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