General Flashcards
(42 cards)
Tanner stage for PH in girls
- nil
- sparce along labia - mean 11.7
- darker and coarser. curls. over pubes - mean 12.4
- as adult but sparse and NO spread - mean 13
- spreads to medial thighs - 14.4
Tanner stage of breast
- nil
- breast tissue palpable under areola - 11.2
- BT beyond areola - 12.2
- secondary mount - 13.1
- areola and BT form smooth contour - 15.3
tanner stage in boys1
- all same size. no PH. Testicle size is less than 3 ml and max length 2 cm
- scrotum and testes enlarge. redning of scrotum. sparse hair at base. - mean 11.4
- elongation of penis. more hair. mean 12.9
- enlargement of the penis. Dev of glans. testicular enlarg. almost adult PH but NO spread. Mean 13.8
- adult. Testicles 12-18 ml or 4-5 cm. hair spreads. Mean 14.9
Amenorrhea def
primary - if nil by 16 (if have breast dev or 14 if have no breast dev)
secondary - if nil for 3 cycles or 6 month
Definition of Yeast vaginitis
increased white DC
PH < 4.5
vulvar itching
Rx fluconazole or clotrimazole vaginal supp
Def of trichomoniasis
yellow green DC, smells bad
PH >5
Itching and inflammation
Dx with seeing motile trich on saline prep
Rx metronidazole x1 or 7 d and treat PARTNER
def of bacterial vaginosis
Diagnosis need 3/4:
- white-gray DC coats vaginal wall
- Whiff test - add 10 % KOH and get fishy smell
- PH > 4.5
- > 20 % clue cells
RX - PO or Top flagyl or Clinda.
no need to treat partner
How do you approach smoking cessation
Ask, Advise, Assess, Assist, and Arrange
If ready - can do nicotine supp and behavioural therapy
bupropion are not approved for use under 18 yr old
What stage of adolescent:
- worried about how they look compared to others
- prefers to hang out with same sex
- concrete thinking, don’t think about the future
early ado 10-13 yrs
What stage of adolescent:
- mood swings
- operational thinking
- narcissistic and feel invincible
- fight with parents
mid ado 14-16
What stage of adolescent:
- think about future
- less self centred
- solid concept of right and wrong
late ado - abstract thinkers 17 and older
Risk factors for suicide
Mental health issues ie DEPRESSION, BP, anxiety…
(Among boys, conduct disorder and substance use convey increased risk)
Stressful situation or loss history of acting out behavior ie promiscuity, delinquency living out of the home (ie in correctional institute or group home) history of physical or sexual abuse Males Access to firearms Past suicide attempt Exposure/FHx Bullies/being bullied Substance abuse
Absolute contraindication to OCP
Pregnancy Undiagnosed genital bleeding Breast cancer Past or present circulatory disease (for example, arterial or venous thrombosis, ischemic heart disease, and cerebral hemorrhage) Thrombophilia Pill induced hypertension Migraine with aura Active liver disease, cholestatic jaundice, Dubin-Johnson syndrome, acute porphyria Systemic lupus erythematosus Hemolytic-uremic syndrome Thrombotic thrombocytopenic purpura
Electrolyte abnormalities with refeeding syndrome
- hypophosphatemia after the cellular uptake of phosphate during the 1st week and can produce weakness, rhabdomyolysis, neutrophil dysfunction, cardiorespiratory failure, arrhythmias, seizures, altered level of consciousness, or sudden death.
- hypokalemia
- hypomanesemia
- hyperglycemia
- thiamine defi
What are the complications of Low PO4?
At levels of ≤0.5 mmol/L can produce weakness, rhabdomyolysis, neutrophil dysfunction, cardiorespiratory failure, arrhythmias, seizures, altered LOC, or sudden death.
PID diagnosis - minimum criteria and routine
- lower abd pain
- adenexal tenderness (bilateral or unilateral)
- cervical motion tenderness
Routine criteria
- oral temp > 38.3
- abn vag/cx/ d/c
- ESR or CRP
- lab documentation of NG or Chlamydia
Treatment of PID
Outpatient:
cetriaxone 250 mg IM x1
+ doxy 100mg BID 14 d
In pt:
Cefoxitin 2g IV q 6 hrs +
Doxycycline 100 mg IV OR po q12 hrs
What is PID
group of inf in upper genial tract - endometritis, salpingitis, Tubo-Ovarian Abscess, pelvic peritonitis
Which drugs affect the efficacy of OCP?
- AED - EXCEPT VPA!!!!!
(2. Rifampin
3. Fluconazole, Griseofulvin, Itraconazole, Ketoconazole, Ritonavir
St John’s Wort (results in breakthrough bleeding)))))
Which drugs have their efficacy decreased if taken with OCP
Lorazepam (Ativan)
Oxazepam
Salicylates
Which AED affect OCP
All Except - VPA, Gabapentin, Keppra, Lamotrigine
Side effects of anabolic steroids
endo - male get testicular atrophy, oligspermia, gynecomastia. females - amenorrhea, breast atrophy, cliteromegaly
MSK - prem epiphyseal closure
Derm - Acne, hirsutism, striae, male patern baldness
Hepatic - impaired excretory fct - cholestatic jaundice, elevated LFT, hepatitis, benign and malignant tumours
CVS - HTN, low HDL, thrombosis
Psych - aggressive, moody, depression
Signs of recent Marijuana use
Conjunctival injection, tachycardia, HTN hypothermia. Alteration in perception , hallucination, paranoia, short term memory loss, poor performance with decrease attention span, increased appetite. Decrease sperm count and anovulation
Risk factors for HPV infections
sexual activity # of partners early age of 1st intercourse never married never pregnant STI immunosuppressed
