Diseases Associated with AdolescenceDiseases Associated with Adolescence
Pathophysiology
Musculoskeletal Abnormalities
• Kyphosis – hunchback– Etiol = osteoporosis, TB, posture
• Lordosis – swayback– Etiol = obesity, posture
• Scoliosis – lateral curvature
– Etiol = genetic, idiopathic (f >m), congenital (from developmental
defects)
• Osteomyelitis• Common from trauma (especially to young males)• Freq site = metaphysis of femur & tibia• Etiol = pathogen (staph aureus)• Serious illness • Needs aggressive management
• Juvenile rheumatoid arthritis (JRA)• Marked onset with primarily large joints
• Incidence = 1:1000 children– 5% of cases of RA are in children
• Etiol = autoimmune
• Prognosis = positive (50% remission)
• Clinically
– Large joints
– Chronic uveitis
– Rheumatoid nodules not only in subcutaneous skin layer but in organs
– Subluxation and ankylosis of cervical spine
Eating Disorders
• Anorexia nervosa• Primarily females
• Smart, over-achievers
• Exercise “freaks”
• Element of secondary gain
• Etiol--- ? hypothalamic dysfunction
• Fear of eating
– Get forced vomiting
– Get forced bm’s
• Get symptoms of severe malnutrition
• Bulimia nervosa• Binge eating followed by
purging
• Usually patients maintain normal weight
• Problems
– Teeth enamel
– Esophagitis
Skin Disorders
• Acne vulgaris• Commonest skin disease
• Increased activity of sebaceous glands with viscous sebum
• Get comedomes (whiteheads & blackheads)
• Get pimples (folliculitis)
– These rupture & get bacterial invasion with pustules
Infections
• Infectious mononucleosis• Etiol = Epstein- Barr virus (EBV)
» Part of herpes family
• Transmitted by:– Saliva thus “kissing disease”
– Airborne droplets
– Blood
• Goes to lymphoid tissue & targets b-lymphocytes – Normal B cells produce antibodies
– Get massive increase in killer T’s (CD8) to clean up the mess
» Some become abnormal (larger)
Diseases Affecting Sexual Development
• Chromosomal disorders• Klinefelter’s syndrome
– Males with XXY
» Dx = atrophic testicles at puberty
• Turner’s syndrome– Females with only 45 chromosomes (XO)
» One missing X chromosome
» No secondary sex characteristics develop
• Testicular tumors• Malignancy in teenagers
• Usually unilateral
• Menstrual abnormalities• Amenorrhea
• Dysmenorrhea