ABIM Adolescent key terms

The five-stage scale describing pubertal breast, genital, and pubic hair development. Stage 1 is prepubertal and stage 5 is adult; staging guides assessment of pubertal timing and pace.

The maximum rate of linear growth during the pubertal growth spurt, averaging roughly 9 cm per year in boys and 8 cm per year in girls, and occurring about two years earlier in girls.

A benign pattern of late pubertal onset and slow growth consistent with family history, in which bone age lags chronologic age and puberty eventually proceeds normally without hormonal intervention.

The first menstrual period, typically occurring between ages 12 and 13 in U.S. girls, roughly two to two and a half years after breast budding begins.

Onset of secondary sexual characteristics before age 8 in girls or age 9 in boys, warranting evaluation for central or peripheral causes depending on the pattern and pace of progression.

A structured psychosocial interview for adolescents covering Home, Education and employment, Activities, Drugs, Sexuality, and Suicide and mood, used to uncover risk behaviors during preventive visits.

Routine immunization against human papillomavirus, recommended at ages 11 to 12 with catch-up through age 26; two doses suffice if started before age 15, otherwise three doses are needed.

Vaccination against Neisseria meningitidis serogroups A, C, W, and Y, routinely given at ages 11 to 12 with a booster at 16; serogroup B vaccine is added through shared clinical decision-making.

The process of bringing an adolescent with incomplete or unknown vaccination history up to date, using minimum intervals from the CDC catch-up schedule rather than restarting completed series.

Universal screening for dyslipidemia once between ages 9 and 11 and again between ages 17 and 21, plus selective screening of high-risk youth based on family history and comorbidities.

A nine-item adolescent self-report depression measure aligned with DSM criteria that yields a severity score; a positive screen requires a clinical interview, since screening alone does not establish diagnosis.

A structured clinical inquiry into suicidal ideation, plan, intent, access to lethal means, prior attempts, and protective factors, used to determine level of care and need for safety planning.

A persistent pattern of inattention and/or hyperactivity-impulsivity causing functional impairment, with symptoms present before age 12; treatment combines behavioral strategies with stimulant or nonstimulant medication.

Deliberate self-inflicted tissue damage without suicidal intent, most often cutting, used to regulate distress; it is a risk factor for later suicide attempts and warrants careful assessment.

Methods such as intrauterine devices and subdermal implants that require no ongoing user action, achieve typical-use effectiveness above 99%, and are highly acceptable to adolescents when counseling is noncoercive.

Methods used to prevent pregnancy after unprotected intercourse: copper IUD (most effective, up to five days), ulipristal acetate (120 hours), and levonorgestrel (120 hours, less effective at higher body weight).

Annual nucleic acid amplification testing of urine or vaginal swab for sexually active females aged 25 or younger, and for males in high-prevalence settings; most infections are asymptomatic.

A person's internal sense of being male, female, or another identity, which may differ from sex assigned at birth; gender dysphoria refers to the distress that can accompany this incongruence.

Upper genital tract infection, often from untreated chlamydia or gonorrhea, presenting with pelvic pain and cervical motion tenderness; treatment must cover gonorrhea and anaerobes, and an IUD need not be removed.

A six-item adolescent substance use screen asking about Car, Relax, Alone, Forget, Family or friends, and Trouble; a score of 2 or more indicates the need for further assessment.

A public health framework of universal Screening, Brief Intervention using motivational techniques, and Referral to Treatment for substance use, delivered in primary care and emergency department settings.

Inhalation of aerosol from electronic nicotine delivery systems, common among adolescents; it delivers high nicotine doses, and EVALI is an associated acute lung injury linked to vitamin E acetate.

Use of buprenorphine, methadone, or naltrexone to treat opioid use disorder; buprenorphine is approved for patients aged 16 and older and is preferred over withdrawal management alone.

Restriction of energy intake relative to requirements leading to significantly low body weight, intense fear of weight gain, and disturbed body image; medical instability often requires hospitalization for supervised refeeding.

Recurrent binge eating with compensatory behaviors such as vomiting or laxative misuse at least weekly for three months, without persistently low weight; electrolyte abnormalities and dental erosion are common.

Avoidance or restriction of intake due to sensory sensitivity, low interest in eating, or fear of aversive consequences, without body image disturbance, causing weight loss or nutritional deficiency.

Potentially fatal fluid and electrolyte shifts, especially hypophosphatemia, occurring when nutrition is reintroduced too rapidly to a malnourished patient; prevention uses cautious caloric advancement and electrolyte monitoring.

A planned, longitudinal process of moving an adolescent, with or without chronic conditions, from pediatric to adult-centered care, including self-management skills, insurance planning, and transfer timing.

A less restrictive alternative to guardianship in which a trusted person helps a young adult with cognitive disability understand options and communicate choices while legal authority remains with the patient.

Educational accommodations for adolescents with health or learning conditions: an IEP under IDEA provides specialized instruction, while a 504 plan provides accommodations for a student in regular education.

A structured history and physical examination for young athletes emphasizing cardiovascular and neurologic screening, musculoskeletal assessment, and a clear determination of medical clearance for sport.

A standardized set of 14 history and physical elements recommended for athletes, targeting exertional symptoms, family history of sudden death, and findings suggestive of conditions causing sudden cardiac arrest.

A trauma-induced alteration in brain function with symptoms such as headache, dizziness, and cognitive slowing; management is relative physical and cognitive rest followed by graded return to learn, then sport.

A syndrome of impaired physiological function, including bone health and menstrual function, resulting from energy intake inadequate for exercise expenditure; it generalizes the original female athlete triad.

Inflammation of pilosebaceous units driven by androgens, sebum, Cutibacterium acnes, and follicular keratinization; treatment is matched to severity, and isotretinoin is reserved for severe nodulocystic disease.

An Epstein-Barr virus infection marked by fever, exudative pharyngitis, cervical lymphadenopathy, and fatigue, often with splenomegaly; athletes should avoid contact sports for about four weeks because of rupture risk.

Streptococcal infection presenting with sore throat, fever, tonsillar exudate, and tender anterior adenopathy without cough; diagnosis requires rapid antigen testing or culture, and penicillin remains first-line therapy.

Legal recognition that adolescents may consent to certain services, such as STI testing, contraception, and mental health care, without parental permission; scope varies by state and shapes confidentiality practices.

The statutory duty of clinicians to report suspected child abuse or neglect to designated authorities, even when the adolescent requests confidentiality; failure to report carries civil and criminal penalties.

Federal privacy rules that generally allow parental access to a minor's record but defer to state law when the adolescent lawfully consented to care, creating challenges for billing and patient portal access.