Term
| Mid-Parental Height for Girls |
|
Definition
[(Father's height - 5in) + (Mother's height)]/2
Target height for the girl will be +/- 4 inches of that number |
|
|
Term
| Mid-Parental Height for Boys |
|
Definition
[(Mother's height +5 in)+ (Father's height)]/2
Target height for the boy will be +/- 4 inches of that number |
|
|
Term
|
Definition
>95th Percentile - Overweight
85th-95th Percentile - Risk for Overweight
<5th Percentile - Underweight |
|
|
Term
|
Definition
| Increase in function as it relates to the body AND mind; Includes: Gross motor, fine motor, cognitive (personal-social, language) |
|
|
Term
|
Definition
| A developmental screening tool for children from birth to 6 years; Tests 4 domains - Personal-Social, Fine motor adaptive, language, gross motor; Normed across sub-groups and cultures |
|
|
Term
| Parental Response Reports |
|
Definition
| Screening tools that provide good validity and promote parental involvement; Examples - Ages and Stages, PEDS, PDQ, M-CHAT |
|
|
Term
| What is Anticipatory Guidance? |
|
Definition
| Information for parents to facilitate optimal growth and development; Verbal, written handouts, the internet |
|
|
Term
| What are the 4 Domains of Anticipatory Guidance? |
|
Definition
| 1) Injury Prevention, 2) Violence Prevention, 3) Sleep Position - until 6 months, 4) Nutrition |
|
|
Term
| Components of a Prenatal History |
|
Definition
| Maternal age, illness, screening for blood type and STDs |
|
|
Term
| Components of an Antenatal History |
|
Definition
| Length of labor and rupture of membranes, Complications, APGAR scores |
|
|
Term
| At what age should kids have the opportunity to have an exam without a parent in the room? |
|
Definition
|
|
Term
| Diphtheria/ Tetanus/ Pertussis (DTaP) Vaccine |
|
Definition
| Diphtheria/ Tetanus-toxoids; All contain inactivated PT (toxin); 2 or more components; Same vaccine used for primary series; Efficacy of 80-85%; Given IM; Adverse Reactions - local rxn, fever |
|
|
Term
|
Definition
| 3 Vaccines; Conjugated Polysaccharide - Protein differs; Fever, local rxn; Given IM |
|
|
Term
|
Definition
PPV23 - polysaccharide, 23 valent vaccine, 95% of invasive disease, Poor response <2 years, high risk over 2 - HIV, sickle cell, asplenia;
PCV7 -polysaccharaide, conjugated vaccine, 90% protection, reduces nasopharyngeal carriage by 60-705;
Both are given IM |
|
|
Term
|
Definition
| Live, attenuated; 3 strains of virus; IgG AND IgA mucosal immunity; VAPP - 1 case/ 6.2 million doses |
|
|
Term
| Innactivated Polio Vaccine (IPV) |
|
Definition
| Higher IgG levels than OPV; No adverse effects; Given SC |
|
|
Term
|
Definition
| 2 vaccines in US; Recombinant DNA, single antigen; 95% protection after 2 doses; Given IM; Adverse effects - pain at site (29%), fever (6%) |
|
|
Term
|
Definition
| Live, attenuated virus; 95% protective after 1 dose; Adverse effects - fever 6-12 days after vaccination, rash in 5%, febrile seizures; Given SC |
|
|
Term
|
Definition
| Live, attenuated virus; Given SC; Adverse effects - fever, rash at site; Decreased incidence of shingles in vaccine recipients |
|
|
Term
|
Definition
| 2 Vaccines available - quadravalent capsular polysaccharide OR diphtheria toxoid-based protein conjugate; Given IM; Temporal relationship with Guillan- Barre |
|
|
Term
|
Definition
Inactivated Virus -Given SC, Split virus for children <12 years;
Live, attenuated virus - intranasal administration, age 5 and above, not for high risk patients |
|
|
Term
|
Definition
| Quadrivalent for 6,11,16,18; Virus-like particles; Given IM |
|
|
Term
|
Definition
| The affective relationship between an infant and the primary caregiver that develops over the first year of life; Two patterns - secure and anxious; 65% of infants demonstrate a secure attachment |
|
|
Term
| Effect of Cortisol on Development |
|
Definition
| Children with chronically high cortisol levels experience more developmental delays (cognitive, motor and social); Cortisol effects metabolism, immune function, and the brain |
|
|
Term
|
Definition
| A national health promotion and disease prevention initiative that addresses children's health needs in the context of family and community; Principles, Guidelines, Resources |
|
|
Term
|
Definition
| Responds to sound by blinking, crying, quieting, changing respiration, or showing a startle reflex; Fixates on human face and follows with eyes; Responds to parent's face and voice; Has flexed posture; Moves all extremities |
|
|
Term
|
Definition
| Responds to sound, human faces, parents' voice and face; Lifts head momentarily when in prone position; Has flexed posture; Moves all extremities; Can sleep for 3-4 hours at a time; Can stay awake for one hour or longer; Consolable |
|
|
Term
|
Definition
| Continues to eat exclusively breastmilk and/or infant formula until 4-6 months of age; Exceptions - added rice cereal for GERD, MCT oil for premies, water/juice for constipation |
|
|
Term
|
Definition
| Coos and vocalizes reciprocally; Attentive to voices; Interested in visual and auditory stimuli; Smiles responsively; In prone position, lifts head, neck and upper chest with support on forearms to 45 degrees; Some head control in upright position; Extensor and flexor muscles more balanced |
|
|
Term
|
Definition
| In prone position, holds head erect and raises body on hands; Controls head well; Starts to roll over from prone to supine; Opens hands, holds own hands, grasps rattle; Regards own hand; Reaches for and bats objects; Laughs; May sleep for 6 hours; Falls asleep by self without breast or bottle |
|
|
Term
|
Definition
| Vocalizes single consonants (dada, baba); Rolls over both ways; Has no head lag when pulled to sit; Sits with Supports; Stands when placed and bears weight; Starts to self-feed; Transfers cubes or other small objects from hand to hand; May begin to show signs of stranger anxiety; Cognitively aware that they can cause a reaction; Time for parents to set limits |
|
|
Term
|
Definition
| Continue breastmilk and/ or formula for bulk of calories; Intro of a low allergenic cereal like rice cereal; New food every 3-7 days; Only highly pureed ("stage one") foods; Start with one meal per day and expand from there; Okay to introduce water more liberally; Avoid highly allergic foods (nuts, shellfish, eggs, strawberries, honey) until 9-12+ months of age |
|
|
Term
|
Definition
| Responds to own name; Understands a few words such as 'no-no'; Babbles, imitates vocalizations; Dada, Mama nonspecifically; Crawls, creeps, scoots; Sits independently easlily, stands holding on; Starts pincer grasp; May show anxiety with strangers |
|
|
Term
|
Definition
| More 'finger foods' (be aware of choking hazards); Use of utensils; Intro of sippy cup, straw, cup; Avoid nuts, shellfish, honey; Continue breastmilk, formula, but weaning |
|
|
Term
| Twelve Month Old Behaviors |
|
Definition
| Stands alone, may walk; Says one word; Points for things desired; Waves bye-bye; Puts blocks in cups; Mastered pincer grasp; Imitates activities |
|
|
Term
| Twelve Month Old Nutrition |
|
Definition
| Transition from breastmilk/ formula to whole cow's milk (whole milk until age 2) - soy milk, rice milk for babies with cow milk allergies; No limitations of foods unless positive family or personal history of food allergies; Wean bottle; Encourage primarily self-feeding, family meal times, primarily foods that the rest of the family eats |
|
|
Term
| Fifteen Month Old Behaviors |
|
Definition
| Has vocabulary of 3 to 6 words; Can point to one or more body parts; Understands simple commands; Walks well, even backward, stoops, stairs; Stacks 2 blocks; Feeds self with fingers, drinks from a cup; Listens to a story; Indicates what he wants by pulling, pointing, grunting |
|
|
Term
| 15-18 Month Old Nutrition |
|
Definition
| Avoid food battles; Keep offering healthy options; Limit juice to 4-6oz per day max; Family meal times; Whole milk intake ~18-24oz per day; Multivitamins for "picky eaters" |
|
|
Term
| Eighteen Month Old Behaviors |
|
Definition
| Walks quickly or runs stiffly; Throws a Ball; Has a vocabulary of 10-20 words; Immitates words; Pulls a toy along the ground; Stacks 2-3 blocks; Uses a spoon and cup; Listens to a story, looking at pictures and naming objects; Shows affection, kisses; Follows simple directions; Imitates a crayon stroke and scribbles; Dumps an object from a bottle without demonstration |
|
|
Term
|
Definition
| Kicks a ball; Traces a circle; Walks up stairs one at a time; Stacks 5 blocks; Pretends; Follows 2 Step commands; Points to pictures; Uses > 20 words, 2-3 word phrases; Calls himself by name; Puts on, removes clothes; Develops fears and emotions |
|
|
Term
|
Definition
| Transition to low-fat or skim milk; Okay to introduce highly allergenic foods for kids with strong family history of food allergies |
|
|
Term
|
Definition
| Jumps in place, balances on 1 foot >18sec; Rides a tricycle; Knows own name, age and sex; >75% of speech is intelligible; Has self-care skills (feeding, dressing, etc.); Shows early imaginative behavior, imaginative friends; Still egocentric in terms of needs and interests; Copies a circle and a cross |
|
|
Term
|
Definition
| Jumps in place, balances on 1 foot >18sec; Rides a tricycle; Knows own name, age and sex; >75% of speech is intelligible; Has self-care skills (feeding, dressing, etc.); Shows early imaginative behavior, imaginative friends; Still egocentric in terms of needs and interests; Copies a circle and a cross |
|
|
Term
|
Definition
| Can sing a song; Gives first and last name; >90% of speech is intelligible; Draws a person with 3 parts; Is aware of gender (of self and others); Distinguishes fantasy from reality; Talks about daily activities and experiences; Hops, jumps on one foot; Builds a tower of 10 blocks |
|
|
Term
|
Definition
| Dresses self; Skips; Copies square and triangle; Catches a ball; Knows address and phone number; Recognizes some letters, copies letters; Understands and follows rules of behavior; Gets along with other children; Draws a person with 5 parts; Counts to 10 |
|
|
Term
| AAP Recommended ages for Standardized Developmental Testing |
|
Definition
|
|
Term
| Ages and Stages Questionnaire |
|
Definition
| Social/ Emotional for children ages 27 months through 32 months |
|
|
Term
| Parents' Evaluation of Developmental Status (PEDS) |
|
Definition
| An evidence-based method for detecting and addressing developmental and behavioral problems in children |
|
|
Term
|
Definition
| Used to recognize normal and abnormal patterns of development in children under age 6 |
|
|
Term
| What is the most common form of Developmental Delay? |
|
Definition
| Language Delay; occurs in up to 5-10% of preschoolers |
|
|
Term
| Red Flags for Language Delay |
|
Definition
| Absent or minimal speech (no words by 15m); No pointing by 1y; Impaired comprehension; Lack of drive to communicate; Regression of early language milestones |
|
|
Term
| Differential Diagnosis of Language Delay |
|
Definition
| Inadequate hearing; developmental language disorder; mental deficiency or retardation; an autism spectrum disorder |
|
|
Term
|
Definition
| No pointing by 1y; No babbling by 1y; No single words by 16m; Any loss of language skills at any time; No pretend play; Extremely short attention span; No response when called by name; Indifference to others; Little or no eye contact; Fixation on a single object, such as a spinning fan; Repetitive body movements such as hand flapping, rocking; Intense tantrums |
|
|
Term
| Modified Checklist for Autism in Toddlers (M-CHAT) |
|
Definition
| One of several brief parental screens for autism spectrum disorders; Validated for ages 16-30m; AAP recommends universal screening at 18m, 24m, and whenever concern arises |
|
|
Term
|
Definition
| A spectrum of chronic developmental disorders; Characterized by difficulties in social interaction, communication, and restrictive and repetitive interests and activities; May have sensory impairment with unusual reactions to physical sensations, overly sensitive to touch; Most often first identified in toddlers; Mostly boys; No cure, but treatable |
|
|
Term
|
Definition
| Early intervention is key; Speech therapy; Occupational therapy for sensory integration and motor skills; Behavioral therapy to improve cognitive skills and reduce inappropriate behavior; Educational therapy using a highly structured approach; Medications similar to those with ADHD; Special diets - eliminating certain food groups such as dairy helps some kids |
|
|
Term
| Cognitive Development of the School Age Child (6-11 years old) |
|
Definition
| Sexual behavior, gender differences, masturbation; Awareness of body image and physical differences |
|
|
Term
| Moral Development of the School Age Child (6-11 years old) |
|
Definition
| Conscience; Family and community values; Early middle childhood - rely on clear rules; Late middle childhood - understand fairness and reciprocity |
|
|
Term
| Social Development of the School Age Child (6-11 years old) |
|
Definition
|
|
Term
| Emotional Development of the School Age Child (6-11 years old) |
|
Definition
| Increasing independence from parents; Seek approval of adults |
|
|
Term
| Physical Development of the School Age Child (6-11 years old) |
|
Definition
| Average wt gain of 3-3.5kg/yr; Average ht gain of 5-7 cm/yr; Growth spurts - irregularly timed spurts lasting ~8 weeks, 3-6x/yr; Head circumference growth of only 2-3 cm; Complete myelinization by age 7 |
|
|
Term
|
Definition
| Skin pigmentation that is a sign of insulin resistance |
|
|
Term
|
Definition
|
|
Term
| Healthy Messages: 5,2,1,0 |
|
Definition
| 5 Fruits and vegetables a day; 2 hours or less of screen time; 1 hour of exercise; 0 calorie drinks |
|
|
Term
| Causes of Underweight and Poor Weight Gain |
|
Definition
| Malnourishment; Chronic Disease (GI, Renal, Cardiac, Heme, Pulmonary, etc.); Iron Deficiency; Hypo-or Hyperthyroidism; Medication side effect; Intentional caloric restriction |
|
|
Term
|
Definition
| Height less than 2 SD below average (below the 3rd percentile); Causes of Short stature: Idiopathic short stature (familial or genetic short stature, constitutional growth delay), Chronic Disease |
|
|
Term
|
Definition
| Familial, Genetic; Normal variant; Inherent limitations of bone growth; Predicts adult height |
|
|
Term
| Constitutional Delay of Growth (and Puberty) |
|
Definition
| Delayed growth; Childhood short stature, but relatively normal adult height; Usually a normal variant; will see a Delayed Bone Age |
|
|
Term
|
Definition
| Slowed growth velocity; Always abnormal; may be caused by Chronic disease or medications such as high dose inhaled steroids or prolonged use of oral steroids |
|
|
Term
| Diagnosis of Idiopathic Short Stature |
|
Definition
| Essentially normal growth velocity (~5cm/yr); No evidence on exam and work-up of chronic disease, chromosomal abnormality |
|
|
Term
| Diagnosis of Familial Short Stature |
|
Definition
| No delay in bone age; Child is growing within predicted parental target range |
|
|
Term
| Diagnosis of Constitutional Delay of Growth |
|
Definition
| Bone age is delayed; Often a family member had delayed growth |
|
|
Term
|
Definition
| Breast development; Average 10-11 years of age; Earliest normal thelarche - 6 years in African-American girls, 7 years in Caucasian girls |
|
|
Term
|
Definition
| Pubic hair; Typically 6-12 months after thelarche; result of adrenocortical activity |
|
|
Term
|
Definition
| Menses; 2-3 years after thelarche; Average age in US is 12.8 years |
|
|
Term
| Earliest Pubertal Changes in Males |
|
Definition
| Ages 9-14; Increase in testicular size >2.5cm in diameter or 4mL; Scrotal reddening and increase in rugations |
|
|
Term
| Progression of Puberty in Males |
|
Definition
| Usually a year after initial testicular growth; Increase in length and breadth of penis; Pubic and axillary hair growth (Pubarch/ adrenarche) |
|
|
Term
|
Definition
| Females - Peak height velocity is typically between 11-12 years, always precedes menarche, breast tanner II-III; Males - peak height velocity is later, typically 13-14 years, genital tanner IV-V; Average age of Epiphyseal fusion - 15y for females, 17y for males |
|
|
Term
| Central Precocious Puberty |
|
Definition
| Gonadotropin-dependent; True precocious puberty; Early maturation of the HPG axis; Onset early, but pattern/ timing of puberty events is normal; 80-90% will have no identifiable cause; Accelerated linear growth for age (tall for chronologic age, then short adult stature); Advanced bone age (usually 2+ years); Can be treated with GnRH analog therapy to stop the progression of secondary sex characteristics and accelerated growth |
|
|
Term
| Peripheral Precocious Puberty |
|
Definition
| GnRH and gonadotropin independent precocious puberty; AKA - pseudo-precocious puberty; Excess secretion of estrogens and androgens from the gonads, adrenal glands (ovarian cysts and tumors, testicular tumors, adrenal tumors and enzymatic defects); McCune-Albright Syndrome; Testotoxicosis; Also have accelerated linear growth and advanced bone age; Pubertal levels of sex steroids; Pre-pubertal levels of LH and FSH |
|
|
Term
| Incomplete Precocious Puberty |
|
Definition
| Early development of secondary sexual characteristics; Benign variant of normal puberty; Non-progressive or slowly progressive; NORMAL bone age; Need regular follow-up |
|
|
Term
| Premature Thelarche seen in Incomplete Precocious Puberty |
|
Definition
| Early, isolated appearance of breast development; No other signs of pubertal development; Normal growth rate; Normal bone age; 18% progress to true precocious puberty; Work-up: complete H&P, growth charts, bone age - if all normal, no further work-up |
|
|
Term
| Premature Adrenarche seen in Incomplete Precocious Puberty |
|
Definition
| Early, isolated appearance of pubic and/or axillary hair; Considered benign, normal variant; Normal growth pattern and bone age; Risk factor for PCOS; 20% progress to true precocious puberty; Work-Up: complete H&P, growth charts, bone age, DHEA level should be appropriate for pubic hair stage, LH FSH and gonadal steroid levels are prepubertal |
|
|
Term
| Individuals with Disabilities Education Act (IDEA) |
|
Definition
| Law Assures that all children with disabilities recieve: a free and appropriate education, appropriate evaluation and assessment for placement and services, education in the "least restrictive environment," and that parents are involved in all decisions |
|
|
Term
| Section 504 of the Rehabilitation Act of 1973 |
|
Definition
| States that any group or program that gets money from the federal government must include people who have disabilities in taking part in and benefiting from its activities; Federal money may be lost if the program discriminates against people with disabilities |
|
|
Term
|
Definition
| Failure to acquire, retrieve and use information competently; Discrepancy between academic performance and intellectual ability; Often presents as school failure; Average or above-average intelligence; 5% of the school population affected; Not learning problems from MR, vision/ hearing impairment, emotional disturbance or environmental or economic influence |
|
|
Term
| Learning Disabilities are Weaknesses in One or More of These... |
|
Definition
| Attention abilities; Memory Skills; Language Skills; Neuromotor skills; Executive function or higher cognition skills; Visual-spatial ordering skills; Temporal-sequential ordering skills |
|
|
Term
| 3 Most Common Learning Disabilities |
|
Definition
| 1) Language processing, reading (dyslexia); 2) Writing (dysgraphia); 3) Mathematical (dyscalculia) |
|
|
Term
|
Definition
| The most common neurobehavioral disorder of childhood; Core sxs of inattention, hyperactivity and impulsivity; School-age prevalence from 4-12% (similar rates througout the world); 60% of kids with ADHD will have sxs as adults; M:F = 4-6:1; Often Co-morbidities of - developmental disorders, mild MR, ODD, anxiety, depression, Tic disorders |
|
|
Term
| Sxs Sometimes Seen with ADHD |
|
Definition
| Emotional lability or immaturity; Little sense of physical safety; Aggressive or oppositional behaviors; Poor social skills; Low self-esteem |
|
|
Term
|
Definition
| Genetic Imbalance in catecholamine metabolism in the cerebral cortex; Impaired executive functions (processes involved in forward planning) or difficulties with response inhibition |
|
|
Term
| Structural Brain Imaging in ADHD |
|
Definition
| Significant differences between children with and without ADHD; In ADHD Patients - smaller cerebral and cerebellar volumes, reversed or absent asymmetry of the caudate nucleus, Smaller posterior corpus callosum regions, Increased gray matter in the posterior temporal and inferior parietal cortices |
|
|
Term
| Functional Brain Imaging in ADHD |
|
Definition
| Children with ADHD have reduced global and local activation in the area of the basal ganglia and anterior frontal lobe (methylphenidate - MPH - affects activation in these areas) |
|
|
Term
| DSM IV Criteria fo ADHD Diagnosis |
|
Definition
| 6 or more symptoms for at least 6 months to a degree that is maladaptive and inconsistent with developmental level in the categories of Inattention and/or Hyperactivity-Impulsivity; Sxs must be present before age 7; Sxs are present in 2 or more settings; There must be clinically significant impairment in social, academic or occupational function |
|
|
Term
| Stimulant Medications and Tics |
|
Definition
| 15-30% of children on stimulant medications develop tics, most are transient |
|
|
Term
|
Definition
| Affect dopaminergic and noradrenergic systems; Cause release of catecholamines from storage sites at the synapse - Increased norepi and dopamine concentrations in the brainstem, midbrain and frontal cortex are thought to be responsible for increased attention span and concentration |
|
|
Term
|
Definition
| 50-60% of children with ADHD will have sxs in adulthood; May have increased risk of substance use disorders; Greater risk of injury than children/ adolescents without ADHD; Often impaired academic functioning; May affect job status; Increased risk of Anti-Social Personality Disorder |
|
|
Term
| Considerations Before Initiating Contraception in Teens |
|
Definition
| Pelvic Exam; Pap Smear; STD Testing; Negative Pregnancy Test |
|
|
Term
| Combined Estrogen & Progestin Birth Control Methods |
|
Definition
| Combined Oral Contraceptives (COCs); Vaginal Ring (NuvaRing) |
|
|
Term
| MOA of Combined Estrogen & Progestin Birth Control |
|
Definition
| Blocks LH and FSH to inhibit ovulation; Thickens cervical mucus to prevent sperm penetration; Inhibits capacitation of sperm |
|
|
Term
| Health Benefits of Combined Estrogen & Progestin Birth Control |
|
Definition
| Menstrual-related benefits; Decreased anemia; Improves acne and hirsutism; Reduces risk of endometrial and ovarian CA; Reduced risk of PID |
|
|
Term
| Estrogen-Related Side Effects and Disadvantages |
|
Definition
| Breast tenderness; Nausea; HTN; Vomiting; Weight gain?; Medications that induce CYP450 may decrease effectiveness (eg seizure meds) |
|
|
Term
| Estrogen-Related Health Risks |
|
Definition
| Rare but serious health risks, including blood clots, heart attack and strokes; Teen should contact medical provider immediately if they experience ACHES: Abdominal pain, Chest pain, Headaches, Eye or visual changes, Severe leg pain or swelling |
|
|
Term
| The Following are NOT Contraindications to Combined Hormonal Contraception |
|
Definition
| Family history of breast CA; Antibiotic use (with the exception of rifampin and certain seizure meds that affect liver enzymes); Tobacco use; History of headaches (unless migrane with aura or focal neurologic deficit) |
|
|
Term
| Before Prescribing Combined Hormonal Contraception Providers Should Be Aware if Their Patient Has... |
|
Definition
| Clotting disorders, Personal history of DVT or PE, Migrane with aura or focal neurological deficits, HTN (with well-controlled HTN, risk generally outweighs benefits) |
|
|
Term
| Combined Oral Contraceptive Pills (COCs) |
|
Definition
| One of 2 methods of combined estrogen & progestin birth control; Come in a variety of formulations with doses of estrogen ranging from 20-50mcgs; Low dose pills have comparable efficacy and safety; Monophasic, Biphasic and Triphasic; Taken daily at about the same time every day |
|
|
Term
| Combined Oral Contraceptive Pills Patterns of Use |
|
Definition
| Monthly cycling 21/7; Shortened pill-free interval (shorten pill-free interval from 7 to 4 days); Extended use (brief manipulation of cycle, bicycling, tricycling) |
|
|
Term
|
Definition
| One of 2 methods of combined estrogen and progestin birth control; A soft, flexible ring approximately 2 in. in diameter; Contains a low dose of combined ethinyl estradiol and etonogestrel; Absorbed continuously, directly into the blood stream through the vaginal wall (vaginal muscles keep it in place); Remains in place for 3 weeks, followed by one ring-free week; Can be effective for up to 5 weeks; Cost: $30-$35/ month |
|
|
Term
| Progestin Only Birth Control Methods |
|
Definition
| Progestin-Only Pills (Mini-Pills); Depot-Medroxy Progesterone Acetate Injection (DepoProvera); Emergency Contraception; Implanon |
|
|
Term
| Benefits of Progestin-Only Birth Control |
|
Definition
| No estrogen-related complications; Non-contraceptive benefits include - lighter or no menses, less anemia, decreased cyclic cramping, pain and headahces; decreased risk of endometrial cancer, uterine cancer and PID |
|
|
Term
|
Definition
| AKA - DepoProvera; An injection of progestin into the deltoid or gluteus muscle administered every 3 months; Cost - each injection costs between $30 and $75; Side Effects of Menstrual Irregularities, weight gain, irreversible for 3 months; Bone mineral loss with increased duration of use (a 2005 study found that bone mineral density recovered completely by 12 months after discontinuation of Depo) |
|
|
Term
| What Should Patients on DMPA (DepoProvera) Be Counseled to do? |
|
Definition
| Exercise regularly; Increase dietary Calcium intake to 1500mg/day |
|
|
Term
| Emergency Contraception Pills |
|
Definition
| Safe and effective back-up birth control method; Provides a last chance to prevent pregnancy after unprotected intercourse or contraceptive failure; Plan B - the only dedicated product on the market (2 pills); Certain brands of COCs can also be used as ECP; MOA - delays or inhibits ovulation; may also inhibit fertilization or implantation but this is purely speculative; NOT and abortifacient; NOT teratogenic |
|
|
Term
| Use and Efficacy of Emergency Contraceptive Pills |
|
Definition
| Use - take 2 Plan B tablets orally up to 5 days after unprotected sex (more effective if taken sooner); Efficacy - ECP reduces the risk of pregnancy by 89% if taken within 72 hours |
|
|
Term
| When are IUDs NOT recommended? |
|
Definition
| If current or recent STI or PID; Purulent cervicitis; Uterine anomaly |
|
|
Term
| MOA of Progestin IUD (Mirena) |
|
Definition
| Releases Levonorgestrel into endometrial cavity at steady rate; Thickens cervical mucus, atrophies endometrial lining, suppresses ovulation |
|
|
Term
|
Definition
| Placed in vagina by health care worker; May be placed at any time in the menstrual cycle and immediately after an abortion; Approved duration 5 years; Extremely effective (7 year failure rate - 0.14-1.1 pregnancy/ 100 women) |
|
|
Term
|
Definition
| A single rod implanted subdermally; Contains etonogestrel; Lasts 3 years; Approved in US in July 2006 |
|
|
Term
|
Definition
Most common reportable bacterial infection in the US;
Typically asymptomatic;
Screen all sexually active females under age 25 annually – at minimum;
Serious sequelae include infertility |
|
|
Term
| Gonorrhea (GC) and Trichomonas |
|
Definition
Symptoms may include vaginal discharge, dysuria, painful sexual intercourse;
GC most commonly diagnosed in females 15-19 years old;
CDC recommends annual screening for GC for “high risk” females;
Trichomonas screening: no published guidelines but done routinely |
|
|
Term
|
Definition
| Testing on a case-by-case basis; No routine testing recommended |
|
|
Term
|
Definition
| CDC recommends that HIV testing be performed "routinely" |
|
|
Term
| CDC Guidelines Concerning Men Who Have Sex With Men |
|
Definition
| Annual HIV and Syphilis screening; Gonorrhea and chlamydia screening targeted depending on whether male is insertive or receptive partner |
|
|
Term
|
Definition
Chlamydia & Gonorrhea - Urine, endocervical, urethral, rectal specimens; Trichomonas - Culture (gold standard) or wet mount;
HIV - Serum, oral fluids;
Syphilis - Serum |
|
|
Term
|
Definition
| Transition between childhood and adulthood; Generally physically healthy period; Needs vary by development and personal circumstances; Experience shaped by race, ethnicity, religion, socioeconomic status, family, peers, etc. |
|
|
Term
| Early Adolescence (11-14) |
|
Definition
| Characterized by a spurt of growth; Beginning of sexual maturation; Starting to move away from family toward friends for companionship, affirmation; Concrete thinking with minimal understanding of consequences; Poor impulse control leads to experimentation and risk taking behaviors |
|
|
Term
| Middle Adolescence (15-17) |
|
Definition
| Physical changes of puberty are completing; Develop a stronger sense of identity and relate more strongly to peer group; Conflicts with family may increase; Feelings of invincibility and omnipotence lead to increased risk taking behaviors; Increased intellectual and creative ability; Beginning to think abstractly |
|
|
Term
|
Definition
| The body takes adult form; Development of identity distinct from parent and family; Ideas and opinions more settled; Begins to integrate self back into family; Peer group values less important than personal; Rational, realistic thinking begins |
|
|
Term
|
Definition
| Violence and injury account for 72% of all deaths during adolescence; MVAs are the leading cause of death among teens, >50% related to drugs or alcohol; Homicide and suicide are the 2nd and 3rd leading cause of death among teens |
|
|
Term
| What does HEEADDSS Screening Screen For? |
|
Definition
H - Home;
E- Education/ Employment;
E- Eating;
A - Activities;
D- Drugs;
S- Sexuality;
S-Suicide |
|
|
Term
| How Often Does Bright Futures Say Teens Need Physicals? |
|
Definition
|
|
Term
| How Often Does GAPS Say Teens Need Physicals? |
|
Definition
| 3 PEs during adolescence: Early adolescence (11-13), Mid Adolescence (15-17), Late adolescence (18-21) |
|
|
Term
| Adolescent Obesity Etiology |
|
Definition
Usually - Diet/ Lifestyle;
Occassionally - Psychiatric (binge eating, depression, anxiety);
Rarely - Endocrine, genetic, medication induced;
Almost never - tumor |
|
|
Term
| Sudden Cardiac Death Etiology |
|
Definition
| Congenital heart disorders are the most common cause: Hypertrophic cardiomyopathy (HCM) is responsible for about 1/3 of cases; Other causes include arrhythmias, Marfans Syndrome and electrical abnormalities (eg Long QT syndrome) |
|
|
Term
| At what age should clinical and self breast exams begin? |
|
Definition
|
|
Term
|
Definition
| An increase in breast tissue in males usually caused by imbalance between estrogen and androgen activity; peaks during genital stage 2-3 and typically resolves within 1-2 years |
|
|
Term
|
Definition
| An abnormal dilation of veins surrounding the spermatic cord in the scrotum; Affects approx. 13% of teen males; Usually on the left side; Suggested association between vericoceles and infertility; Observation perviously thought to be treatment of choice, newer thinking suggests early referral is best |
|
|
Term
|
Definition
Genital stage 1 persists past 13.7 years;
Pubic Hair stage 1 persists past 15.1 yrs;
Greater than 5 years pass before completion of genital growth;
Pubertal progression begins but then progress stalls |
|
|
Term
|
Definition
Breast stage 1 persists past 13.4 yrs;
No menarche by age 16 yrs;
Greater than 5 years have passed between onset of breast development (Tanner II) and menarche;
Pubertal progression begins but then progress stalls |
|
|
Term
| In Which Conditions is Bone Age Delayed? |
|
Definition
| Constitutional Delay of Puberty, Hypothyroidism, and Chronic Illness |
|
|
Term
|
Definition
| 12.5 years old (usually earlier in African American teens); Normal range anywhere from 9-16 years of age |
|
|
Term
|
Definition
| No menarche by 16; Concern if 2-3 yrs past thelarche (breast budding) or if patient is Tanner 5; Should be no more than 4 years between Tanner 2 and menarche |
|
|
Term
|
Definition
| No menses for 6 months or no menses for the length of time equal to 3 cycles |
|
|
Term
| Causes of Secondary Amenorrhea |
|
Definition
| Pregnancy; Immature HPG axis; Thyroid problems; PCOS; Female athlete triad (amenorrhea, osteoporosis, and disordered eating) |
|
|
Term
|
Definition
Combination of amenorrhea, osteoporosis and disordered eating;
Amenorrhea may be one of the first signs;
Highest risk athletes: gymnasts, ballet dancers, figure skaters;
Strenuous exercise and weight loss suppress the hypothalamic-pituitary axis and can cause amenorrhea |
|
|
Term
|
Definition
| TDaP, Menactra, HPV, Varicella (catch up), Hep B (catch up) |
|
|
Term
|
Definition
| Effective against HPV types 6,11,16,18 (types 16 and 18 cause the vast majority of cervical cancers); OK to vaccinate teens already infected with HPV; Vaccinate at 11-12 year old exam |
|
|
Term
| S/S of Inattentive-type ADD |
|
Definition
| Hard to organize or finish tasks; Poor attention to details; Difficulty following instructions; Child is easily distracted, forgets details |
|
|
Term
| S/S of Hyperactive-Impulsive Type ADHD |
|
Definition
| Hard to sit still, fidgets; Talks a lot; Interrupts others, grabs things; Hard to wait for turn; Difficulty listening to directions |
|
|
