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 MALE QUESTIONNAIRE - PAGE 8 

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FAMILY HISTORY
889.  Do you have any knowledge of diseases/conditions that your parents, grandparents, brothers or sisters have had? Answer 'no' if, for example, you were adopted or simply have no idea.
No, I can't answer questions about close relatives
Yes, I can answer questions about close relatives
More questions later...
CHILDHOOD
890.  Have you ever had chicken pox?
Don't know
Definitely not
Yes
891.  Did you have allergies or signs of allergy such as an "allergic crease" across the nose, runny nose or bags under the eyes?
No / don't know
Yes, but insignificant
Yes, a few minor ones
Yes, one or two severe
Yes, several severe
892.  Did you experience growing pains?
No / don't know
Minor
Moderate
Serious
Severe
893.  Have you suffered from Osgood-Schlatter Disease (growing pains at the knee)?
No / don't know
Mildly in past
Significantly in the past
Currently mildly
Currently significantly
894.  Did you have Osteochondrosis or Leg-Hip Perthes Disease?
No / don't know
Yes, but good recovery
Severely - lasting skeletal damage
895.  Was your hair sensitive to brushing or combing (pulling, manipulation), or was it painful to remove something from your hair?
No / don't know
Yes
896.  Did your head sweat easily or at night?
No / don't know
Yes
897.  Did you roll your head on the mattress, or tend to rock back and forth?
No / don't know
Yes
898.  Were you inappropriately physically punished / abused as a child? Do not include sexual abuse here.
No / don't know
Mildly - an occasional smack
Moderately - regular light physical punishment
Occasional severe physical punishment/abuse
Severely - frequent hard physical punishment/abuse
899.  Were you ever molested / sexually abused / raped as a child? Only include incidents that occurred up until the age of 18.
No / can't remember / don't know
There was occasional molestation
Frequent molestation and/or isolated serious abuse
Occasional serious abuse over a long period
Frequent serious abuse over a long period
900.  Did your legs get tired easily; did you want to be carried a lot?
No / don't know
Yes
901.  Were you a hyperactive child?
No / don't know
Somewhat - I was more active than most children
Definitely - I was a 'real handful'
Severely - I was out of control
902.  Have you had some or all of the 'required' vaccinations?
Don't know
I have not been vaccinated at all
I have had vaccinations but will not have any more
I have had vaccinations and may have more
Yes, and I am careful about keeping up-to-date
903.  At what age was puberty onset, based on first physical signs (usually pubic hair development)?
10 or younger
11
12 / don't know
13
14 or older

Add any additional information here for the questions above:

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GLOSSARY

Allergic Salute (Allergic Crease)
When the itchy, runny or blocked nose is being wiped in an upwards direction. This movement helps to open up the nasal airways but can lead to an Allergic Crease - a horizontal crease or pale line that develops across the lower part of the nose as a consequence of frequent upward wiping of the nose.

Allergy (Allergies)
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Chicken Pox
An acute, highly infectious illness, principally of young children, caused by the chicken pox-herpes zoster virus and marked by fever and successive eruptions of clear blisters over the body. Chicken pox may enter latency in the deep nerve ganglia and reactivate years later in the form of herpes zoster.

Growing Pains
Unexplainable pain, usually in the legs, that occurs in growing children and is not accompanied by swelling or any other symptoms. Treatment includes massage and rest. The problem is distinguishing this pain from that caused by more serious problems: even physicians often have difficulty knowing how many laboratory and X-ray tests to perform.

Osgood-Schlatter Disease
One of the most common causes of knee pain in young athletes. It causes swelling, pain and tenderness just below the knee, at the top of the shin bone (tibia). It occurs mostly in boys who are having a growth spurt. One or both knees may be affected.

Osteochondrosis
The osteochondroses, also called Epiphyseal Ischemic Necrosis, are a relatively common group of orthopedic disorders of children, which are poorly understood. In an osteochondrosis, the epiphysis (growing end) of a bone dies and then is gradually replaced over a period of years, resulting in abnormal bone growth and deformity. The immediate cause of bone death is loss of blood supply, but why this occurs remains unclear.

Perthes Disease
Also known as Legg-Calvé-Perthes Disease (capital femoral epiphysis). The most common osteochondrosis, which occurs in the head of the thighbone, which dies and is then gradually replaced over a period of years. It occurs in youngsters aged 3-13 and is much more frequent in boys than in girls. Persistent pain is the most prominent symptom. Uncorrected severe cases lead to arrest of growth, deformity, and arthritic changes in the hip joint.





























 

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