Androgen Insensitivity Syndrome

Category: generalpediatrics-Adolescent Care 2

Findings: adolescent girl with breasts and no pubic hair, elevated testosterone, present but undescended testes

Notes: XY chromosome

Question: Which disease is associated with these findings?


Bacterial Vaginosis

Category: generalpediatrics-Adolescent Care 2

Findings: thin white vaginal discharge, pH more than 4.5, fishy odor with ten percent KOH prep, epihthelial cells on saline wet prep

Notes: Caused by replacement of normal vaginal flora such as Lactobacillus with other organisms.

Question: Which disease is associated with these findings?


Bulimia

Category: generalpediatrics-Adolescent Care 2

Findings: eroded enamel, overeating, overweight, enlarged parotids, elevated amylase, irregular menses, lanugo hair, metabolic alkalosis

Question: Which disease is associated with these findings?


Chlamydia Trachomatis

Category: generalpediatrics-Adolescent Care 2

Findings: urethral discharge, extra leukocytes without organisms on gram stain of urethral exudates

Notes: Treat with azithromycin 1 g PO once or doxycycline 100 mg twice daily for 7 days.

Question: Which organism can cause these findings?


Congenital Adrenal Hyperplasia

Category: generalpediatrics-Adolescent Care 2

Findings: elevated ACTH, low cortisol and aldosterone, excess innate androgens, metabolic acidosis, hyponatremia, hypoglycemia

Notes: Results from problem with synthesis of cortisol and aldosterone in adrenal glands. Will see elevated 17-hydroxyprogesterone.

Question: Which disease is associated with these findings?


Delayed Puberty In Female

Category: generalpediatrics-Adolescent Care 2

Findings: no breast buds by age of 13, no menses within 2 years of SMR 4 breasts and pubic hair

Question: Which problem is associated with these findings?


Epididymitis

Category: generalpediatrics-Adolescent Care 2

Findings: fever, dysuria, urethral discharge, unilateral scrotal pain, relief of pain with elevation of scrotum

Notes: May be caused by Chlamydia, gonorrhea, E. coli

Question: Which disease is associated with these findings?


Exogenous Androgens

Category: generalpediatrics-Adolescent Care 2

Findings: pubic hair growth without testicular enlargement

Notes: Obtain ultrasound to look for adrenal masses in males or ovarian masses in females. Obtain FSH, LH, and adrenal steroid hormones levels to differentiate between central and peripheral causes.

Question: Which problem is associated with these findings?


Fibrocystic Disease

Category: generalpediatrics-Adolescent Care 2

Findings: most common breast disease, bilateral, tender, alleviated by oral contraceptives

Question: Which disease is associated with these findings?


Fitz-Hugh-Curtis Syndrome

Category: generalpediatrics-Adolescent Care 2

Findings: right upper quadrant pain, sexually active teenager, vaginal discharge, fever

Notes: Also known as perihepatitis and caused by N. gonorrhea, C. trachomatis, polymicrobial organisms. May cause pain that worsens with breathing and is referred to right shoulder.

Question: Which disease is associated with these findings?


Foreign Body

Category: generalpediatrics-Adolescent Care 2

Findings: menstrual bleeding at tanner stage 2

Notes: breast bud is first sign of puberty, some hair seen along labia

Question: What should you consider if a teenage girl has the following?


Growth Hormone

Category: generalpediatrics-Adolescent Care 2

Findings: Turner syndrome

Notes: Look for lack of breast development or just breast buds, amenorrhea, and scant hair

Question: With what medication may you treat the following condition?


Haemophilus Ducreyi

Category: generalpediatrics-Adolescent Care 2

Findings: painful ulcer with gray purulent exudate, inguinal lymphadenopathy, painful buboes

Notes: Chancroid is caused by the gram negative rod Haemophilus ducreyi

Question: Which organism is associated with these findings?


Herpes Simplex

Category: generalpediatrics-Adolescent Care 2

Findings: white vaginal discharge, inguinal lymphadenopathy, pruritic and tender vesicular lesions

Question: Which organism causes the following?


Hypothyroidism

Category: generalpediatrics-Adolescent Care 2

Findings: short stature, overweight, delayed bone age, constipation, dry skin

Question: Which disease is associated with these findings?


Kallmann Syndrome

Category: generalpediatrics-Adolescent Care 2

Findings: anosmia, optic nerve hypoplasia, absent septum pellucidum, low central and peripheral hormones, micropenis

Notes: Due to isolated defect of hypothalamus not secreting necessary gonadotropin.

Question: Which disease is associated with these findings?


Klinefelter Syndrome

Category: generalpediatrics-Adolescent Care 2

Findings: gynecomastia, small testes, infertility, mildly decreased intelligence, tall stature, long arms, low upper to lower segment ratio

Notes: 47 XXY. Obtain a chromosomal analysis. Has higher chance of breast cancer.

Question: Which disease is associated with these findings?


Male Condom

Category: generalpediatrics-Adolescent Care 2

Findings: Most effective method to present STI besides abstinence

Question: Which fits this finding?


Motor Vehicle Accidents

Category: generalpediatrics-Adolescent Care 2

Findings: leading cause of adolescent morbidity and mortality

Notes: Motor vehicle accidents, followed by homicide.

Question: What describes below?


Orchitis

Category: generalpediatrics-Adolescent Care 2

Findings: lack of dysuria or discharge, unilateral scrotal pain, fever

Notes: Bilateral orchitis puts one at risk for infertility. If one side is atrophied, there is a increased risk of testicular cancer.

Question: Which disease is associated with these findings?


Premature Adrenarche

Category: generalpediatrics-Adolescent Care 2

Findings: pubic hair without breast development in female

Notes: Obtain bone age film. If more than one year from chronological age, refer to endocrinology. Look for source of androgen such as from exogenous, tumors, excess protection from ovaries, or early adrenal puberty.

Question: Which disease is associated with these findings?


Prolactinoma

Category: generalpediatrics-Adolescent Care 2

Findings: delayed puberty, suppressed GnRH, decreased LH and FSH, irregular periods, galactorrhea

Notes: May be treated with bromocriptine. If macroadenoma or greater than 10 cm, may need additional treatment.

Question: Which disease is associated with these findings?


Spermatocele

Category: generalpediatrics-Adolescent Care 2

Findings: painless mass, superior and posterior to testes, does not change with position

Notes: Also transluminate just like hydroceles. No treatment.

Question: Which issue is associated with these findings?


Syphilis

Category: generalpediatrics-Adolescent Care 2

Findings: painless punched out ulcer on dorsal penis, bilateral lymphadenopathy

Notes: Obtain RPR nontreponemal test first and confirm with treponemal test like FTA-ABS. Treat with penicillin G benzathine 2.4 million units IM. If patient is under 48 kg, treatment 50,000 units per kg IM.

Question: Which disease is associated with these findings?


Tanner Stage 3

Category: generalpediatrics-Adolescent Care 2

Findings: accelerated penile growth, curly hair at pubis, gynecomastia

Question: At which tanner stage does this occur?


Tanner Stage 4

Category: generalpediatrics-Adolescent Care 2

Findings: peak height velocity, axillary hair, acne

Question: At which tanner stage do males achieve the following?


Testicular Torsion

Category: generalpediatrics-Adolescent Care 2

Findings: absence of cremasteric reflex, increased pain with elevation of scrotum

Question: Which disease is associated with these findings?


Thelarche, adrenarche, menarche

Category: generalpediatrics-Adolescent Care 2

Findings: What is the order of development for females?

Question: Question:


Trichomoniasis

Category: generalpediatrics-Adolescent Care 2

Findings: strawberry cervix, frothy yellow-green vaginal discharge, dysuria, pruritus

Notes: Treat with metronidazole 2 g once or tinidazole 2 g once.

Question: Which disease is associated with these findings?


Turner Syndrome

Category: generalpediatrics-Adolescent Care 2

Findings: breast buds, scant pubic hair, no menses, short stature

Notes: Obtain a karyotype

Question: Which disease is associated with these findings?