ABP Adolescent flashcards

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

Tanner stage B2

Breast bud stage in girls: areola widens and breast tissue emerges; typically the first visible sign of puberty, average onset ages 9-11.

First sign of male puberty

Testicular enlargement to at least 4 mL is usually the first sign of puberty in boys, typically between ages 9.5 and 14.

Precocious puberty thresholds

Puberty before age 8 in girls or age 9 in boys; evaluate for central or peripheral causes with GnRH stimulation and bone age.

Delayed puberty definition

Absence of breast development by age 13 in girls or testicular enlargement by age 14 in boys, or puberty taking more than five years to complete.

Peak height velocity

Maximum growth rate during puberty: about 9 cm/year in girls and 10.5 cm/year in boys; boys' spurt occurs later, around Tanner 3-4.

Menarche timing

First menstrual period, typically 2 to 2.5 years after thelarche and around age 12-12.5; growth slows after menarche.

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; ±8.5 cm range.

HPV vaccine schedule

Routine at 11-12 years; two doses if started before 15th birthday (0, 6-12 months); three doses if started at 15 or older.

Tdap and MenACWY

Tdap and meningococcal ACWY booster at 11-12 years; MenACWY booster at 16; MenB shared decision at 16-18.

HEEADSSS assessment

Psychosocial interview covering Home, Education, Eating, Activities, Drugs, Sexuality, Suicide/depression, and Safety; used at adolescent preventive visits.

USPSTF depression screening

Screen adolescents aged 12-18 for major depressive disorder; the USPSTF also recommends anxiety screening for ages 8-18.

Chlamydia screening

Annual chlamydia and gonorrhea screening for sexually active females aged 24 or younger; also screen males in high-prevalence settings.

Lipid screening in adolescents

AAP recommends one lipid panel between ages 9-11 and again between 17-21; earlier if risk factors such as obesity or family history.

Minor confidentiality

Adolescents may consent to confidential care for STIs, contraception, and mental health in many jurisdictions; explain limits such as imminent danger.

PHQ-A depression screen

Adolescent PHQ-9; score of 10 or more suggests moderate depression; item 9 assesses suicidal ideation and requires immediate follow-up.

First-line adolescent depression

Fluoxetine is approved for ages 8 and older; escitalopram for ages 12 and older; combine with cognitive behavioral therapy.

Suicide risk screening

Ask directly about thoughts, plans, intent, and access to lethal means; positive screens need same-day safety assessment and means counseling.

ADHD diagnostic criteria

DSM-5 requires symptoms before age 12, in two or more settings, causing impairment; stimulants are first-line medication after cardiac history review.

Anorexia nervosa criteria

Restriction causing low weight, intense fear of weight gain, and body image disturbance; amenorrhea is no longer required in DSM-5.

CRAFFT screening

Six-item substance use screen for adolescents; score of 2 or more indicates high risk and warrants brief intervention or further assessment.

Delayed sleep phase

Adolescent circadian shift causes late sleep onset; treatment includes fixed wake time, morning light, and limited evening screens.

LARC first-line

Long-acting reversible contraception, including implants and intrauterine devices, is recommended first-line for adolescents because it is highly effective.

Emergency contraception timing

Levonorgestrel works best within 72 hours; ulipristal within 120 hours; copper IUD can be placed within 5 days for emergency contraception.

Chlamydia treatment

Doxycycline 100 mg twice daily for 7 days is first-line for chlamydia in adolescents; azithromycin is no longer preferred due to resistance.

Gonorrhea treatment

Ceftriaxone 500 mg intramuscularly once for patients under 150 kg; add doxycycline if chlamydia is not excluded.

Condom counseling

External condoms reduce STI and pregnancy risk; advise consistent use with every act and offer dual protection with a long-acting method.

HPV and STI prevention

HPV vaccination prevents most cervical and anogenital cancers; screen sexually active adolescents for STIs regardless of vaccination status.

Asthma step therapy

Use inhaled corticosteroids as controller for persistent asthma; short-acting beta agonist as reliever; step up or down based on control.

Diabetic ketoacidosis signs

Polyuria, polydipsia, weight loss, nausea, abdominal pain, Kussmaul breathing, and fruity breath; check glucose and ketones urgently.

E-cigarette counseling

Vaping nicotine is common in adolescents and causes dependence; screen at every visit and offer cessation counseling and nicotine replacement when appropriate.

Opioid overdose response

Give naloxone intranasally or intramuscularly for suspected overdose; call emergency services and support breathing until help arrives.

Concussion return to learn

Cognitive rest followed by gradual return to school; return to sports only after symptoms resolve and a stepwise protocol is completed.