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Studying > CPS statements - Adolescent > Flashcards

CPS statements - Adolescent Flashcards

1
Q

4 ways to calculate target goal weight in anorexia nervosa

A
  1. return on menstruation weight + 2kg
  2. median BMI (50th percentile BMI for age and sex)
  3. premorbid growth percentiles
  4. based on weight at same percentile as height percentile
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2
Q

Effects of cannabinoids on adolescent brain

A
  1. impacts on frontal cortex
  2. impacts on dopaminergic systems involved in maturation of cortical neuronal networks (toxic changes to neurons)
  3. structural changes including lower brain volumes
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3
Q

Cannabis withdrawal syndrome

A
  1. Experiencing at least 2 of 5 psycholgoical sx :
    - irritability
    - anxiety
    - depressed mood
    - sleep disturbances
    - appetite changes
  2. Experiencing at least 1 physical sx:
    - abdo pain
    - shaking
    - fever
    - chills
    - headache
    - diaphoresis
  3. heavy use
  4. sx occur 24-72 hr after last use and persist for 1-2 weeks up to 1 month
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4
Q

Counselling for cannabis

8 As

A
  1. Assure confidentiality
  2. Ask about cannabis
  3. Answer questions
  4. Assess impacts
  5. Appraise willingness to change
  6. Assist with goal setting
  7. Arrange a follow up
  8. Acknowledge parental concerns when they arise
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5
Q

Tiers of contraception

A

1st tier: LARC e.g. IUD
2nd tier: hormonal = depend on consistent use
3rd tier: used at time of intercourse e.g. barrier

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6
Q

Hormonal contraceptions and bone

A
  • DMPA associated with decreased bone mineralizations

- pills with estrogen < 30 mcg associated with poorer bone mineralization

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7
Q

Estrogen containing contraceptives increase risk of VTE and stroke by how much

A

VTE: 2-4x

Stroke 1.5-2x

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8
Q

Starting contraception when to do pregnancy test

A
  • if starting contraceptive and not in first 7 days past menstrual period
    check it and then screen again in 21 days
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9
Q

Most important risk factors for unhealthy weight control behaviours

A
  1. dissatisfaction with weight
  2. obesity
  3. low self esteem
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10
Q

Risks of e-cigarettes

A
  1. nicotine dependency
  2. risk for acute cardiac events (dripping –> larger bolus)
  3. asthma/bronchitis due to particulates in aerosol
  4. filler materials (propylene glycol and glycerin): mouth and throat irritation and dry cough
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11
Q

Family based therapy initial goal

A
  • slow weight restoration is initial goal
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12
Q

Youth are at risk for firearms-related injury because (RFs)

A
  • lack experience
  • lack cognitive development
  • lack impulse controle
  • incompletely developed self-regulation skills
  • cannot differentiate real from toy, understand consequences
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13
Q

Pathologic gambling

A

Impulse control disorder

  • persistent and recurrent maladaptive gambling behaviour
  • deleterious legal, financial, physical and psychosocial consequences
  • NOT better accounted by a manic episode
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14
Q

RFs for developing a gambling problem

A
  • depression
  • loss
  • abuse
  • impulsivity
  • antisocial traits
  • learning disabilities
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15
Q

Screen for gambling behaviours especially when…

A
  • parental concerns
  • academic performance is suffering
  • sleep problems
  • money/possessions go missing
  • substance misuse
  • impaired relationships
  • any comorbidities associated with gambling (substance use, conduct disorder, personality disorders, mood disorders)
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16
Q

Primary prevention vs. secondary prevention in adolescent behaviours

A

Primary prevention: discouraging the behaviour (e.g. delaying sex)
Secondary prevention: minimizing the consequences (e.g. using condoms)

17
Q

Children of adolescents are at risk for…

A
  • increased risk of prenatal death
  • increased risk of premature birth
  • increased risk of low birth weight
  • growth and development esp cognitive and speech and language delays
  • higher risk of accidental injury and neglect
  • challenges with behaviour and in school
  • higher risk of substance use, sexual activities, struggle acadmeically as teens
18
Q

Adolescent mothers at risk for

A
  • higher rates of mental health disorder
    -repeat pregnancy
  • substance use
  • IPV
    lower self-esteem
  • lower SES+income
  • lower educational attainment
  • lower social support
  • higher substance use, smoking and STI
19
Q

Factors increasing risk of abuse for youth with disabilities

A
  • institutions
  • Societal factors
  • educational factors
  • health care factors
  • disability-specific factors
20
Q

Street involved youth barriers to health care

A

Individual barriers: money, transportation, knowledge, drust of authrotiy figures, confidentiality,
Systems-levels; adult consent, health card, address, poorly coordinted services that are difficult to access

21
Q

Factors making teen more likely to quit smoking

A
  • older teenager
  • male
  • teen pregnancy and parenthood
  • scholastic success
  • team sport participation
  • peer and family support
  • CYP2A6 slow nicotine metabolicse
22
Q

Factors making teen less likely to quit smoking

A
  • nicotine addiction
  • mental health conditions
  • substance use
  • chronic illness
  • family stress
  • peer and family tobacco use
  • overweight/preoccupation with weight
  • developmental drive to experiment
  • fear of peer rejection
  • perceived lack of privacy and autonomy
23
Q

Interventions with strongest level of evidence for smoking cessation

A
  1. individual counselling
  2. motivational enhancement
  3. CBT
24
Q

Nicotine effect on adolescent brain

A
  • changes in neural connectivity in brain (e.g. emotional regulation)
  • higher risk for addiction
  • epigenetic changes that sensitize brain to other drugs
  • increase impulsiveity, decrease attention performance
25
Q

Evidence for SSRIs in adolescent depression and which drug

A
  • 40-70% response rates
  • best evidence for fluoxetine (and fluoxetine is only drug that showed evidence in < 12 yrs)
    (other options = sertraline, citalopram, escitalopram for older kids)
26
Q

SSRI side effects

A
  • GI symptoms
  • sleep changes
  • restlessness
  • appetite changes
  • sexual dysfunction
  • behavioural activation may occur (monitor for hypomania)
    rare SE: bleeding risk, SIADH, serotonin syndrome
27
Q

Serotonin syndrome toxicity symptoms

A

SHIVERS

  • shiver
  • hyperreflexia, myoclonus and ataxia
  • increased temp
  • vital sign instability
  • encephalopathic/
  • restless
  • sweating
28
Q

Citalopram specific side effects

A
  • dose dependent QT interval prolongation and risk of arrhythmia (for dosages > 40mg/day)
29
Q

SSRIs with evidence in anxiety for teens

A

similar effectiveness btw fluoxetine, fluvoxamine and paroxetine

30
Q

Non-medical issues addressed by transition care

A
  • emotional health
  • reproductive health
  • social impacts
  • employment/cognitive
31
Q

two core principles of transition planning

A
  1. start early in childhood (increasing levels of responsibility given to child)
  2. collaboration with adult HCPs
32
Q

Risk factors for increased risk of suicide

A
  • mental illness
  • prior deliberate self-harm or suicide attempt
  • impulsivity
  • precipitating factors
  • family factors
  • lack of connection to psychosocial support

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