Paediatrics & Child Health: Adolescent and Young Adult Medicine

General

Presentations

• Abdominal pain

Conditions

• Acne
• Migraine
• Overweight and obesity

Mental health and behavioural difficulties

Presentations

• Health risk behaviours, such as unintentional injury
• Self-harm or intentional injury
• Somatic symptoms disorder presentations, such as headache or abdominal pain

Conditions

• Anxiety disorders
• Attention deficit hyperactivity disorder (ADHD)
• Autism
• Depression
• Eating disorders:
  
  • anorexia nervosa
  • binge eating
  • bulimia nervosa
• Learning difficulties
• Somatic symptoms disorder
• Substance use and misuse:
  
  • alcohol
  • amphetamines
  • cannabis​
  • nicotine
  • opioids
  • paracetamol
  • solvents

Sexuality and reproductive health

Presentations

• Amenorrhoea, primary and secondary
• Dysmenorrhoea
• Menorrhagia
• Suspected sexual abuse and assault

Conditions

• Pregnancy
• Sexually transmissible infections (STIs):
  • anogenital warts and human papillomavirus (HPV)
  • chlamydia
  • genital herpes simplex virus
  • gonorrhoea
  • pelvic inflammatory disease
  • syphilis
  • trichomoniasis​

For each presentation and condition, Basic Trainees will know how to:

Synthesise

• recognise the clinical presentation
• identify relevant epidemiology, pathophysiology, and clinical science
• take a relevant clinical history
• conduct an appropriate examination
• establish a differential diagnosis
• plan and arrange appropriate investigations
• consider the impact of illness and disease on patients¹ and their quality of life

Manage

• provide evidence-based management
  For less common or more complex presentations and conditions the trainee must also seek expert opinions
• prescribe therapies tailored to patients’ needs and conditions
• recognise potential complications of disease and its management, and initiate preventative strategies
• involve multidisciplinary teams

Consider other factors

• identify individual and social factors and the impact of these on
  diagnosis and management

General

Conditions

• Chronic fatigue syndrome
• Pain disorders

Mental health and behavioural difficulties

Presentations

• Attempted suicide

Conditions

• Conduct disorder
• Psychosis

Sexuality and reproductive health

Presentations

• Female genital mutilation

Conditions

• Gender dysphoria

For each presentation and condition, Basic Trainees will know how to:

Synthesise

• recognise the clinical presentation
• identify relevant epidemiology, pathophysiology, and clinical science
• take a relevant clinical history
• conduct an appropriate examination
• establish a differential diagnosis
• plan and arrange appropriate investigations
• consider the impact of illness and disease on patients¹ and their quality of life

Manage

• provide evidence-based management
  For less common or more complex presentations and conditions the trainee must also seek expert opinions
• prescribe therapies tailored to patients’ needs and conditions
• recognise potential complications of disease and its management, and initiate preventative strategies
• involve multidisciplinary teams

Consider other factors

• identify individual and social factors and the impact of these on diagnosis and management

• Actions of neurotransmitters and the limbic system
• Modes and sites of transmission, incubation periods, symptoms, and possible complications of common STIs
• Neurobiology of normal and abnormal psychological development
• Normal growth and development, including puberty
• Pharmacology of drugs of misuse; effects, side effects, and interactions, including toxicological aspects
• Principles of addiction and tolerance
• Vaccines relevant to age group

Investigations

• Drug screening tools and investigations
• Genital swabs and serological screening for STIs:
  
  • hepatitis B
  • hepatitis C
  • HIV
  • syphilis
• Investigations for STIs

Clinical assessment tools

• Alcohol assessment using validated tools
• Anthropometry and puberty staging
• Mental Status Examination (MSE)
• Psychosocial assessments, such as HEADSS
• Suicide risk evaluation
  
  
  

General

• Awareness of personal reactions to childhood illness, behaviour, disability, family situations, and the impact these may have on personal professional practice
• Common risk behaviours and how to counsel and educate young people regarding these
• Factors that may affect adherence to treatment regimes, including medications
• Impact of emotional, intellectual, physical, psychological, and social factors in adolescent development and disease
• Need for confidentiality when balancing autonomy with dependence
• Use of techniques for improving adherence

Mental health and behavioural difficulties 

• Indications for the use of the Mental Health Act
• Interactions that cause serotonin syndrome and how to avoid these
• Local protocols for liaison with psychiatric services
• Mental health manifestations of systemic disease
• Mode of action, adverse effects, interactions, judicious use indications, and pharmacokinetics of antidepressants, antipsychotics, and benzodiazepines
• Nature and specific manifestations of psychological disorders in the young
• Non-pharmacological approaches that may be used initially where use of psychotropic medication is indicated
• Normal and abnormal child and adolescent psychological development and its relationship to mental health
• Psychotropic medication

Substance use and misuse​

• Brief interventions to reduce harm from substance use
• Nature and specific manifestations of addiction in the young
• Prevalence and onset of substance use and misuse in adolescents
• Signs of substance use and misuse and its impact on general history and examination

Sexuality and reproductive health

• Contact tracing and partner notification in STI management
• Contraception and protection against STIs
• High-risk groups for different STIs
• Preparing girls with a disability for menarche
• Principles of sexual and reproductive health
• Referral pathways for adolescents disclosing recent or distant sexual abuse or assault
• Responding to disclosures of same-sex attraction and knowledge of possible psychological and physical risks associated with patients ‘coming out’ and commencing sexual activity with people of the same sex
• Risk factors and clinical indicators suggestive of sexual abuse or assault
• Sexual health promotion and ‘protective behaviours’ in adolescents
• Sexuality:
  
  • in previously-abused patients
  • in young people with chronic conditions
  • issues for patients with a disability
• Specific issues of ethics, law, and adolescent confidentiality relating to sexuality

Ethical and legal issues

• Legal and ethical principles when dealing with adolescents, including consent

Chronic illness and transitioning in the healthcare system

• Impacts of chronic conditions on growth and development
• Transition of care for young people with chronic conditions
• Liaising and communicating with community, drug and alcohol, health, and education, and welfare practitioners
• Risk of driving with specific conditions

Community engagement

• Accessing health, education, and welfare services in the community that support children and adolescents in their ordinary life
• Resources for adolescents and young people with special needs, especially those with psychological disorders