ABIM Adolescent flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Tanner stage 2 in girls

Thelarche (breast budding) marks Tanner stage 2, typically between ages 8 and 13. Growth acceleration begins around this stage, and menarche follows about 2 to 2.5 years later.

Peak height velocity

The maximum growth rate during puberty. It averages about 8–9 cm/year in girls near age 11.5 and about 9–10 cm/year in boys near age 13.5, then decelerates.

Delayed puberty in boys

Absence of testicular enlargement (volume <4 mL) by age 14. Evaluation includes growth velocity, bone age, LH/FSH, testosterone, and karyotype when indicated.

Mid-parental height

For boys: (father's height + mother's height + 13 cm)/2. For girls: (father's height + mother's height − 13 cm)/2. The target range is plus or minus 8.5 cm.

HPV vaccine schedule

Routine at ages 11–12. Two doses if started before age 15 (0 and 6–12 months); three doses if started at 15 or older or if immunocompromised. Catch-up through age 26.

Meningococcal vaccine schedule

MenACWY at ages 11–12 with a booster at 16. MenB at ages 16–18 through shared clinical decision-making. Both are indicated for complement deficiency and asplenia.

Chlamydia screening in adolescents

Annual chlamydia and gonorrhea NAAT screening is recommended for all sexually active females aged 24 or younger, and for males in high-prevalence clinical settings.

PHQ-A

A nine-item adolescent depression screener adapted from the PHQ-9. Scores of 10 or higher suggest moderate depression and require further assessment, including suicide risk.

Suicide risk screening

Ask directly about suicidal ideation, plan, intent, and access to lethal means. Suicide is the second leading cause of death in ages 10–24; means restriction is a key intervention.

First-line adolescent depression treatment

Fluoxetine or escitalopram, the FDA-approved antidepressants for adolescents, combined with CBT or interpersonal therapy for moderate to severe major depressive disorder, with close monitoring for activation.

ADHD diagnostic criteria

DSM-5 requires at least six inattentive and/or hyperactive-impulsive symptoms for six months or more, onset before age 12, present in two or more settings, causing functional impairment.

LARC first-line contraception

Long-acting reversible contraception, including the subdermal implant and IUDs, is recommended first-line for adolescents. Typical-use failure rates are under 1% per year, far below pills or condoms.

Emergency contraception timing

Levonorgestrel 1.5 mg is effective up to 72 hours (best within 24 hours); ulipristal acetate up to 120 hours; copper IUD up to 5 days is the most effective option.

Confidential STI care

Most states allow minors to consent to STI testing and treatment without parental involvement. Explain confidentiality limits, including mandated reporting and insurance billing disclosures.

CRAFFT screening tool

A six-item adolescent substance use screen: Car, Relax, Alone, Forget, Friends, Trouble. Two or more yes answers indicate high risk and prompt brief intervention or referral to treatment.

Electronic cigarette risks

E-cigarettes deliver nicotine, ultrafine particles, and flavoring chemicals. Adolescent use is associated with nicotine dependence, EVALI from vitamin E acetate, and later combustible tobacco initiation.

Naloxone for opioid overdose

Intranasal or intramuscular naloxone reverses opioid-induced respiratory depression. Provide it to at-risk adolescents and household contacts, and repeat dosing as needed.

Anorexia nervosa criteria

Restriction causing significantly low weight, intense fear of weight gain, and disturbed body image. In adolescents weight may be normal, and amenorrhea is no longer required in DSM-5.

Refeeding syndrome

Dangerous electrolyte shifts, including hypophosphatemia, hypokalemia, and hypomagnesemia, after rapid nutrition reintroduction in malnourished patients. Monitor electrolytes and advance calories slowly.

Family-based treatment for anorexia

FBT (Maudsley) is first-line psychotherapy for adolescents with anorexia nervosa. Parents initially supervise renourishment, then gradually return control to the adolescent.

Pediatric obesity definition

BMI at or above the 95th percentile for age and sex defines obesity; at or above the 99th percentile defines severe obesity. Screen for hypertension, dyslipidemia, diabetes, and mental health comorbidity.

Health care transition

The planned movement from pediatric to adult care, ideally starting at ages 12–14 with readiness assessment, self-management skill building, and a written transition plan by age 14.

Guardianship alternatives

For youth lacking decision-making capacity, consider supported decision-making, power of attorney, or limited guardianship. Full guardianship is the most restrictive and should be a last resort.

Concussion return to play

After suspected concussion, remove from play the same day. Progress through symptom-limited activity, light aerobic exercise, sport-specific drills, non-contact practice, full contact, then game, at 24 hours per step.

Female athlete triad and RED-S

Interrelated low energy availability, menstrual dysfunction, and low bone mineral density. Screen athletes with stress fractures, amenorrhea, or disordered eating and address energy intake.

Preparticipation physical exam

Screen for cardiac symptoms (syncope, chest pain, palpitations, family history of sudden death), prior concussions, musculoskeletal injury, and substance use. Personal history is the highest-yield component.

Infectious mononucleosis

EBV infection with fever, pharyngitis, fatigue, and posterior cervical lymphadenopathy. Splenomegaly risk requires avoiding contact sports for about four weeks or until resolved.

Acne first-line therapy

For mild comedonal acne, use a topical retinoid. For inflammatory acne, add benzoyl peroxide with or without a topical antibiotic. Avoid topical antibiotic monotherapy; doxycycline is used for moderate-severe disease.

Group A streptococcal pharyngitis

Diagnose with rapid antigen test or culture. Treat with penicillin or amoxicillin for 10 days to prevent acute rheumatic fever. Do not treat asymptomatic household contacts.

Minor consent for contraception

Many states allow minors to consent to contraceptive services. Confidentiality may be limited by insurance explanation-of-benefits forms, so discuss billing and privacy options.

Mandated reporting

Clinicians must report suspected child abuse or neglect, including statutory rape as defined by state law, even when the adolescent requests confidentiality. Explain these limits in advance.

Mature minor doctrine

A legal principle allowing some minors to consent to certain medical care based on demonstrated maturity. Its scope varies by state and is often limited to specific services.