1. Adolescent Health Stephen L Kebe, M.D. American Health Network Grove City Pediatrics

2. Health Care Visit • Family History • Medical History • Social History • Exam • Anticipatory Guidance/Plan

3. Family History

4. Family History • Asthma • Allergies(“allergic triad”) • Cardiac Disease • Diabetes • Mental Disorders

6. Medical History • Medications • Allergies • Surgery • Chronic Problems • Asthma • Headaches • Allergies

7. Social History

8. Social History Family life School Peer relationships Significant other Activities outside of school Hobbies Social networking Gaming

9. Physical Exam

11. Confidentiality

12. Social History Risky Behavior Smoking Drugs Alcohol Pornography Sexual activity

13. Risky Behavior

14. Impulsivity Immature Prefrontal cortex development

15. Impulsivity

20. Drugs Marijuana Ecstasy Methamphetamines Cocaine

21. Heroin/Krokodil Bath Salts/K2 or Snow White Steroids

22. The eyes don’t lie

23. Warning Signs Mood Swings Withdrawal Changes in school performance Sleeping in class Reduced attention span

24. Sexual Activity

25. Pornography

26. Common Adolescent HealthConditions

27. obesity Past 30 years, doubled in childhood and quadrupled in adolescents

28. Nutrition “You are what you eat!”

29. Obesity Ages 6-11 increased 7% to 18% Ages 12-19 increased 5% to 21% In 2012, Greater than 1/3 children and adolescents are overweight or obese.

30. obesity Complications ↑ cardiovascular disease ↑ diabetes ↑ stroke ↑ cholesterol ↑ cancer ↑ hypertension ↑ osteoarthritis

31. Calories consumed – Calories burned

32. Dietary Habits Too much sugar carbohydrates Too little exercise Too little balance of vegetables and fruit

33. Nutrition Fluid Intake Inadequate hydration Excess caffeine and sugar

34. Adequate hydration 64 oz. per day Improve cognitive function Blood pressure stability Physical function Mental awareness Aides in dental decay prevention

35. Eating schedules Enhanced metabolism Reduces swings in glucose metabolism Hypoglycemia

36. Eating disorders 24 million people of all ages suffer from eating disorders 3rd most chronic illness 50% tied to depression Highest mortality rate of any mental illness

37. Eating Disorders 20% will prematurely die from complications: Suicide Heart disease Media driven

38. Eating Disorder Prototype Depression Perfectionist Competitive

39. Physical activity

40. Physical Activity Improves strength Increases mental awareness Decreases: Weight Blood Pressure cholesterol Stress

41. Hygiene

42. Puberty

43. Puberty

45. Some Common Conditions in Adolescents Asthma Controlled or rescue medications Exacerbations

46. ADHD/LD Stimulants Behavioral Therapy Nutrition

47. Some Common Conditions in Adolescents Allergies Medication Prevention

48. Headaches Migraines Cluster Pseudo tumor Cerebra

49. ABDOMINAL PAIN

50. Abdominal Pain Constipation UTI Irritable Bowl Syndrome (IBS) Stress