potential carcinogen


Which of the following is not a risk of artificial tanning?
a) erythema/sunburn
b) photodrug reactions
c) acne
d) infections

c) acne is not, the others are
also get aging of skin around eyes etc.

1/4 demonstrate adverse health effect

can get addicted to tanning since it simulates endorphins, can get withdrawal


Which of the following is false of vitamin D?
a) conclusive evidence that vitamin D helps bone health
b) UV radiation is not a great source of vitamin D
c)may influence risk of DM1
d) conclusive evidence that it influences risk of cancer

d)false, only conclusive evidence for bone health, need to study relationship with MS, cancer, heart disease, glucose dysregulation, as well as how in prenatal period influences DM1 risk

a)true - only conclusive evidence that helps with bone health
b) not a great idea, lots of DNA damage as well as vitamin D

exposure is complicated by skin colour, amount of skin exposed, wavelength and degree of deficiency
articificial tanning further complicates the matter, intensity and variability of UVA and UVB


Which of the following was a not a stipulation of the Cancer Society to tanning salons?
a) stop linking indoor tanning to benefits of vitamin D
b) pay a monetary penalty of 62500
c) acknowledge in promotions that tanning is not needed for vitamin D
d) not market to teenagers

d) the other 3 were stipulations by the Cancer Society


Which of the following is not part of the legislation for tanning in Canada?
a) banned in Vancouver Island for children

is not banned in Canada, but working on legislation that bans them. should be prohibited for kids


Which of the following statements is false?
a) students with a disability are more likely to be physically abused
b)more likely to be sexually abused
c) emotionally abused
d)all of the above


BC study showed that 2x more likely to be physically abused (31% vs. 15%), sexually abused 19% vs 7%, 3x more likely to experience both physical and sexual abuse (12% vs 4%)


Which of the following factors is likely not related to the increased probability of sexual abuse for disabled youth?
a) sex education in institutions and homes
b) decreased self-expression
c) viewed to be hypersexualized
d) low level of privacy

a) the opposite, these kids will have less of the sex education, makes them more vulnerable.

can be seen hypersexualized or less sexualized.

also vulnerable because of cognitive and other delays, harder to resist abuse/report abuse.


Which of the following is not a likely a red flag for sexual abuse in the population of young people with chronic condition or disability?
a) unexplained UTI
b) sexual activity with peers
c) unexplained fear of physical exam
d) encopresis

b) not as likely, sexual activity with age inappropriate partners more likely a red flag for sexual abuse

other risks
unexplained UTI
STIs, vaginal/anal trauma, running away from home, sexually abusive behaviour towards others, somatic complaints with no organic cause.


Which of the following is true of disclosure of sexual abuse in children with disability and/or chronic conditions?
a)the physician should lead the investigation
b)likely to be believed by police
c) most interpreters are trained in sexual vocabulary
d) should be conducted using the patient's preferred communication method

d) - i.e. sign language, computer programs etc.
should advocate to have more training for interpreters in sexual vocabulary/language
The augmentative communication community partnerships Canada (lots of info) on website

the others are false - physician not job to investigate, one study showed disabled women less likely to be believed, more likely to be seen as promiscuous.

need to explain mandatory reporting.


Respect for privacy for teens can be modelled in all but which of the following ways?
a) draping for physical exam
b)using rewards for cooperating
c)chaperoning of physical exam and procedures
d) promoting institutional culture of patient privacy

b) using rewards or consequences for cooperating is not a good idea, can make it harder for young people to identify abuse

quick intervention if abuse occurs, work with institutions to identify abuse, anticipatory guidance on sexuality in youth, to help identify risks etc.


Which of the following statements is false?
a) The age of consent in Quebec is 14
b) The age of consent in Ontario is 16
c) Dedicated adolescent units are a better option for most teens
d) Minority and Aboriginal teens may have more difficulties than their peers when hospitalized

b) The Age of Consent law : consent for medical treatment depends on mental capacity, not age.
Quebec - age of 14, everywhere else, not based on age
most teens will chose to work in collaboration with their parents or another important figure in their life to make health care decisions.

the rest true - dedicated teen units better option, not realistic for Canada, teens often don't fit in, loss of privacy, loss of cultural support, should offer translator, encourage family support etc. , also risk of adolescent specific issues getting missed when non adolescent units/working with people that are not trained in adolescent issues.


Which of the following has not been reported to be associated with teens living with a chronic condition?
a) increased depression
b)increased social problems
c) lower unemployment rates as adults
d) increased stress

c) is the answer, actually reported to have higher unemployment as adults

15% of youth in N.A have chronic health condition

increased stress with death, school concerns, the future; some do repot being emotionally healthy, better perspective/maturity on life

need to address sexuality - effect of condition on sexuality, how pregnancy would be affected by their disease/treatment


Which of the following statements is true?
a) children with cognitive disabilities should be let out of transition programs
b) important to teach skills of negotiation and communication that are needed in the adult system
c) preparation for transition should not occur prior to adolescence
d) community health clinics are not useful for youth with chronic health conditions

b) important to teach these skills as the teen approaches the age where they need to start transitioning, important to know the services

the rest false
a) actually more important for these kids
c) false, should start in childhood, families need to be informed participants, increase the amount of info as child enters adolescence.
d) these clinics a great resource


Which of the following is not part of the on-track program for transition?
a) typically start around age 14
b)educational, vocation and personal planning
c) health active living
d) foster personal autonomy and independence

a) false, start around age 10-12 for discussion about transition

the rest are true

additional strategies, talk to teens alone, teach them to present history, ask questions and advocate for themselves (helps to transition from family centred multi d to patient lead care, group meetings, certificate of transition, acknowledge graduation. educational materials. transition should work at the youth's pace. tools online include my health passport, others in the website


How many children diagnosed with a chronic health condition may reach the age of 20 years?
a) 80%
b) 88%
d) 98%

d) now it's 98%


Which of the following statements is false?
a) teens with chronic health conditions more likely to be sexually abused
b) students with a chronic health condition can have poor attendance at school, as much as 30% in one study
c) sexual activities in teens with chronic health conditions may be higher than their healthy peers
d) teens with chronic health conditions are less likely to have an STI than their healthy peers

d) false, more likely to have an STI than peers, the rest are true


Which of the following conditions does not cause premature pubertal development?
a) Turner syndrome
b) cerebral palsy
c)spina bifida
d) McCune albright syndrome
e) Neurofibromatosis

a) Turner causes delay

the others can cause precocious puberty.
CF can cause sterility, as well as certain spinal cord lesions and cancer in men


Which of the following conditions does not contradict combined OCP?
a) diabetes
b) cyanotic heart disease
c) asthma
d) liver disease
e) post transplantation

c) is the answer, the others may contraindicate the use of contraception

need to warn teens of risks of contraception and risks of pregnancy in their case

(not from statement directly)
cardiac contraindications to estrogen containing contraception
- pulmonary hypertension
- artificial valves
- cyanosis
- certain arrythmias
-previous thrombosis

i think it's diabetes with end organ findings not all diabetes ?

gyne exam in sexually active only, external exam in all
also take care of pain control, don't underestimate it.


Which of the following is true?
a) youth in custodial facilities are governed by federal government
b) more youth in custody have required medical attention than youth not in custody
c) if a child is sent to an adult court, they no longer retain the rights of the child
d) while in custody, the institution does not have a role in providing health care for individuals

b) true

a) false governed by provincial government
c) false, they are judged as an adult but retain the rights of a child in their province
d) false, they are obliged to pay attention to health problems

common problems: skin conditions, URTI, STIs, contraception, pregnancy, mental health/violence, substance abuse, respiratory, dental, endocrine and urological problems.

a high percentage of people in facilities need physical or mental health care 23-50%


Which of the following statements is false?
a) an advisory committee should set the health policies in custodial facilities
b) larger custodial facilities should have a physician on site
c) the health program in facilities must be lead by a health care professional
d) smaller custodial facilities should consult a physician in a community clinic

c) in smaller settings, does not need to be a health care professional if not available, do need a designated staff member to oversee the health policy

the rest true
a) can be on or offsite, includes a team, in smaller settings may be a consultant group
larger sites should consult a physician


Which of the following is not a symptom of opioid withdrawal?
a) myalgias
g) autonomic instability

b) is not, the rest are, rarely can also have cardiac etc.

benzo withdrawal - at risk of seizures, need medically supervised setting

need health assessment within 72 hours, medical history and physical as well as mental health assessment, record a plan on the chart to ensure that it is carried out, tell the youth +/- family as they consent