Adolescence Flashcards

1
Q

Sexual Maturity Rating (SMR) Stages AKA Tanner Stages

SMR 1

A

pre-puberty

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2
Q

SMR 2

A

pubic hair is sparse, fine, non pigmented, and downy

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3
Q

SMR 2- boys

A

testes increase in size and skin and scrotum reddens

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4
Q

SMR 2 - girls

A

breast buds begin

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5
Q

SMR 3

A

pubic hair is pigmented and curly and increase in amount

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6
Q

SMR 3 - boys

A

penis grows in length

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7
Q

SMR 3 - girls

A

breast and areola grow

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8
Q

SMR 4

A

pubic hair is adult texture but limited in area

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9
Q

SMR 4 - boys

A

penis grows in width

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10
Q

SMR 4 - girls

A

nipple and areola from separate mound protruding from breast

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11
Q

SMR 5

A

adult maturity

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12
Q

Physical Developmental Stages - Middle

A

girls - menarche, end growth spurt

boys - voice breaks, begin growth spurt

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13
Q

Early Cognitive/Psychological Development Stage

A

concrete thinking

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14
Q

Middle Cognitive/Psychological Development Stage

A

abstract thinking

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15
Q

Late Cognitive/Psychological Development Stage

A

complex abstract thinking

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16
Q

Early and Middle Social Development

A

friends > family

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17
Q

Late Social Development

A

self > friends

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18
Q

Psychosocial

10 - 13 years old

A

independent, conform to friends, preoccupied with appearance

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19
Q

Psychosocial

14 - 16 years old

A

less conformity and more identity, peak parental conflict

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20
Q

Psychosocial

17 - 20 years old

A

peak transition from concrete to abstract reasoning

21
Q

Puberty Sequence of Events

Girls

A

breast - pubic hair - height -menarche

22
Q

Puberty Sequence of Events

Boys

A

testicular volume - genitalia size - pubic hair - height

23
Q

Puberty - Physiology

A

gonads make sex steroids (gonadarche)

  • ovaries make estrogen and progesterone
  • testes make testosterone
24
Q

Puberty - Delayed

A

girls > 13 years old

boys > 14 years old

25
Q

Puberty - Precocious

A

girls < 8 years old

boys < 9 years old - most common

26
Q

Puberty - Normal Variants

A

gynecomastia in boys (40-65%)
asymmetry in breast size in girls
perimenarchal

27
Q

Perimenarchal

A
  • psysiologic leukorrhea (clear)
  • irregular menstrual cycle (may last several years)
  • dysmenorrhea (increasing ovulation)
28
Q

Irregular Menses

A

duration and flow (prolonged or heavy) often physiologic in first year but 30% is pathologic
-follow longitudinally due to risk of iron deficiency anemia

29
Q

Primary dysmenorrhea

pathologic or not pathologic

A

not pathologic

30
Q

Primary amenorrhea

A

> 14 years old without menarche and secondary sex characteristics or >16 years old without menarche but with secondary sex characteristics

31
Q

No parental consent needed for

A
  • birth control
  • mental health, substance abuse care >13 years old
  • STI screening/treatment > 14 years old
32
Q

HEADSS Assessment

A
Home
Education/Employment
Activities
Drug/Drinking
Sexuality 
Suicide
33
Q

Depression Screening

A

yearly starting at 12 years of age

34
Q

Anemia Screening

A

hematocrit once after menarche

35
Q

Dyslipidemia Screening

A

occur once between 9 and 11 years and once between 18 and 21 years

36
Q

Sexually transmitted infections Screening

A

universal screen at 15-18 years

37
Q

Vision Screening

A

universal test at 12 and 15 years

38
Q

Hearing Screening

A

universal audiometry once at 11-14 years, 15-17 years, and 18-21 years

39
Q

Pap Screening

A

sexually active > 3 years or anyone > 21 years old

40
Q

Immunizations

11-12 years

A

-Tdap, HPV series (2nd dose 6-12 m later). meningococcal vaccine (booster at 16 years)

41
Q

Pre-participation physical evaluation (PPE) or sports physical

A

thorough history and emphasis on cardiac and musculoskeletal

42
Q

Musculoskeletal

A

weakness, limited ROM, evidence of previous injuries

43
Q

Spine

A

Scoliosis - in depth abdominal and lower extremity neuro exam

44
Q

Scoliosis - Refer if

A

skeletally immature > 20 degrees
skeletally mature > 40 degrees
suspicious pain or neurologic symptoms

45
Q

Cleared - Epilepsy

A

seizure free internal - 3 to 6 months

46
Q

Cleared - Type I DM

A

close monitoring of diet

47
Q

Cleared - Down Syndrome

A

no collision sports

48
Q

Not cleared - cardiovascular

A

obtain consult

49
Q

Not cleared - temporary conditions

A

febrile illness, acute injury (concussion), contagious infection (mono)