Exam (elaborations)
CDP - Adolescence, Puberty, & Growth
- Institution
- Crimes Against Property - SCCJA.
CDP - Adolescence, Puberty, & Growth
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CDP - Adolescence, Puberty, & Growth"bones age" - ANS-- Significantly delayed bone age is consistent with constitutional
delay of growth/puberty
- Significantly accelerated bone age is consistent with precocious puberty
"delayed puberty" - ANS-- Pubertal onset at an age 2-3 standard deviations (SD) above
the mean age of puberty
- For females, this means pubertal onset after the age of 13
- For males, this means pubertal onset after the age of 14
"Precocious Puberty" - ANS-- Pubertal onset at an age 2-3 standard deviations (SD)
below the mean age of puberty
- For females, this means pubertal onset before the age of 8
- For males, this means pubertal onset before the age of 9Its just "time"
"Romeo and Juliet" Law - ANS-- Allows 14+ teenagers to "consent" to sex as long as
the other partner is also 14+ and the age gap is no more than 3 years
- Only applies to opposite sex partners
administration of GnRH agonist - ANS-GnRH agonist administration results in an initial
transient stimulation of gonadotropin secretion from the pituitary, followed by a
complete, but reversible, suppression of the pituitary-gonadal axis
Adolescent Mental Health - ANS-- One-half of all lifetime cases of mental disorders start
showing symptoms by age 14 and three-quarters are apparent by age 24
- Pediatric behavioral, developmental, and mental health issues are more common than
childhood cancer, cardiac problems, and renal problems combined
Adolescent Mental Health management - ANS-- Educate all adolescents on signs of
worsening mental health and resources to access in these time
- Medical providers
- Psychotherapy
- School counselors
- Suicide hotline
- Non-pharmacologic or pharmacologic management as indicated by specific diagnosis
- Refer to Adolescent Medicine Specialist or Psychiatrist
Adolescent Mental Health Screening - ANS-slide 11
, Adolescent Mental Health Screening - ANS-slide 11
Adolescent Sexual Development management - ANS-- Offer education through many
different forms
- Discuss forms of contraception
- Discuss protection and treatment of STDs
Adolescent Sexual Development management: discuss forms of contraception - ANS--
Can discuss and provide condoms to any minor even without parental consent
- Can discuss prescription contraceptives with minors without parental consent, but
cannot provide prescription contraceptives to minors without parent consent (unless
minor is able to consent for own medical care)
Adolescent Sexual Development management: Discuss protection and treatment of
STDs - ANS-- Educate patient that only condoms prevent STDs, not any form of
prescription contraceptives
- Can provide care for STD's to any minor even without parental consent
Adolescent Sexual Development management: education - ANS-- Verbal: in office
discussion
- Reading: patient education handouts/pamphlets
Adolescent Sexual Development screening - ANS-- The health professional needs to
discuss sexual development, contraception, STI's, and pregnancy with ALL adolescent
patients
- Annual visit
- Physical Exam
slide 18!
Adolescent Sexual Development screening: Physical Exam - ANS-- Providers should
perform sexual maturity ratings starting at age 7 years old
- Tanner Staging is the standard measure for sexual maturity
5 levels of Tanner staging
- 1= prepubertal
- 5= adult development
- Check for any signs of STD's (ex: urethral discharge, genital rashes)
Age of consent - ANS-Age of consent in Texas is 17
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