Teenage angsts
A 14-year-old girl presents with:
-Anxiety the way her body looks
-Intense fear of becoming obese
- BMI< 5th percentile
WHAT IS THE MOST LIKELY DIAGNOSIS
Anorexia Nervosa:
This patient meets all DSM-5 Criteria for AN.
Severe AN has a mortality rate 10-12x higher than the general population
Most common cause of secondary amenorrhea
Pregnancy
Amenorrhea: > 3 months (regular) or >6 months (irregular
Adolescent boy presents:
- Dizziness
- Dilated Pupils
- Delusions that he "sees smells"and "hears colors"
What did he most likely ingest?
LSD (lysergic acid diethylamide)
Potent Hallucinogen
-Somatic symptoms (dizziness, dilated pupils, flushing)
-Psych effects (delusional ideations, psychosis)
Newborn presents in the delivery room with:
-Missing frontal and Parietal bones
-Missing forebrain
- Facial/eye abnormalities
Which serum marker alteration would you expect the mother had prenatally?
Anencephaly
Elevated serum levels of Alpha Feto Protein5 year old asymptomatic female comes as a new patient for a WCC. On physical exam, you see a tuft of hair in the midline of her lower back
What does this suggest?
Spina Bifida Occulta
-10% population
-Rarely causes any problems
-Syrinx or tethered cord
For which STI should sexually active adolescent females be screened anually?
Chlamydia Trachomatis and Neisseria Gonorrheae
Pregnant teen is in active labor. She has active genital warts; otherwise there are no other issues.
Which type of delivery should she have?
Vaginal Delivery
Genital warts are not a contraindication for Vaginal delivery unless they obstruct the birth canal
Monitor for laryngeal papillomatosis
Most common drug used in adolescents
Alcohol
Newborn presents in the delivery room with herniation of the brain and its coverings through a skull defect in the occipital region
What is the diagnosis?
Encephalocele
What is the #1 cause of adolescent mortality?
Unintentional Injuries
What does thumb sucking that persists into adolescence possibly indicate?
Underlying psychological issues
(Most commonly seen in girls)
Pregnant adolescent has secondary syphilis. She has anaphylaxis to penicillin.
What is the most appropriate therapy?
Desensitization followed by penicillin therapy
An adolescent presents to the ED after binging on methamphetamines. Temp and BP are elevated and he has an irregular heart rate.
How would you manage this patient?
Cooling Blankets + Lorazepam/Diazepam
After a difficult labor, a newborn presents with:
- Paralysis of the flexors and extensors of the forearm and intrinsic muscles of the right hand
-Sensory loss of the ulnar side of the right hand
Klumpke Palsy
What is the most common reason for Hospitalization of adolescents 15-21 years of age?
Pregnancy
Teen with AN admitted and placed on observed meals.
Besides Potassium and Magnesium, What electrolyte abnormality are you concerned about?
Hypophosphatemia
Sexually Active 17 yo female presents with:
-RUQ pain
-Vaginal Discharge
- Fever
Most likely diagnosis?
Fitz-Hugh-Curtis syndrome
(N. Gonorrhoeae, C. trachomatis, polymicrobial)
Name 3 Risk Factors associated with development of substance use disorder in adolescents
-Household drug use
-Peer group drug use
-untreated ADHD
-Depression, Anxiety, mood disorders
-Impulse control problems
-Hypoactive/absent DTR
-Corticospinal tract dysfunction
-Impaired vibratory and propioceptive function
-Hypertrophic Cardiomyopathy
-Diabetes mellitus
Friederich Ataxia
A neonate presents with a stroke
What is the most common inheritable cause of stroke?
Activated Protein C (APC) resistance (Factor 5 Leiden)
Most common inheritable cause of venous thrombosis, followed by Protein C and S deficiency or antithrombin deficiency
Mineral deficieny associated with trichotillomania
Iron deficiency
16 year old female has PID and requires inpatient treatment. She has anaphylaxis to cephalosporins.
What 2 antibiotics should be used fro her therapy?
Clyndamycin and Gentamycin
Cover: CT, NG, Strep. Gram negative enteric bacilli and anaerobic organisms.
A healthy Teen presents to the ED following a syncopal episode after huffing room deodorizer
What do you expect to see in this patient?
Inhalants:
-Hypotension
-Cutaneous flushing followed by vasoconstriction
- Dizziness and syncope
- Tachycardia and inverted T waves, ST depression
3-hour-old infant is born to a mother with a neurological disease. The infant presents:
-Hypotonia, facial weakness, ptosis
-Difficulty feeding
What is the likely cause of the infant's problems?
-Weak cry, respiratory distress
Neonatal Myasthenia Gravis from transplacental transmission of maternal Acetylcholine receptor antibodies (AChR-Ab)- Resolves 2-6 weeks
Vs congenital myastenia gravis (AR disorder and has no circulating antibodies)
An infant is born with a severe seizure disorder. CT scan shows bilateral clefts within the cerebral hemispheres.
Diagnosis?
Schizencephaly