2. Having a Healthy Relationship with Your Teen
Dr. Jonas Aharoni, MD
Clinical Instructor of Internal Medicine and Pediatrics
UCLA Health – Burbank/Santa Clarita

3. Goal of Screenings for Your Teenager
Important to integrate preventative care into routine health maintenance.
Early identification of risk behaviors and disease
Works as an adjunct to preventative services provided through school and the community

4. Goals of Teenager Encounter
Update basic immunizations
Screening and counseling to prevent injuries from violence and accidents
Reduce high risk behaviors
Promote dental health

5. Important Screenings Hypertension Obesity and eating disorders
Hyperlipidemia
Tuberculosis
Learning or school problems
Substance abuse
Mental health and risk of suicide
STDs

6. Anticipatory guidance for your teen
Healthy dietary habits
Reduction of injuries by wearing seatbelt and bicycle helmet
Regular exercise
Limiting screen time
Optimal sleep of 8-10 hours per day
Responsible sexual behaviors
Avoidance of alcohol and tobacco
Avoidance of risky online behaviors like “sexting”
Ways of dealing with bullying

7. Immunizations They are safe!! Main vaccines for 11 years or older
Human Papilloma Virus (causes cervical cancer and genital warts)
Meningococcal Vaccine
Annual Flu Vaccine
Tdap booster

8. Puberty
Adolescents experience cognitive, psychosocial, and physical maturation
Increase in height and secondary sexual characteristics
Fertility achieved
Increase in bone mineralization and brain development
Mean age is 10.5 in girls and 11.5 in boys

9. Hormonal Axis of Puberty

10. Pubertal Changes Growth spurt, lasts for about 2 years
Bone growth accelerates
Sequence of pubertal maturation:
Breast development in girls
Increase of testicular volume in boys

11. Issues Arising with Puberty
Anemia and Iron deficiency due to menstruation
Gynecomastia in boys due to increase in estrogen
Acne due to higher levels of testosterone
Musculoskeletal injuries, greatest risk of fracture around growth plates (Osgood-Schlatter disease)
Accelerated progression of scoliosis
Sexually transmitted diseases

12. Psychological Changes in Puberty
Prevalence of depression may be twice as great in girls as compared with boys
Boys tend to become happier with their appearance as puberty continues
It is the opposite for girls
Girls that go through puberty early may show greater risk taking behavior early on

13. Precocious Puberty
Precocious puberty is traditionally defined as the onset of secondary sexual characteristics before the age of eight years in girls and nine years in boys
May show early development of secondary sexual characteristics.

14. Confidentiality
Some medical information is kept confidential from your teen and at their exam and we take time to discuss issues with them separate from their parent

15. Questions?

16. Thank You