By Jennifer Rosenblum (auth.), Mark A. Goldstein (eds.)
The MassGeneral clinic for kids Adolescent medication guide, is a definitive, functional advisor for the optimum medical care of kids. This precise and valuable source isn't just replete with simple diagrams, tables, charts and pathways; it most significantly covers intimately the simplest practices in adolescent medication the place perform not just capacity the main applicable methods, diagnostic evaluate and most sensible remedies, but additionally the simplest how you can attach, speak and proceed care with children. Divided into 3 sections, the guide covers common adolescent drugs, sexuality, and psychological healthiness. Chapters are written by means of remarkable general practitioner authors who characterize services in pediatric or grownup specialties and feature taught or informed at Massachusetts basic health center. The MassGeneral health facility for kids Adolescent drugs instruction manual joins jointly the collective wisdom and knowledge of its esteemed individuals to supply a multi-specialty method of adolescent healthcare that balances the technology and the artwork of adolescent medicine.
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Extra resources for The MassGeneral Hospital for Children Adolescent Medicine Handbook
Sample text
It is important to tell your patient that you will explain everything as you proceed. The external genital exam includes Tanner staging, evaluation of clitoral size, and inspection for external genital lesions, assessment of estrogenization status, vaginal discharge, and anatomy. Pink, moist vaginal mucosa reflects adequate estrogenization, while beefy, red, thin vaginal mucosa reflects low estrogen levels seen in disorders such as anorexia nervosa. Prior to inserting the speculum, place the water-warmed speculum on the inner thigh to prepare her for the next step of the exam.
The adolescent usually is in significant pain so a thorough testicular examination may not be possible. Immediate ultrasonography with color Doppler allows determination of blood flow, is readily available and less time consuming than radionuclide imaging of the scrotum. This test is highly reliable and does not expose the adolescent to radiation. 9). Epididymitis: This disorder is usually characterized by scrotal pain and swelling that occurs over a period of days rather than hours. Generally the epididymis is enlarged and tender as is the spermatic cord.
Adolescents complain of a dragging or heavy sensation to the testicle. Some teens develop gynecomastia when a tumor is secreting human chorionic gonadotropins. Others may have back or flank pain from metastatic disease. Examination reveals a firm/hard mass attached to the testicle that does not transilluminate. Testing should initially include a scrotal ultrasound (be sure to evaluate both testicles), which can discriminate between a malignant and a nonmalignant process. 11). D. University of California, San Diego, School of Medicine, San Diego VA Medical Center for allowing me to use images in this chapter.