Annual physical examination

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A 14-year old girl presents to you with her mom for an annual physical examination. The patient reports that she is happy with her life, interested in school, and very diligent about running with her champion cross country team. She is academically successful in the ninth grade. The patient has not yet begun to have regular menstrual cycles, although she did have some rust-colored spotting in her underwear last month. She does not have a boyfriend and denies any sexual activity. Physical examination is within normal limits for the patient's age. She is has Tanner 4/5 breast development and pubic hair. The mother asks you when her daughter should be scheduled for her first Pap smear. What should you tell her?r mother to examine a breast mass. On physical examination, her breasts are raised beyond the areolar parameter and have a small amount of long, slightly pigmented, downy hair along the labia majora. What should you advise the patient's mother?

Reference no: EM134036396

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