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Adolescent Medicine, An Issue of Primary Care: Clinics in Office Practice, E-Book

Adolescent Medicine, An Issue of Primary Care: Clinics in Office Practice, E-Book

William B. Shore

(2014)

Additional Information

Abstract

This issue of Primary Care: Clinics in Office Practice, devoted to Adolescent Medicine, is edited by Drs. William B. Shore, Francesco Leanza, and Nicole Chaisson. Articles in this issue include: Health Care Maintenance for Adolescents; Adolescent Growth and Development; Puberty; Current Concepts of Psychosocial Development; Body Image and Health: Eating Disorders and Obesity; Working with Families with Adolescents; Care for Adolescents with Developmental Delay; Sports Medicine; Sports Injuries; Teens and Technology; Care of Incarcerated Youth; Mental Illness in Adolescence; Substance Use/Abuse; Current Approach to Contraception and Pregnancy; Oral/Hormonal Contraception; Sexually Transmitted Infections; Teen Sexuality and GLBT Youth; and Bullying and Violence Prevention.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Adolescent Medicine i
Copyright ii
Contributors iii
Contents vii
Primary Care:\rClinics In Office Practice xii
Foreword xiii
Preface xv
Adolescent Health Care Maintenance in a Teen-Friendly Clinic 451
Key points 451
Caring for teens in the primary care setting 451
Communication with Teens and Their Families 451
Systems/Structure 452
Minor consent and confidentiality 453
Strengths and resiliency 454
Assessing risk factors 454
Psychosocial screening tools 454
Health maintenance and screening 455
Immunizations 459
Summary 461
References 462
Adolescent Growth and Development 465
Key points 465
Introduction 465
Physical growth and development 466
Neuroendocrine Basis of Puberty 466
Hypothalamic Pituitary-Gonadal Axis 467
Adrenal Gland Changes 467
Growth Hormone Axes 467
Physical changes of puberty 467
Development of Secondary Sexual Characteristics 467
Height Growth 469
Body Composition 471
Approach to Normal Pubertal Variations and Abnormal Pubertal Growth and Development 471
Normal pubertal variations 474
Premature Adrenarche and Premature Thelarche 474
Abnormal growth and development 476
Precocious Puberty 476
Delayed Puberty 477
Short Stature 480
Tall Stature 481
Psychosocial growth and development 481
Developmental tasks and phases of adolescence 482
Cognitive development 482
Moral development 482
Self-concept and identity development 482
Relationship development 483
Adolescence as a social phenomenon: When does adolescence end? 483
References 483
Parents and Family Matter 489
Key points 489
Introduction 490
Why parents and family matter for adolescents 491
How Do Community and Neighborhood Factors Affect Parenting Practices and Ultimately Adolescent Health? 492
Optimizing primary care to meet the needs of adolescents and their families 493
The Current Status 493
Primary Care for Adolescents with Developmental Disabilities 507
Key points 507
Introduction 507
Definition of Developmental Disability 507
Barriers to Accessing Care 508
Interdisciplinary Team 509
Examination Room Etiquette 509
Assessment 510
Diagnostic Assessment 510
Developing Strengths 510
Adaptive Behavior 510
Communication 510
Establishing goals of care 511
Transition planning (patient centered) 512
Medical Summary 512
Health Passport 512
Documentation 512
Maximizing Social Environment 513
Maximizing Physical Environment 513
Improving Function-building Life Skills 513
Self-determination 514
Prevention of Abuse and Neglect 514
Bullying 515
Isolation/Seclusion 515
Navigating puberty 515
Changing Roles 515
Family Adjustment: Acceptance 515
Sexuality 515
Accessing Service Systems 516
Person-centered Planning 516
Monitoring health and safety 516
Care Management 516
Circles of Support 516
Crisis Intervention 516
Estate Planning 517
Summary 517
Acknowledgments 517
References 517
Body Image and Health 519
Key points 519
Introduction 519
Assessing eating behavior and activity in adolescents 520
The psychosocial context of eating behavior 524
Adolescent obesity screening, treatment, and referrals 525
Screening 526
Treatment 526
Referrals 528
Adolescent eating disorders screening and referrals 528
Screening and Diagnosis 530
Treatment 532
Summary 534
References 535
Common Issues Encountered in Adolescent Sports Medicine 539
Key points 539
Introduction 539
Preparticipation Cardiac Screening 540
Cardiac Physical Examination 541
Electrocardiogram 542
Sudden cardiac death 543
Hypertrophic Cardiomyopathy 543
Preparticipation Concussion Screening 544
Acute Concussion Diagnosis and Management 545
Recovery 547
Preparticipation Evaluation of Musculoskeletal Injuries 550
Traumatic Shoulder Injury 550
Nontraumatic Shoulder Injury 551
Anterior Knee Pain 552
Anterior Cruciate Ligament 554
The Adolescent Spine 554
Clearance to play 555
Summary 556
References 557
Teens, Technology, and Health Care 559
Key points 559
Introduction 559
Health Information Seeking Among Teens 560
Use of Technology for Health Care Engagement and Promotion Among Teens 560
Tools to Manage Chronic Illness 562
Sexual and reproductive health 563
Summary 564
References 565
Adolescent Substance Involvement Use and Abuse 567
Key points 567
Introduction 567
Risk and protective factors: vulnerability to SUDs 568
Prevalence/Incidence 569
Impact of substance use on adolescent health 569
Substances of abuse 570
Screening, brief intervention, and referral to treatment: a framework for addressing adolescent substance use 571
Screening 571
Tobacco Use: Special Considerations 577
Screening for Alcohol and Other Drugs of Abuse 577
Brief Intervention 578
Referral to Treatment 582
The Facilitated Referral 583
References 583
Mood Disorders in Adolescents 587
Key points 587
Introduction 587
Epidemiology and comorbidity 588
Risk factors 588
Recognizing symptoms of mood disorders in adolescents 589
Mental Status Examination 590
Screening and assessment 590
Depression Screening 590
BD Screening 594
Assessment of Mood Disorders 594
Suicide 596
Demographics 596
Risk Factors 596
Suicide Warning Signs and Assessment 597
Treatment 598
Psychosocial Interventions 598
Pharmacologic Interventions 599
Educating Families and Obtaining Consent 600
Referral to Mental Health Services 600
Case 601
Summary 601
References 602
Adolescent Pregnancy and Contraception 607
Key points 607
Case study 607
Introduction 607
Confidentiality, reproductive health, and the adolescent patient 609
Caring for the pregnant adolescent 609
Diagnosis and Screening 609
Pregnancy Options Counseling 610
Health Risks of Adolescent Pregnancy 611
Psychosocial Consequences 611
Improving Outcomes for Pregnant Adolescents 612
Pregnancy Prevention 612
First-line contraceptives for adolescents 613
When Can LARC Methods Be Initiated? 614
Contraceptive implant 614
Trouble-Shooting 620
Levonorgestrel IUD 620
Copper IUD 621
Trouble-Shooting IUDs 621
Second-line contraceptives 621
Depo-Medroxyprogesterone Acetate 621
Trouble-shooting 623
Combined Hormonal Contraception (Pills, Patch, Ring) 623
Trouble-shooting 624
Progestin-Only Pills 624
Emergency contraception 624
Dual methods 625
Summary 625
References 625
Common Sexually Transmitted Infections in Adolescents 631
Key points 631
General background 631
Special Considerations 632
STI prevention programs 632
Expedited partner therapy 632
Condom use 633
Confidentiality 633
Circumcision 633
Health education 634
Most common bacterial infections 634
Chlamydia 634
Organism/Transmission/Epidemiology 634
Screening 634
Symptoms 634
Diagnosis 635
Management 635
Gonorrhea 635
Organism/Transmission/Epidemiology 635
Screening 635
Symptoms 638
Complications 638
Diagnosis 638
Management 638
Syphilis 639
Organism/Transmission/Epidemiology 639
Screening 639
Symptoms 639
Early syphilis 639
Late syphilis 640
Diagnosis 640
Management 640
Special considerations/specific counseling points 641
Trichomonas Vaginalis 641
Organism/Transmission/Epidemiology 641
Screening 641
Symptoms 641
Complications 641
Diagnosis 641
Management 641
Preferred treatment 642
Special considerations 642
Most common viral infections 642
Human Papillomavirus 642
Organism/Transmission/Epidemiology 642
Screening 642
Symptoms 642
Diagnosis 642
Management 642
Vaccination 643
Special considerations 643
Genital Herpes 643
Organism/Transmission/Epidemiology 643
Screening 643
Symptoms 644
Diagnosis 644
Management 644
Human Immunodeficiency Virus 645
Organism/Transmission/Epidemiology 645
Screening 645
Symptoms 645
Diagnosis 646
Management 646
Special considerations 646
Summary 647
References 647
Sexual Minority Youth 651
Key points 651
Introduction 651
LGBT terminology 652
Sexuality constructs 655
Cause of sexual orientation and gender identity 656
LGBT prevalence 656
Mental health 656
The Psychosocial Factors 656
Coming Out 657
The Environmental Factors 657
Gender Variant Youth 658
Medical primary care 658
Health Maintenance 659
Body Image 659
Emotional Well-Being 659
Academic Concerns 660
Substance Use 660
Violence and Injury Prevention 660
Gay and bisexual men’s sexual health 660
Lesbian sexual health 662
Gender variant youth 662
Primary Care 662
Gender-Affirming Therapies for Transgender Youth 663
Prepubertal children 663
Puberty blocking agents 663
Cross-gender hormones 663
Surgical treatments 664
Summary 664
References 665
Adolescent Interpersonal Violence 671
Key points 671
Introduction 671
Adolescent violence involvement: scope of the problem 672
Risk and protective factors for adolescent violence involvement 673
Risk Factors for Adolescent Violence Involvement 673
Protective Factors Against Adolescent Violence Involvement 675
Resilience 675
Two contexts of adolescent violence and violence-related behaviors: bullying and dating 676
Adolescent Bullying Involvement 676
Definition of bullying 676
Risk and protective factors for adolescent bullying involvement 676
Adolescent bullying involvement and other forms of adolescent violence 677
Consequences of adolescent bullying involvement 678
Adolescent Dating/Relationship Violence 678
Definition of adolescent dating/relationship violence 678
Risk and protective factors for adolescent dating/relationship violence 679
Adolescent dating/relationship violence and other forms of adolescent violence 680
Consequences of adolescent dating/relationship violence 680
Adolescent violence involvement: implications for primary office practice 680
Importance of Screening 680
Preparing the Office Setting 685
Advocacy Outside of the Office 686
Summary 686
References 686
Health Care for Youth Involved with the Correctional System 691
Key points 691
Introduction 691
Demographics 691
Juvenile justice process 692
Health care services in detention facilities 692
Health of detained youth and goals for care in detention 693
Immunizations 693
Chronic Illnesses 694
Sexual and Reproductive Health Issues 694
General Health Complaints 695
Mental Health Issues and Suicidality 695
Substance Use and Abuse 696
Special populations 696
Girls 696
Gay, Lesbian, Bisexual, or Transgender Youth 697
Selected relevant biological and congenital genetic disorders 698
Klinefelter Syndrome 698
Fetal Alcohol Spectrum Disorders 698
Challenges to care 699
Follow-up care considerations 701
Summary 702
References 702
Index 707