Patient Management > FINAL- Adolescent > Flashcards

FINAL- Adolescent Flashcards

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1
Q

What is the parent-level intervention that improves communication about sex?

A

Families Talking Together (FTT)

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2
Q

What school-level program connects adolescents to sexual/reproductive healthcare?

A

Project Connect

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3
Q

What community-level intervention reduces alcohol, tobacco, and delinquency?

A

Communities That Care (CTC)

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4
Q

What policy-level intervention reduces fatal crashes among teen drivers?

A

Graduated Driver Licensing (GDL)

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5
Q

What is the recommended weekly PE time for adolescents?

A

225 minutes

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6
Q

What are the four ACA provisions relevant to adolescent health?

A

Insurance coverage, Medical home, Preventive services, Transition to adult care

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7
Q

What are the five principles of youth-friendly health care?

A

Availability, Appropriateness, Accessibility, Approachability, Acceptability

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8
Q

What types of care can minors consent to under many state laws?

A

STI treatment, mental health, substance use, reproductive/contraceptive care

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9
Q

Name three risk factors for perpetration of teen dating violence.

A

Trauma symptoms; antisocial behavior/substance abuse; attitudes accepting violence.

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10
Q

What family-related risk factors increase likelihood of TDV?

A

Harsh or inconsistent parenting, lack of supervision, lack of warmth.

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11
Q

What is the Safe Dates program?

A

9-session curriculum + activities that reduced psychological, physical, and sexual violence perpetration.

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12
Q

What is The Fourth R program?

A

21-session health class curriculum focusing on safety, sexuality, and substance use; effective for boys in reducing violence and increasing condom use.

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13
Q

What is the CDC’s Dating Matters program?

A

A free 60-minute online training for educators/providers to prevent teen dating violence.

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14
Q

Which eating disorders are listed in DSM-5?

A

Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Pica, Rumination Disorder, Avoidant/restrictive intake, Night Eating Syndrome.

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15
Q

What are the three main diagnostic criteria for Anorexia Nervosa?

A

Restriction of energy intake → low body weight; intense fear of weight gain; distorted body image.

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16
Q

How is severity of Anorexia Nervosa determined?

A

By BMI: Mild ≥17, Moderate 16–16.9, Severe 15–15.9, Extreme <15.

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17
Q

What are the diagnostic criteria for Bulimia Nervosa?

A

Binge eating + compensatory behaviors ≥1/week for 3 months; body image disturbance.

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18
Q

How is severity of Bulimia Nervosa classified?

A

By compensatory episodes/week: Mild 1–3, Moderate 4–7, Severe 8–13, Extreme 14+.

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19
Q

How is severity of Binge Eating Disorder classified?

A

By episodes/week: Mild 1–3, Moderate 4–7, Severe 8–13, Extreme 14+.

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20
Q

What individual risk factors increase likelihood of eating disorders?

A

Body image issues, perfectionism, impulsivity, mood dysregulation, athletic pressure.

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21
Q

What are validated assessment tools for eating disorders?

A

SCOFF questionnaire (Sick, Control, One stone (14-15 lbs), Fat, Food), EAT-26, Yale-Brown-Cornell Eating Disorder assessment.

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22
Q

What therapeutic approaches help in treatment?

A

Motivational interviewing, family collaboration, team-based care.

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23
Q

What are causes of delayed puberty without short stature?

A

Constitutional delay (most common), acquired/isolated gonadotropin deficiency, gonadal disorders, androgen receptor defects, chronic diseases.

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24
Q

What are causes of delayed puberty with short stature?

A

Constitutional delay with short stature, panhypopituitarism, congenital syndromes, glucocorticoid excess, chronic diseases.

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25
What physical exam findings are assessed in delayed puberty?
Nutritional status, body measurements, SMR, thyroid, chest, heart, abdomen, pelvic, neuro exam.
26
What labs are included in initial delayed puberty evaluation?
CBC, UA, ESR, CMP, bone age, TSH, T4, IGF-1, LH/FSH.
27
What advanced tests may be needed in delayed puberty evaluation?
Karyotype, celiac panel, pelvic US, gonadotropins, GH, GnRH stimulation test, hCG test.
28
What are required features of constitutional delay?
Negative ROS, good nutrition, ≥3.7 cm/yr growth, normal PE, normal labs, bone age delayed 1.5–4 yrs.
29
What are causes of short stature without pubertal delay?
Familial short stature, GH deficiency, hypothyroidism, congenital syndromes, IUGR (Intrauterine Growth Restriction), skeletal disorders, chronic illness, HIV.
30
What are causes of short stature with pubertal delay?
Constitutional delay, panhypopituitarism, Turner’s, hypogonadotropic syndromes, glucocorticoid excess, chronic illness.
31
What are key evaluation elements for short stature?
Pregnancy/birth history, growth history, family/diet history, PE including SMR (Sexual Maturity Rating), thyroid, congenital stigmata, labs including bone age and thyroid.
32
What are causes of tall stature?
Constitutional tall stature, GH excess, anabolic steroids, adrenal/gonadal tumors, CAH (congenital adrenal hyperplasia), precocious puberty, hyperthyroidism, Marfan, NF (neurofibromatosis), hypogonadism in boys, androgen receptor deficiency, homocystinuria, Soto syndrome.
33
How is tall stature treated?
Hormone therapy (estrogen in females, testosterone in males) until epiphyseal closure, but only if adolescent is distressed; counseling may be preferable.
34
What is precocious puberty? Ages?
Development of secondary sexual characteristics earlier than normal. Male: before 9.5yrs Female: before 8yrs (7 white, 6 black)
35
What are the types of precocious puberty?
Isosexual, Heterosexual, Incomplete, Complete, True, Pseudoprecocious.
36
What history is important in precocious puberty evaluation?
Onset of puberty, intercurrent disease, drug use, family history, trauma, CNS radiation, behavioral changes.
37
What physical exam findings are assessed in precocious puberty?
Growth velocity, SMR, gonadal size, thyroid, pelvic/abdominal exam, neuro/ophthalmologic exam, stigmata like café au lait spots.
38
What is the key lab in precocious puberty evaluation?
Bone age; GnRH stimulation test if advanced.
39
How are incomplete forms of precocious puberty managed?
Usually self-limited, no treatment needed.
40
How is true precocious puberty managed?
Observe 6–12 months; if rapid progression, endocrine referral for possible treatment.
41
Definition of recurrent abdominal pain in adolescents?
3 or more separate episodes of pain over 3 months; common complaint; prevalence 5–10%; usually no specific organic cause.
42
Key differential diagnosis for abdominal pain in adolescents?
Functional abdominal pain, IBS, lactose intolerance, gynecologic conditions, musculoskeletal issues, hepatitis/pancreatitis, GI infections, referred pain, GI disease (PUD, IBD, SBO), systemic (DKA, sickle cell crisis).
43
Workup for abdominal pain in adolescents?
History, PE, growth charts, abdominal exam, systemic signs, labs (CBC, ESR, UA, BMP, LFTs), stool/H. pylori/KUB if indicated.
44
Treatment of functional abdominal pain?
Reassurance; treat underlying condition if organic cause identified.
45
Most common differential diagnoses for chest pain in adolescents?
Musculoskeletal (strain, costochondritis, Tietze’s), psychogenic (stress, hyperventilation, depression), pulmonary (asthma, pneumonia, PE), GI (GERD, PUD, gastritis), trauma, breast lesions, cardiac (MVP, pericarditis, myocarditis).
46
Red flag features for chest pain?
Pain precipitated by exercise, interferes with sleep, dyspnea, palpitations, dizziness, syncope.
47
Red flag headache presentation?
Single, very severe acute headache (possible organic disease).
48
Differential for acute severe headache?
Febrile: meningitis, brain abscess, sinusitis. Afebrile: SAH, intracerebral bleed, post-seizure, severe HTN, acute dental/orbital disease.
49
Management of school phobia?
Explore fears privately, advise parents/adolescent, consider SSRI for GAD if warranted.
50
Evaluation for academic problems?
History (interview parents/adolescent separately), PE (growth, nutrition, neurological), diagnostics (hearing, vision, cognitive testing, achievement tests, LD analysis, neuropsychological tests, ADHD/psychopathology/family screens).
51
What defines a learning disability?
Discrepancy of ≥2 SD between IQ and achievement test scores.
52
Legal framework for learning disabilities?
IDEA Act (testing + services funded), Section 504 (reasonable accommodations, no funding), ADA (extends protections, no funding).
53
DSM-IV diagnostic criteria for ADHD?
Inattention and/or hyperactivity symptoms since age 6–7, impairment in ≥2 settings, significant impairment in functioning, not explained by other disorders.
54
Comorbidities of ADHD?
Oppositional defiant disorder, conduct disorder, learning disabilities, mood/anxiety disorders, substance abuse, risky driving/sexual behavior, poor family relations.
55
Key features of early adolescence (11–14)?
Growth spurt, sexual maturation, anxieties about genital size, independence-dependence struggle, emotional lability, peer group importance, daydreaming, testing authority, need for privacy, lack of impulse control.
56
Key features of middle adolescence (15–17)?
Stronger identity, peer conformity, body image concerns, dating/sexual experimentation, intense peer involvement, increased intellectual ability, feelings of immortality.
57
Key features of late adolescence (18–21)?
Adult body form, firm identity, stable relationships, independence, realistic vocational goals, refined values, ability to delay gratification, focus on intimacy and future commitments.
58
Key elements of adolescent-friendly health services?
Comfortable, confidential, safe space; respectful communication; screening for high-risk behaviors; cultural/gender/SES sensitivity; accessible, affordable, adolescent-focused, interdisciplinary, flexible, comprehensive, continuous care, support for transition to adult care.
59
What does HEEADSSS stand for?
Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/Depression, Safety (+ Strengths, Spirituality).
60
How does strengths-based interviewing help?
Identify resilience, past successes, give positive feedback, build trust, provide balance in sensitive discussions.
61
What are the main legal issues in providing care to minors?
Consent (who gives it), confidentiality (who controls info), payment (who pays).
62
What rights do adolescents have per constitutional law?
1967 In re Gault: constitutional rights incl. free speech, due process. 1976 Carey & Danforth: right to privacy incl. contraception and abortion.
63
Who has the right to a minor’s confidential information?
Legally the parent/guardian, but adolescent assent should be recorded along with parental consent.
64
Definition of scoliosis?
Lateral spinal curvature ≥11° with rotational component.
65
Difference between structural and nonstructural scoliosis?
Structural: curve does not correct with side bending (idiopathic, congenital, neuromuscular, misc). Nonstructural: curve corrects with side bending (postural, hysterical, nerve irritation, inflammatory, leg length discrepancy).
66
Evaluation for scoliosis?
Annual screen age 10–16; exam for neuromuscular, cardiopulmonary, skin, LE abnormalities; back symmetry; standing/bending test. Diagnostics: AP/lateral radiographs, MRI if left thoracic curve or neuro findings.
67
History elements for scoliosis evaluation?
Age, pain, cardiopulmonary/neurologic symptoms, PMH/PSH, developmental milestones, family history of spine issues, prior diagnoses.
68
Treatment options for scoliosis?
Observation, bracing, surgery, exercise.
69
Definition of true kyphosis in adolescents?
Not poor posture; Scheuermann Disease = rigid thoracic/thoracolumbar kyphosis that does not correct with hyperextension, due to anterior vertebral wedging.
70
Differential for kyphosis?
Infectious spondylitis, compression fractures, congenital kyphosis type II, juvenile ankylosing spondylitis, osteodystrophies.
71
Treatment for kyphosis?
Exercise, bracing, spinal fusion.
72
Definition of sudden cardiac death in athletes?
Non-traumatic, unexpected cardiac death within 1 hr of symptom onset. Rare, often asymptomatic before death, more common in boys in football/basketball.
73
Common causes of SCD in young athletes?
Hypertrophic cardiomyopathy, Marfan syndrome, arrhythmias, myocarditis, commotio cordis.
74
Key history questions for PSE?
Past injuries, concussions/LOC, exclusions, chronic illnesses, surgeries, allergies/asthma, meds/supplements, tetanus status, menstrual history, weight changes, FHx of premature death/heart disease, personal cardiac history (murmur, HTN, fatigue, syncope, SOB, chest pain).
75
Key physical exam elements for PSE?
Height/weight, BP/pulse, vision, skin, dental; cardiac auscultation (supine/standing/squatting), femoral pulses, murmurs/clicks/rubs; ortho exam (symmetry, scoliosis, joints, ROM); abdomen, male genital exam.
76
How do peer relationships evolve across adolescence?
Early: same-sex intense friendships; Middle: conformity, sexual experimentation, peer importance; Late: peer group less important, more intimate relationships.
77
How does identity develop across adolescence?
Early: fantasy, idealistic goals, lack impulse control; Middle: intellectual growth, risk-taking; Late: realistic goals, refined values, compromise.
78
Key nutrition concerns in adolescence?
Overweight prevalence 12.7–24% (likely higher now), iron deficiency 0.6–7%, pregnant teens often deficient in protein/vitamins/minerals.
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