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 2019년 10월 무이 
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미용피부성형시술의 외래진료지침서
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Berek and Hacker's Gynecologic Oncology,6/e
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    Pediatric and Adolescent Gynecology-7판   
Pediatric and Adolescent
       판매가 : 190,000171,000
       적립금 : 3,420
       저   자 : Emans
       역   자 :
       출판사 : LWW
    ISBN(13) : 9781975107444
       발행일 : 2019-11-27  /   7판   /   1200 페이지
       상품코드 : 26973
       수 량 :
       



Offering multidisciplinary guidance to all health care practitioners who provide clinical care for children and
adolescents, the 7th Edition of Emans, Laufer, Goldstein's Pediatric & Adolescent Gynecology has been extensively
revised to keep you up to date in this complex field. You'll find comprehensive coverage of the full spectrum of
medical and surgical approaches to common and uncommon problems - everything from infants with vulvar rashes,
to the child with early or late onset of puberty, to adolescents and young adults with ovarian cysts or STDs.
More than 40 experts in the field, led by editors from Boston Children's Hospital and Harvard Medical School,
have contributed to ensure this classic text remains relevant and useful in daily practice.

◦ Completely revised and reorganized to include 19 new chapters, including all-new content on working with LGBTQ teens;
transgender adolescents undergoing surgical/hormonal transition; gynecologic cancers; abuse, violence, and human
trafficking; caring for athletes; bone health; gastrointestinal issues; surgical techniques, vaginoscopy, and
laparoscopy, as well as new videos on surgical procedures.

◦ Logically organized, beginning with history and physical examination and the physiology of puberty, followed by
medical and surgical approaches to common issues seen in practice.

◦ More than 700 full-color images and 100 case examples throughout, as well as full references for assistance with
further reading or research.

◦ Recommended by the North American Society for Pediatric and Adolescent Gynecology Guidelines for the short and long
pediatric and adolescent gynecology resident core curriculum.

◦ Ideal for pediatricians, gynecologists, emergency medicine specialists, reproductive endocrinologists, adolescent
medicine specialists, family medicine practitioners, physician assistants, nurse practitioners, nurses, residents, and
fellows.

Enrich Your eBook Reading Experience◦Read directly on your preferred device(s), such as computer, tablet, or smartphone.

◦ Easily convert to audiobook, powering your content with natural language text-to-speech.


목차

PART 1 Foundations of Pediatric and Adolescent Gynecology
1 Office Evaluation of the Child and Adolescent
OFFICE EVALUATION OF THE CHILD
OBTAINING THE HISTORY
GYNECOLOGIC EXAMINATION
EXAM UNDER ANESTHESIA (EUA), SPECULUM EXAM, VAGINOSCOPY
VAGINAL SAMPLES
COMPLETING THE EXAMINATION
OFFICE EVALUATION OF THE ADOLESCENT
OBTAINING THE HISTORY
GYNECOLOGIC EXAMINATION
DIAGNOSTIC TESTS
PAPANICOLAOU TEST
WET PREPARATIONS
OTHER COMMERCIAL TESTS FOR BACTERIAL VAGINOSIS
pH
TESTS FOR NEISSERIA GONORRHOEAE AND CHLAMYDIA TRACHOMATIS
OTHER TESTS
PROGESTERONE WITHDRAWAL TEST
PREGNANCY TESTS
BONE AGE
IMAGING TECHNIQUES
DETECTION OF OVULATION
TRACKING MENSTRUAL CYCLES
2 Interviewing the Adolescent: Strategies That Promote Communication and Foster Resilience
TALKING WITH TEENS: ADOPTING A STRENGTH-BASED APPROACH
STRATEGIES THAT OPTIMIZE COMMUNICATION WITH ADOLESCENTS
EMBRACING A PATIENT-CENTERED APPROACH TO COMMUNICATION
PAYING ATTENTION TO BODY LANGUAGE
“SETTING THE STAGE” FOR HONEST COMMUNICATION
“SETTING THE STAGE” WITH THE TEEN’S PARENTS
TRAUMA-INFORMED PRACTICE
A NEW APPROACH TO THE SOCIAL HISTORY
STRATEGIES FOR STRENGTH-BASED RISK BEHAVIOR COUNSELING
AVOIDING SHAME: LISTENING FOR THE POSITIVE
STATING THE CONCERN IN CONTEXT OF THE TEEN’S LIFE AND ASKING FOR PERMISSION TO ADDRESS IT
ADJUSTING THE COUNSELING APPROACH BASED ON STAGE OF CHANGE
TAKING COGNITIVE DEVELOPMENT INTO ACCOUNT
GUIDING INSTEAD OF LECTURING
TEACHING NEGOTIATION SKILLS
TAKING SOCIAL CONTEXT INTO ACCOUNT
INCORPORATING MOTIVATIONAL INTERVIEWING TECHNIQUES
NURTURING A RESILIENT YOUTH
3 Embryology of the Reproductive Tract
4 The Physiology of Puberty
HORMONAL CHANGES AT PUBERTY
STAGES OF BREAST AND PUBIC HAIR DEVELOPMENT
GROWTH PATTERNS
BONE DEVELOPMENT AND ACCRETION
MENARCHE
HORMONE LEVELS IN NORMAL OVULATORY CYCLES
CLINICAL APPLICATIONS
5 Adolescent Sexuality and Sex Education
ADOLESCENT SEXUAL BEHAVIORS
SEXUAL BEHAVIOR
NONCONSENSUAL SEXUAL EXPERIENCES
SEXUALLY TRANSMITTED INFECTIONS
PREGNANCY AND BIRTHS AMONG ADOLESCENTS
DRUGS AND ALCOHOL
ISSUES FOR LGBT ADOLESCENTS
THE NEED FOR LGBT-INCLUSIVE SEX EDUCATION
ADOLESCENT RELATIONSHIPS
SEX EDUCATION
SUPPORT FOR SEX EDUCATION IN SCHOOLS
EFFECTIVE PREGNANCY AND HIV/AIDS PREVENTION PROGRAMS
DIGITAL APPROACHES TO SEX EDUCATION
YOUNG PEOPLE WITH DISABILITIES
PEER INFLUENCES
THE ROLE OF PARENTS
THE MEDIA
A GLOBAL PERSPECTIVE
ROLE OF THE HEALTH CARE PROVIDER
6 Education and Support of the Child and Adolescent With Gynecologic Issues
OFFICE EDUCATION
GYNECOLOGIC EDUCATIONAL CONSIDERATIONS
PAP TEST AND COLPOSCOPY EDUCATION
MAYER-ROKITANSKY-KüSTER-HAUSER SYNDROME
ENDOMETRIOSIS
GYNECOLOGIC SURGICAL CONSIDERATIONS
PREOPERATIVE EDUCATION
PERIOPERATIVE EDUCATION
POSTOPERATIVE EDUCATION AND SUPPORT
SPECIFIC GYNECOLOGIC SURGICAL CONSIDERATIONS
CONCLUSION
7 Training in Pediatric and Adolescent Gynecology
TRAINING EXPERIENCES IN PEDIATRIC AND ADOLESCENT GYNECOLOGY
RESIDENCY TRAINING
FELLOWSHIP TRAINING
ADVANCED TRAINING
TEACHING TOOLS IN PEDIATRIC AND ADOLESCENT GYNECOLOGY
TEXTBOOKS AND CURRICULA
INTERACTIVE AND ELECTRONIC LEARNING PLATFORMS FOR PAG TEACHING
SIMULATION FOR TEACHING PAG
SUMMARY
8 Patient Safety and Quality Improvement in Office Gynecology
FACTORS CONTRIBUTING TO PATIENT HARM IN THE OFFICE
MEDICAL MALPRACTICE AND AMBULATORY CARE
MEDICAL MALPRACTICE AND OFFICE GYNECOLOGY
STRATEGIES FOR PREVENTING ERRORS AND IMPROVING OFFICE-BASED PRACTICE
CULTIVATE A CULTURE OF SAFETY
ASSESS SAFETY CULTURE
PROVIDE LEADERSHIP FOR PATIENT SAFETY IN THE OFFICE
FOSTER A LEARNING ENVIRONMENT
ADDRESS COMMON PITFALLS IN OFFICE PRACTICE
QUALITY IMPROVEMENT AND METRICS IN OFFICE-BASED CARE
CREATE A SAFE ENVIRONMENT FOR OFFICE-BASED SURGERIES
CONCLUSION
9 Legal Issues in Pediatric and Adolescent Gynecology
NATURE AND SOURCES OF LAW
CONSENT TO MEDICAL CARE
CONFIDENTIALITY OF PATIENT INFORMATION
SEXUAL ABUSE
CONTRACEPTION
STERILIZATION
ABORTION
SEXUALLY TRANSMITTED INFECTIONS
HIV AND AIDS
SUMMARY
PART 2 Evaluation and Management of Developmental and Structural Gynecologic Issues
10 Ambiguous Genitalia in the Newborn and Disorders of Sex Development
TERMINOLOGY
APPROACH TO THE CHILD WITH DSD
GENDER DESIGNATION
ASSESSMENT OF THE NEONATE
HISTORY
PHYSICAL EXAMINATION
LABORATORY AND RADIOGRAPHIC TESTS
REVIEW OF EMBRYOGENESIS
TESTICULAR DIFFERENTIATION
PHENOTYPIC SEX
DIFFERENTIAL DIAGNOSIS OF AMBIGUOUS GENITALIA IN THE NEWBORN
SEX CHROMOSOME DISORDERS OF SEXUAL DEVELOPMENT
XX DISORDERS OF SEXUAL DEVELOPMENT
CONGENITAL ADRENAL HYPERPLASIA
MATERNAL OR FETOPLACENTAL ANDROGENS
46,XX TESTICULAR DSD
XY DISORDERS OF SEXUAL DEVELOPMENT
DISORDERS OF GONADAL (TESTICULAR) DEVELOPMENT
DISORDERS IN ANDROGEN SYNTHESIS OR ACTION
MALFORMATION SYNDROMES
HYPOSPADIAS AND CRYPTORCHIDISM
11 Structural Abnormalities of the Female Reproductive Tract
ABNORMALITIES OF THE FEMALE REPRODUCTIVE TRACT
EXTERNAL GENITALIA
DISORDERS OF MESONEPHRIC REMNANTS
INTROITAL ABNORMALITIES
ANOMALIES OF THE UTERUS, FALLOPIAN TUBE, CERVIX, AND VAGINA
DIAGNOSIS AND TREATMENT OF SPECIFIC ANOMALIES OF THE FEMALE GENITAL TRACT
IMPERFORATE HYMEN
MICROPERFORATE/SEPTATE/COMPLEX HYMEN
ANOMALIES OF THE VAGINA
TRANSVERSE VAGINAL SEPTUM
DISTAL VAGINAL ATRESIA/AGENESIS OF THE LOWER VAGINA/SEGMENTAL VAGINAL AGENESIS
VAGINAL AGENESIS (MÜLLERIAN APLASIA)
McINDOE VAGINOPLASTY
WILLIAMS PROCEDURE
BOWEL VAGINAS
DAVYDOV, AMNION, WHARTON, AND SHEARES PROCEDURE
VECCHIETTI AND MODIFIED VECCHIETTI PROCEDURES
OUTCOMES OF NONSURGICAL AND SURGICAL NEOVAGINA
CERVICAL ANOMALIES
CERVICAL ATRESIA/HYPOGENESIS
UTERINE ANOMALIES
TRUE DUPLICATION AND INCOMPLETE FUSION OF THE MÜLLERIAN DUCTS
LONGITUDINAL VAGINAL SEPTUM
DISORDERS OF THE UTERUS
UTERINE SEPTUM (ARCUATE/NORMAL, PARTIAL SEPTUM, COMPLETE SEPTUM)
FERTILITY OPTIONS AND PREGNANCY OUTCOME IN WOMEN WITH MüLLERIAN DUCT ANOMALIES
12 Pediatric Urology
PRESENTING SYMPTOMS: EVALUATION AND DIFFERENTIAL DIAGNOSIS
DYSURIA
HEMATURIA
INCONTINENCE
RENAL COLIC
FLANK PAIN AND FEVER
PERINEAL MASS
INCIDENTAL: CONGENITAL ANOMALIES OF THE URINARY TRACT
SUMMARY OF ESSENTIAL EVALUATION MODALITIES
ULTRASOUND
CYSTOGRAPHY—RADIOGRAPHIC, ULTRASOUND, AND RADIONUCLIDE
INTRAVENOUS PYELOGRAM
RADIONUCLIDE RENAL SCANS: DMSA AND MAG-3
COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING/MAGNETIC RESONANCE UROGRAPHY
URODYNAMICS
MAJOR CONDITIONS
DYSFUNCTIONAL VOIDING
NOCTURNAL ENURESIS
URINARY OBSTRUCTION: URETEROPELVIC JUNCTION OBSTRUCTION AND URETEROVESICAL JUNCTION OBSTRUCTION
URINARY TRACT INFECTION
REFLUX
STONE
ECTOPIC URETER AND URETEROCELE
RENAL MASSES
PELVIC TUMORS
EXSTROPHY AND EPISPADIAS
URETHRAL PROLAPSE
ACKNOWLEDGMENT
13 Multidisciplinary Management of Complex Urologic, General Surgical, and Gynecologic Anomalies
SUBSYMPHYSEAL EPISPADIAS
BLADDER EXSTROPHY
CLOACAL ANOMALY
AMBIGUOUS GENITALIA
XX DISORDERS OF SEX DEVELOPMENT (FORMERLY ADRENOGENITAL SYNDROMES)
HIGH AGENESIS OF THE LOWER VAGINA
CONCLUSION
PART 3 Vulvar and Vaginal Disorders
14 Vulvovaginal Problems in the Prepubertal Child
VULVOVAGINITIS
NORMAL VAGINAL FLORA
ETIOLOGY OF VULVOVAGINITIS
OBTAINING THE HISTORY
PHYSICAL EXAMINATION
LABORATORY TESTS
TREATMENT
LICHEN SCLEROSUS
VAGINAL BLEEDING
TREATMENT OF NONTRAUMATIC ETIOLOGIES OF VAGINAL BLEEDING
INTERLABIAL MASSES
CLITORAL LESIONS
LABIAL ADHESIONS
MISCELLANEOUS ENTITIES
15 Vulvar Dermatology
IS IT VULVOVAGINITIS OR A VULVAR DERMATOSIS?
THE ETIOLOGY OF PEDIATRIC VULVAR COMPLAINTS—GYNECOLOGIC OR DERMATOLOGIC, OR WHO SEES WHAT?
SPECIAL CHARACTERISTICS OF VULVAR SKIN
FACTORS PREDISPOSING TO VULVAR DERMATOSES IN CHILDREN AND ADOLESCENTS
OFFICE APPROACH TO VULVAR DERMATOLOGY
THERAPEUTICS
GENERAL MEASURES
MEDICATIONS
VULVAR SKIN BIOPSY
OTHER USEFUL DERMATOLOGIC PROCEDURES
CURETTAGE
LIQUID NITROGEN CRYOTHERAPY
NORMAL VULVAR FINDINGS THAT MAY BE CONFUSED WITH SKIN DISEASE
SEBACEOUS GLANDS
VESTIBULAR PAPILLOMATOSIS
VULVAR DERMATOSES IN INFANCY
IRRITANT DIAPER DERMATITIS
CANDIDAL DIAPER DERMATITIS
JACQUET EROSIVE DERMATITIS
GRANULOMA GLUTEALE INFANTUM
SEBORRHEIC DERMATITIS
LANGERHANS CELL HISTIOCYTOSIS
ACRODERMATITIS ENTEROPATHICA
HEMANGIOMA OF INFANCY
INFANTILE PERIANAL PYRAMIDAL PROTRUSION
VULVAR DISEASE IN OLDER CHILDREN AND ADOLESCENTS
PIGMENTARY DISORDERS
INFLAMMATORY DISEASES
VULVAR ULCERS
INFECTIOUS DISEASES
BACTERIAL
VIRAL
FUNGAL
AUTOIMMUNE BLISTERING DISEASES
BENIGN SOFT TISSUE TUMORS
VULVAR MANIFESTATIONS OF SYSTEMIC DISEASE
SPECIAL TOPICS
CHRONIC VULVAR PRURITUS AND VULVAR PAIN (VULVODYNIA)
PUBIC HAIR REMOVAL
GENITAL PIERCING
16 Genital Trauma
PATIENT ASSESSMENT
EXAMINATION IN A CHILD OR ADOLESCENT
DIAGNOSIS
ETIOLOGY OF ACCIDENTAL GENITAL INJURIES
TREATMENT
MEDICAL CARE OF SEXUALLY ABUSED CHILDREN AND TEENS
MANAGEMENT OF GENITAL INJURIES
SPECIAL CONSIDERATIONS
FOLLOW-UP
SUMMARY
17 Vulvovaginal Complaints in the Adolescent
VAGINAL DISCHARGE
PHYSIOLOGIC DISCHARGE
TRICHOMONAL VAGINITIS
TREATMENT
CANDIDA VAGINITIS
BACTERIAL VAGINOSIS
DESQUAMATIVE INFLAMMATORY VAGINITIS (DIV)
VAGINITIS SECONDARY TO A FOREIGN BODY
GENITAL HERPES SIMPLEX VIRUS (HSV)
MOLLUSCUM CONTAGIOSUM
PEDICULOSIS PUBIS (CRABS)
SCABIES
PINWORMS
VULVAR DISORDERS
VULVAR TRAUMA
VULVAR ULCERS
NEVI
STEVENS–JOHNSON SYNDROME/TOXIC EPIDERMAL NECROLYSIS
TOXIC SHOCK SYNDROME
DYSURIA
LABIAL HYPERTROPHY
PART 4 Vulvar and Vaginal Disorders
18 Sexually Transmitted Infections: Chlamydia, Gonorrhea, Pelvic Inflammatory Disease, Syphilis, and Mycoplasma
genitalium
CHLAMYDIA TRACHOMATIS INFECTION
SCREENING
DISEASE MANIFESTATIONS AND SEQUELAE
RECURRENT INFECTIONS
DIAGNOSIS
REACTIVE ARTHRITIS
TREATMENT
INFECTIONS IN NEONATES AND PREPUBERTAL CHILDREN
NEISSERIA GONORRHOEAE INFECTIONS
SCREENING
DIAGNOSIS
UROGENITAL GONOCOCCAL INFECTION
TREATMENT OF ASYMPTOMATIC INFECTIONS, CONTACTS, URETHRITIS, AND CERVICITIS
GONOCOCCAL PHARYNGITIS
GONOCOCCAL PROCTITIS
MANAGEMENT
GONOCOCCAL CONJUNCTIVITIS
DISSEMINATED GONOCOCCAL INFECTION
GONOCOCCAL INFECTIONS IN NEONATES AND PREPUBERTAL CHILDREN
PELVIC INFLAMMATORY DISEASE
DIAGNOSIS
OUTPATIENT THERAPY FOR ACUTE PELVIC INFLAMMATORY DISEASE
INPATIENT (PARENTERAL) THERAPY FOR ACUTE PID
TREATMENT OF TUBO-OVARIAN ABSCESS
FOLLOW-UP
SPECIAL POPULATIONS
CONSEQUENCES OF ACUTE PELVIC INFLAMMATORY DISEASE
SYPHILIS
STAGES OF SYPHILIS
DIAGNOSIS OF SYPHILIS
TREATMENT
SYPHILIS AND HIV INFECTION
SYPHILIS IN PREGNANCY
OTHER MANAGEMENT CONSIDERATIONS
Mycoplasma Genitalium
PREVALENCE
PRESENTATION AND DIAGNOSIS
TREATMENT
19 Diagnosis, Management, and Prevention of Human Immunodeficiency Virus in Young Women
EPIDEMIOLOGY
ESTIMATES OF HIV/AIDS INCIDENCE AND PREVALENCE IN YOUTH/YOUNG WOMEN
HIV SEROPREVALENCE AND BEHAVIORAL RISK FACTOR STUDIES
ASSESSMENT
HIV SCREENING, TESTING, AND RISK ASSESSMENT
SCREENING AND TESTING FOR HIV: BARRIERS AND FACILITATORS
DIAGNOSING HIV
PRENATAL SCREENING FOR HIV
PREVENTION OF MATERNAL TO CHILD TRANSMISSION
ACUTE RETROVIRAL SYNDROME
DIAGNOSING AIDS
TREATMENT AND INITIAL CARE
CARE ENTRY: STAGING INFECTION—BASELINE EVALUATION FOR YOUNG WOMEN WITH HIV
HIGHLY ACTIVE ANTIRETROVIRAL THERAPY AND TREATMENT INITIATION
PREVENTION
PrEP
nPEP
REPRODUCTIVE AND GYNECOLOGIC CONDITIONS IMPACTED BY HIV
GYNECOLOGIC CONDITIONS IMPACTED BY HIV
REPRODUCTIVE HEALTH ISSUES
CONTRACEPTION
FOLLOW-UP AND PRIMARY CARE
PSYCHOSOCIAL CARE AND SUPPORT AND PROMOTING HEALTHY TRANSITIONS
20 Human Papillomavirus Infection and Cervical Cancer Screening and Prevention in Adolescents
BACKGROUND
PREVENTION OF HUMAN PAPILLOMAVIRUS INFECTION AND SEQUELAE
PRIMARY PREVENTION
SECONDARY PREVENTION
BIOLOGY OF HUMAN PAPILLOMAVIRUS INFECTION
VIROLOGY AND GENETICS
HUMAN PAPILLOMAVIRUS TYPING
NATURAL HISTORY AND EPIDEMIOLOGY OF HUMAN PAPILLOMAVIRUS INFECTION
HUMAN PAPILLOMAVIRUS IN CHILDREN
HUMAN PAPILLOMAVIRUS INFECTION IN ADOLESCENTS
CONDYLOMATA ACUMINATA
ABNORMAL CYTOLOGY
EVALUATION AND MANAGEMENT OF HUMAN PAPILLOMAVIRUS INFECTION IN CHILDREN
RISK FACTORS FOR HUMAN PAPILLOMAVIRUS IN ADOLESCENTS
EVALUATION OF HUMAN PAPILLOMA VIRUS IN ADOLESCENTS
CERVICAL CANCER SCREENING AND MANAGEMENT IN ADOLESCENTS
HISTORY OF CERVICAL CANCER SCREENING GUIDELINES
UPDATED GUIDELINES FOR CERVICAL CANCER SCREENING IN YOUNG WOMEN
SPECIAL POPULATIONS
LESBIAN AND BISEXUAL WOMEN
WOMEN WITH DISABILITIES
HIV POSITIVE OR OTHERWISE IMMUNOCOMPROMISED FEMALES
UNDERSERVED AND INCARCERATED ADOLESCENT FEMALES
MÜLLERIAN ANOMALIES
ADOLESCENTS WITH AN INTRAUTERINE SYSTEM (IUS) IN PLACE
TRANSGENDER YOUTH
MANAGEMENT OF HUMAN PAPILLOMAVIRUS IN ADOLESCENTS
CONDYLOMATA
CURRENT GUIDELINES FOR MANAGEMENT OF ABNORMAL CERVICAL CYTOLOGY IN YOUNG WOMEN
COLPOSCOPIC EXAMINATION
HUMAN PAPILLOMAVIRUS VACCINATION
DEVELOPMENT AND LICENSING OF HUMAN PAPILLOMAVIRUS VACCINES
EFFICACY AND EFFECTIVENESS OF HUMAN PAPILLOMAVIRUS VACCINES
SAFETY OF THE VACCINES
VACCINE ADMINISTRATION IN CLINICAL SETTINGS
ISSUES TO CONSIDER IN IMPLEMENTATION OF HUMAN PAPILLOMAVIRUS VACCINATION PROGRAMS
CONCLUSIONS
ACKNOWLEDGEMENT
PART 5 Pubertal and Menstrual Disorders
21 Precocious Puberty
PREMATURE THELARCHE
PATIENT ASSESSMENT
TREATMENT AND FOLLOW-UP
PREMATURE ADRENARCHE
PATIENT ASSESSMENT
TREATMENT AND FOLLOW-UP
PRECOCIOUS PUBERTY
CENTRAL PRECOCIOUS PUBERTY
CAUSES OF CENTRAL PRECOCIOUS PUBERTY
IDIOPATHIC
CEREBRAL DISORDERS
SECONDARY CENTRAL PRECOCIOUS PUBERTY
PERIPHERAL (GONADOTROPIN-INDEPENDENT) PRECOCIOUS PUBERTY
OVARIAN TUMORS
ADRENAL DISORDERS
AUTONOMOUS FOLLICULAR OVARIAN CYSTS
IATROGENIC DISORDERS
PRIMARY HYPOTHYROIDISM
PATIENT ASSESSMENT
TREATMENT AND FOLLOW-UP
CONTRASEXUAL PRECOCIOUS PUBERTY (ANDROGEN EXCESS WITH VIRILIZATION)
PATIENT ASSESSMENT
TREATMENT AND FOLLOW-UP
PREMATURE MENARCHE
22 Delayed Puberty
EVALUATION—HISTORY AND PHYSICAL EXAMINATION
EVALUATION—LABORATORY TESTING AND IMAGING STUDIES
HYPOGONADOTROPIC HYPOGONADISM
LOW TO NORMAL FSH AND LH LEVELS
HYPERGONADOTROPIC HYPOGONADISM
HIGH FSH AND LH LEVELS
TURNER SYNDROME
OTHER ABNORMALITIES CAUSING ELEVATED FSH LEVELS
ELEVATED FSH LEVELS SECONDARY TO RADIATION OR CHEMOTHERAPY
ABNORMALITIES OF ESTROGEN SYNTHESIS
OTHER CAUSES OF POI
TREATMENT
PSYCHOLOGICAL AND SOCIAL ISSUES IN MANAGEMENT OF DELAYED PUBERTY
CASES OF DELAYED SEXUAL DEVELOPMENT
CASE 1
CASE 2
CASE 3
CASE 4
CASE 5
23 Amenorrhea in the Adolescent
PATIENT ASSESSMENT
PHYSICAL EXAMINATION
LABORATORY TESTS
HYPOGONADOTROPIC HYPOGONADISM
EATING DISORDERS
FEMALE ATHLETE TRIAD
HYPERPROLACTINEMIA
PRIMARY OVARIAN INSUFFICIENCY
EXTERNAL OR INTERNAL GENITAL ANOMALIES
IMPERFORATE HYMEN AND TRANSVERSE VAGINAL SEPTUM
AGENESIS OF THE VAGINA/CERVIX/UTERUS
ANDROGEN INSENSITIVITY
AMENORRHEA AND VIRILIZATION
TREATMENT
SECONDARY AMENORRHEA
OLIGOMENORRHEA
CASES OF AMENORRHEA
CASE 1
CASE 2
CASE 3
CASE 4
CASE 5
CASE 6
CASE 7
CASE 8
CASE 9
CASE 10
24 Female Athlete Triad
PATHOPHYSIOLOGY OF THE TRIAD
ENERGY AVAILABILITY
MENSTRUAL DISTURBANCES
BONE HEALTH
HEALTH OUTCOMES ASSOCIATED WITH THE TRIAD
MUSCULOSKELETAL INJURY
ENDOTHELIAL DYSFUNCTION
PSYCHOLOGICAL STRESS
EVALUATION AND MANAGEMENT
HISTORY
PHYSICAL EXAMINATION
ENERGY AVAILABILITY EVALUATION
LABORATORY STUDIES
BONE HEALTH EVALUATION
INTERPRETATION OF DXA RESULTS
TREATMENT
SCREENING
PREVENTION
25 Primary Ovarian Insufficiency
GENETIC CONDITIONS AND CHROMOSOMAL ABNORMALITIES
IATROGENIC
OTHER CAUSES
AUTOIMMUNE
EVALUATION
ANTI-MüLLERIAN HORMONE (AMH)
HORMONE REPLACEMENT THERAPY
OTHER TREATMENTS
COMORBIDITIES
CONCLUSION
PATIENT RESOURCES
26 Abnormal Uterine Bleeding in the Adolescent
PATHOPHYSIOLOGY
PATIENT ASSESSMENT
TREATMENT
BLEEDING WITHOUT ANEMIA
BLEEDING WITH MILD ANEMIA
BLEEDING WITH MODERATE ANEMIA
BLEEDING WITH SEVERE ANEMIA
FOLLOW-UP
CASE STUDIES
CASE 1
CASE 2
CASE 3
CASE 4
27 Gynecologic Issues in Adolescents With Developmental Delay
COMMUNICATION AND HISTORY
PHYSICAL EXAMINATION AND SCREENING
EDUCATION
SEXUALITY EDUCATION
MEDICAL ISSUES
MENSTRUAL CONCERNS
CONTRACEPTION
MENSTRUAL MOOD DISORDERS
ISSUES FOR TEENS WITH EPILEPSY
28 Polycystic Ovary Syndrome in the Adolescent
DIAGNOSIS
PHYSIOLOGY: GONADOTROPINS, ESTROGENS, AND ANDROGENS
PHYSIOLOGY: PRODUCTION OF ANDROGENS
PHYSIOLOGY: INSULIN RESISTANCE
OTHER PATHWAYS TO POLYCYSTIC OVARY SYNDROME
ULTRASOUND FINDINGS
QUALITY OF LIFE
ANDROGEN EXCESS, HIRSUTISM, AND ANDROGENIC ALOPECIA
ETIOLOGY OF HIRSUTISM
ANDROGENIC ALOPECIA
OTHER DIAGNOSES
PATIENT EVALUATION
LABORATORY STUDIES
TREATMENT
LIFESTYLE CHANGE
PHARMACOLOGIC THERAPY
COMORBIDITIES AND OUTCOMES
ADDITIONAL RESOURCES
29 Congenital Adrenal Hyperplasia
CAUSES OF CAH
21-HYDROXYLASE DEFICIENCY
CLASSIC SALT-WASTING 21-HYDROXYLASE DEFICIENCY
SIMPLE VIRILIZING 21-HYDROXYLASE DEFICIENCY
NONCLASSIC 21-HYDROXYLASE DEFICIENCY
11β-HYDROXYLASE DEFICIENCY
3β-HYDROXYSTEROID DEHYDROGENASE DEFICIENCY
17α-HYDROXYLASE/17,20-LYASE DEFICIENCY
P450 OXIDOREDUCTASE
LIPOID CONGENITAL ADRENAL HYPERPLASIA AND P450 SIDE CHAIN CLEAVAGE DEFICIENCY
DIAGNOSIS IN THE NEONATE
DIAGNOSIS IN THE CHILD AND ADOLESCENT
TREATMENT IN THE NEONATE
TREATMENT IN THE CHILD OR ADOLESCENT
NONCLASSIC CAH
CONTROVERSIAL THERAPIES
FERTILITY
30 Dysmenorrhea and Premenstrual Syndrome
THE OFFICE VISIT FOR THE ADOLESCENT WITH MENSTRUAL CONCERNS
DEFINITION AND PREVALENCE OF DYSMENORRHEA
PATHOPHYSIOLOGY OF DYSMENORRHEA
APPROACH TO THE YOUNG PERSON WITH DYSMENORRHEA
TREATMENT OF DYSMENORRHEA IN ADOLESCENTS AND YOUNG ADULTS
MITTELSCHMERZ
PREMENSTRUAL SYNDROME
DEFINITION
EPIDEMIOLOGY
DIAGNOSIS
ETIOLOGY
SYMPTOMS AND IMPACT
MANAGEMENT AND TREATMENT OPTIONS
CONCLUSION
PART 6 Gynecologic Causes of Acute and Chronic Pelvic Pain
31 Gynecologic Pain: Acute Pelvic Pain
ACUTE PELVIC PAIN
ADNEXAL (OVARIAN AND/OR TUBAL) TORSION
LAPAROSCOPY IN CASES OF ACUTE PELVIC PAIN
MITTELSCHMERZ
32 Gynecologic Pain: Chronic Pelvic Pain and Endometriosis
PELVIC PAIN
CHRONIC PELVIC PAIN/PERSISTENT DYSMENORRHEA
ENDOMETRIOSIS
BACKGROUND
ETIOLOGY OF ENDOMETRIOSIS
GENETIC PREDISPOSITION
ENDOMETRIOSIS AND ASSOCIATION WITH OTHER DISEASES
CLINICAL PRESENTATION AND DIAGNOSIS OF ENDOMETRIOSIS
DELAY OF DIAGNOSIS OF ENDOMETRIOSIS
EMPIRIC MEDICAL THERAPY FOR A DIAGNOSIS OF ENDOMETRIOSIS
SURGICAL DIAGNOSIS (AND TREATMENT) OF ENDOMETRIOSIS
APPEARANCE AND STAGING OF ENDOMETRIOSIS
ENDOMETRIOSIS AND OBSTRUCTIVE ANOMALIES OF THE REPRODUCTIVE TRACT
ENDOMETRIOSIS AND FUTURE FERTILITY
ENDOMETRIOSIS AND CANCER
TREATMENT OF ENDOMETRIOSIS
ENDOMETRIOSIS AND ADHESIONS
ENDOMETRIOMAS IN ADOLESCENTS
ADENOMYOSIS IN ADOLESCENTS
MEDICAL TREATMENT OPTIONS OF ENDOMETRIOSIS
DURATION OF MEDICAL THERAPY FOR ENDOMETRIOSIS
PAIN MANAGEMENT
MANAGEMENT OF REFRACTORY PAIN FROM ENDOMETRIOSIS
LONG-TERM FOLLOW-UP AND FUTURE RESEARCH
SUPPORT AND EDUCATION RELATING TO ENDOMETRIOSIS
ISSUES IN ADOLESCENT ENDOMETRIOSIS FOR FUTURE CONSIDERATION
ENDOSALPINGIOSIS
UTERINE AND VAGINAL MALFORMATIONS WITH OBSTRUCTION
LEIOMYOMAS IN ADOLESCENTS
33 Pain Management for the Gynecology Patient
INTRODUCTION
EPIDEMIOLOGY
NEUROANATOMY AND NEUROPHYSIOLOGY OF CHRONIC PELVIC PAIN
EVALUATION OF CHRONIC PELVIC PAIN
PHYSICAL EXAMINATION AND EVALUATION
CAUSES OF PELVIC PAIN
CHRONIC PELVIC PAIN MANAGEMENT
MEDICATION MANAGEMENT
PHYSICAL THERAPY
PSYCHOLOGY
INTERVENTIONAL PELVIC PAIN MANAGEMENT
MUSCULOSKELETAL INJECTIONS
PERIPHERAL NERVE INJECTIONS
SYMPATHETIC NERVE BLOCKS
SPINAL INJECTIONS
SUMMARY
PART 7 Gynecologic Benign and Malignant Cysts/Masses/Tumors
34 Adnexal Masses
FALLOPIAN TUBE/BROAD LIGAMENT MASSES
HYDROSALPINX
SEGMENTAL TUBAL AGENESIS
OVARIAN MASSES
FETAL OVARIAN CYSTS
NEONATAL OVARIAN CYSTS
OVARIAN CYSTS IN THE PREPUBERTAL CHILD
POSTPUBERTAL OVARIAN CYSTS
OVARIAN TUMORS/NEOPLASMS
PRESENTATION AND EVALUATION
IMAGING
TUMOR MARKERS
SURGERY
SPECIFIC BENIGN OVARIAN TUMORS/NEOPLASMS
ENDOMETRIOMAS
GERM CELL TUMORS
NON–GERM CELL TUMORS
“Epithelial” (Coelomic) Tumors
35 Uterine and Cervical Masses
BENIGN UTERINE MASSES
MÜLLERIAN PAPILLOMAS
LEIOMYOMAS
ADENOMYOSIS/ADENOMYOMAS
ENDOMETRIAL POLYP
ADENOSARCOMAS
RHABDOMYOSARCOMAS
BENIGN CERVICAL MASSES
NABOTHIAN AND MESONEPHRIC CYSTS
CERVICAL POLYP
WARTS
ENDOMETRIOSIS
ADENOSIS
PAPILLOMAS
LEIOMYOMAS
CERVICAL ADENOSARCOMA
36 Gynecologic Cancers in Children and Adolescents
VAGINA
SARCOMA
OTHER MALIGNANCIES
CERVIX
SARCOMA
ADENOCARCINOMA
SQUAMOUS CARCINOMA
UTERUS
OVARY
OVARIAN TUMORS
CLINICAL PRESENTATION
IMAGING
TUMOR MARKERS
SURGERY
STAGING
REVISED RISK STRATIFICATION FOR GERM CELL TUMORS IN CHILDREN AND ADOLESCENTS
SPECIFIC MALIGNANT OVARIAN TUMORS/NEOPLASMS
SEX CORD–STROMAL TUMORS
EPITHELIAL TUMORS
OTHER TUMORS
PART 8 Imaging and Specific Procedures in Pediatric & Adolescent Gynecology
37 Radiologic Imaging
ULTRASOUND OF THE FEMALE PELVIS
OTHER PELVIC IMAGING MODALITIES: MAGNETIC RESONANCE IMAGING, COMPUTED TOMOGRAPHY SCANS, OR PLAIN FILM RADIOGRAPHY
NORMAL ULTRASOUND IMAGES OF THE UTERUS, ENDOMETRIUM, AND OVARIES
UTERINE SIZE AND MORPHOLOGY
NORMAL VARIABILITY IN ENDOMETRIAL THICKNESS AND APPEARANCE
OVARIAN SIZE AND APPEARANCE
OVARIAN CYSTS
POLYCYSTIC OVARIAN SYNDROME
OVARIAN MASSES
ADNEXAL TORSION
PELVIC INFLAMMATORY DISEASE
ENDOMETRIOSIS
APPENDICITIS
PRIMARY AMENORRHEA
PREGNANCY AND ITS COMPLICATIONS
FOREIGN BODY INSERTIONS INTO THE URETHRA, VAGINA, AND RECTUM
BREAST IMAGING
38 Vaginoscopy
OBTAINING INFORMED CONSENT
SETTING
PREPROCEDURE PREPARATION AND CONSIDERATIONS
INSTRUMENTATION
EXAMINATION TECHNIQUE
COMMON ANATOMIC FINDINGS
PATHOLOGY
FOREIGN BODIES
VAGINAL OR CERVICAL MASSES
PELVIC TRAUMA
FISTULAS
UROGENITAL TRACT ANOMALIES
VAGINITIS OR CERVICITIS
CONCLUSION
39 Laparoscopy in the Pediatric and Adolescent Gynecology Population
HISTORY
PREOPERATIVE EVALUATION AND PREPARATION
CANDIDATES AND CONTRAINDICATIONS
INFORMED CONSENT
ANTIBIOTIC PROPHYLAXIS
THROMBOPROPHYLAXIS
SICKLE CELL DISEASE
VENTRICULOPERITONEAL SHUNTS
OPERATIVE SET-UP
ANESTHESIA CONSIDERATIONS
PATIENT POSITIONING
INSTRUMENTATION
PERITONEAL ACCESS AND INSUFFLATION
INSTRUMENTS
ENERGY SOURCES
PROCEDURES
COMPLICATIONS OF GYNECOLOGIC LAPAROSCOPY
VASCULAR INJURY
VISCERAL ORGAN INJURY
BOWEL INJURY
BLADDER INJURY
OTHER ORGAN INJURY
NERVE INJURY
PORT SITE HERNIATION
CONCLUSION
PART 9 Contraception and Pregnancy
40 Introduction to Contraception
ADOLESCENTS AND CONTRACEPTION
CONTRACEPTIVE COUNSELING
CONTRACEPTIVE EFFECTIVENESS AND EVIDENCE-BASED GUIDELINES
41 Short-Acting Contraception
COMBINED HORMONAL CONTRACEPTION
MECHANISM OF ACTION OF COMBINED HORMONAL CONTRACEPTIVE METHODS
METHODS OF COMBINED HORMONAL CONTRACEPTION
EFFICACY OF COMBINED HORMONAL METHODS
FACTORS AFFECTING EFFICACY OF COMBINED HORMONAL METHODS
USE OF COMBINED HORMONAL CONTRACEPTION IN ADOLESCENTS
PROGESTIN-ONLY CONTRACEPTION
PROGESTIN-ONLY PILLS
PROGESTIN-ONLY INJECTABLE CONTRACEPTION
NONHORMONAL CONTRACEPTION
CONDOMS
INTERNAL (FEMALE) CONDOMS
SPERMICIDES
SPONGE
DIAPHRAGM
CERVICAL CAP
COITUS INTERRUPTUS
“NATURAL” FAMILY PLANNING OR FERTILITY AWARENESS
EMERGENCY CONTRACEPTION
EC METHODS
EFFICACY AND TIMING OF EC AFTER UNPROTECTED INTERCOURSE
OBESITY AND EC EFFICACY
MECHANISM OF ACTION OF EC
42 Long-Acting Reversible Contraception for the Adolescent
PROGESTIN-ONLY IMPLANTABLE CONTRACEPTION
MECHANISM OF ACTION
USE OF NEXPLANON
INSERTION AND REMOVAL OF NEXPLANON
SIDE EFFECTS
ADVERSE EVENTS
INTRAUTERINE CONTRACEPTION
LEVONORGESTREL-RELEASING INTRAUTERINE DEVICES
COPPER T-380A INTRAUTERINE DEVICE
USE OF IUDs IN ADOLESCENTS
IUD INSERTION
SIDE EFFECTS AND COMPLICATIONS OF IUDS
REMOVAL OF INTRAUTERINE DEVICES
43 Teen Pregnancy
INCIDENCE OF TEEN PREGNANCY
RISK FACTORS ASSOCIATED WITH TEEN PREGNANCY
TEEN PREGNANCY PREVENTION
PREGNANCY DIAGNOSIS AND COUNSELING
PREGNANCY HORMONE TESTING
MEDICATIONS/TOXINS DURING PREGNANCY
RADIATION EXPOSURE DURING PREGNANCY
EMOTIONAL SUPPORT AROUND THE TIME OF TEEN PREGNANCY DIAGNOSIS
CONTINUING THE PREGNANCY
NUTRITION
SUBSTANCE ABUSE
Abusive Relationships
Depression
Pregnancy Termination
DISORDERS OF EARLY PREGNANCY
ECTOPIC PREGNANCY
NONVIABLE INTRAUTERINE PREGNANCY
GESTATIONAL TROPHOBLASTIC DISEASE
RH(D) IMMUNE GLOBULIN
CONCLUSIONS
PART 10 Special Populations
44 Care of the Lesbian, Gay, Bisexual, Transgender, and Queer Teen
TERMINOLOGY
MEDICAL CARE
HISTORY AND PHYSICAL EXAM
LABORATORY TESTING
TRANSGENDER ADOLESCENTS
HOW TO MAKE YOUR OFFICE WELCOMING
FRONTLINE STAFF
FORMS
PHYSICAL SPACE
PSYCHOSOCIAL CONSIDERATIONS
MENTAL HEALTH
RESILIENCE
FAMILY
COMMUNITY RESOURCES AND SUPPORT
45 Gender Affirmation Treatment for Transgender Patients
DIAGNOSIS AND INITIAL MANAGEMENT
MENTAL HEALTH CARE
APPROACH TO THE PREPUBERTAL CHILD
APPROACH TO THE CHILD DURING EARLY PUBERTY
APPROACH TO THE PATIENT IN LATE PUBERTY
GENDER AFFIRMATION
CROSS-SEX HORMONE THERAPY
SURGICAL MANAGEMENT
46 Bone Health
INTRODUCTION
DETERMINANTS OF PEAK BONE MASS
GENETICS
PUBERTY
DIET
PHYSICAL ACTIVITY AND EXERCISE
FRACTURES
LOW BONE MASS AND OSTEOPOROSIS
BONE DENSITY TESTING
SPECIAL BONE HEALTH CONSIDERATIONS
HYPOGONADISM AND BONE
CONTRACEPTION AND BONE
PCOS AND BONE
CONCLUSION
47 Nutrition: Disordered Eating Behaviors and Obesity
Adolescent Nutrition
EATING DISORDERS
MENSTRUAL ABNORMALITIES
SCREENING
OBESITY
MENSTRUAL ABNORMALITIES
CONTRACEPTIVE USE
CONCLUSIONS
48 Sexual and Reproductive Health Issues in Young Women With Chronic Disease
INTRODUCTION
ASTHMA
PUBERTAL DEVELOPMENT AND MENSTRUATION
REPRODUCTIVE ISSUES
CYSTIC FIBROSIS
PUBERTAL DEVELOPMENT AND MENSTRUATION
REPRODUCTIVE ISSUES
OTHER ISSUES
SICKLE CELL DISEASE
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
DIABETES MELLITUS
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
OTHER ISSUES
THYROID DISEASE
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
CARDIOVASCULAR DISEASE
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
GASTROINTESTINAL DISEASE
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION IN INFLAMMATORY BOWEL DISEASE
REPRODUCTIVE ISSUES IN INFLAMMATORY BOWEL DISEASE
OTHER CONDITIONS
LIVER DISEASE
PUBERTAL DEVELOPMENT AND MENSTRUAL DYSFUNCTION
CONTRACEPTION IN LIVER DISEASE
RENAL DISEASE
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
SOLID ORGAN TRANSPLANT
CONTRACEPTIVE ISSUES
CONNECTIVE TISSUE DISEASES
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
NEUROLOGIC ABNORMALITIES
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
SEXUAL, GYNECOLOGIC, AND REPRODUCTIVE ISSUES
MENTAL HEALTH DISORDERS
PUBERTAL DEVELOPMENT AND MENSTRUAL FUNCTION
REPRODUCTIVE ISSUES
STERILIZATION
SUMMARY
49 Gastrointestinal Issues in the Adolescent Gynecologic Patient
CONSTIPATION
IRRITABLE BOWEL SYNDROME
GASTROESOPHAGEAL REFLUX DISEASE
CELIAC DISEASE
INFLAMMATORY BOWEL DISEASE
50 Gynecologic and Fertility Issues for Cancer Patients and Survivors
PUBERTAL DEVELOPMENT, MENSTRUAL FUNCTION, AND FERTILITY
RADIATION THERAPY
CHEMOTHERAPY
COMBINED CHEMOTHERAPY AND RADIATION THERAPY
BONE MARROW TRANSPLANTATION
SUPPRESSION OF MENSTRUATION DURING CHEMOTHERAPY
MENSTRUAL FUNCTION AFTER CHEMOTHERAPY
MARKERS OF OVARIAN RESERVE
FERTILITY PRESERVATION
OOPHOROPEXY
GONADAL SUPPRESSION
ASSISTED REPRODUCTIVE TECHNOLOGIES AND CRYOPRESERVATION
PREGNANCY OUTCOMES
THYROID CANCER
WILMS TUMOR
BONE MARROW TRANSPLANT
VAGINAL GRAFT-VERSUS-HOST DISEASE
HORMONE REPLACEMENT
RISKS OF SECOND MALIGNANCY
51 Sexual Abuse and Sexual Assault
DEFINITION
THE SCOPE OF CHILD SEXUAL ABUSE
INCIDENCE
PREVALENCE
SUMMARY
RISK FACTORS
CLINICAL PRESENTATION
MEDICAL EVALUATION
INFORMED CONSENT
HISTORY
PHYSICAL EXAM
GENITAL EXAM
ANUS EXAM
DOCUMENTATION
INTERPRETATION OF FINDINGS
FORENSIC EVIDENCE COLLECTION
STI AND PREGNANCY TESTING
TOXICOLOGY TESTING
POST-EXPOSURE PROPHYLAXIS AND TREATMENT
FOLLOW-UP EVALUATION
MANDATED REPORTING
ADDRESSING MENTAL HEALTH AND WELL-BEING
CONCLUSION
52 Adolescent Relationship Abuse, Sexual Exploitation, and Trafficking
ADOLESCENT RELATIONSHIP ABUSE
DEFINITIONS
PREVALENCE
RISK AND PROTECTIVE FACTORS
COMMERCIAL SEXUAL EXPLOITATION OF CHILDREN
DEFINITIONS
PREVALENCE
RISK AND VULNERABILITY
GROOMING AND RECRUITMENT
HEALTH IMPACTS OF ARA AND CSEC
SEXUAL HEALTH
MENTAL HEALTH
GENERAL PHYSICAL HEALTH
PRACTICE CONSIDERATIONS
WHY TRAUMA-INFORMED CARE?
ESTABLISHING YOUR CLINIC AS A SAFE SPACE
CONFIDENTIALITY
PRIVACY
UNIVERSAL EDUCATION AND SCREENING
PATIENT-CENTERED EXAM
TRAUMA-INFORMED CARE: FINAL THOUGHTS ON YOUTH AT RISK
FURTHER ASSESSMENT FOR ARA/CSEC
RED FLAGS
ASSESSING FOR SAFETY
MANAGING DISCLOSURES
MEDICAL EXAM AND COUNSELLING
RESOURCES AND REFERRALS
CONCLUSION
53 Complementary, Alternative, and Integrative Medicine for Adolescent Gynecology Patients
DEFINITIONS AND EPIDEMIOLOGY
HERBS AND DIETARY SUPPLEMENTS
URINARY TRACT INFECTIONS
VAGINITIS
DYSMENORRHEA, ENDOMETRIOSIS, AND PREMENSTRUAL SYNDROME
ACUPUNCTURE
YOGA
WEIGHT LOSS AND EATING DISORDERS
MOOD DISORDERS: ANXIETY, DEPRESSION, AND STRESS
SUMMARY
PART 11 Breast Health
54 The Breast: Examination and Lesions
BREAST EXAMINATION
BREAST SELF-EXAMINATION
MASTALGIA (BREAST PAIN)
PROBLEMS OF BREAST DEVELOPMENT
ASYMMETRY
MACROMASTIA
TUBEROUS BREASTS
LACK OF BREAST DEVELOPMENT
PREMATURE THELARCHE AND PRECOCIOUS PUBERTY
ACCESSORY NIPPLES OR BREASTS
BREAST DISCHARGE
MONTGOMERY TUBERCLES
INTRADUCTAL PAPILLOMAS
MAMMARY DUCT ECTASIA
APOCRINE CHROMHIDROSIS
CONTUSION
INFECTION
PERIAREOLAR HAIR
OTHER PROBLEMS
BREAST CYSTS AND MASSES
BREAST CYSTS
FIBROCYSTIC BREAST CHANGES
FIBROADENOMAS
PHYLLODES TUMORS
JUVENILE PAPILLOMATOSIS
BREAST CANCER
CLINICAL MANAGEMENT OF BREAST MASSES
FOLLOW-UP
Appendix 1 Summary of Classifications for Hormonal Contraceptive Methods and Intrauterine Devices
Appendix 2 Percentages and Estimated Mature Heights for Girls, Using Skeletal Age
Index

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