A 15-year-old girl comes to the office due to yellow vaginal discharge for the past 2 days. The patient has also had bleeding between menstrual periods for the past 2 months. She has no fevers, chills, or pelvic pain. She is sexually active. The patient's parents are at work and she comes to the appointment alone. She does not have any medical conditions, takes no medications, and has no allergies. Temperature is 36.7 C (98 F), blood pressure is 110/70 mm Hg, and pulse is 78/min. Physical examination shows a nontender abdomen. Pelvic examination reveals mucopurulent discharge at the cervical os; there is no cervical motion or adnexal tenderness. Urine pregnancy test is negative. The patient is prescribed the appropriate treatment and leaves the office. Several hours later, the patient's mother comes to the office asking for an explanation for the visit and for the antibiotic prescription. Which of the following is the most appropriate response?

Question

A 15-year-old girl comes to the office due to yellow vaginal discharge for the past 2 days.  The patient has also had bleeding between menstrual periods for the past 2 months.  She has no fevers, chills, or pelvic pain.  She is sexually active.  The patient's parents are at work and she comes to the appointment alone.  She does not have any medical conditions, takes no medications, and has no allergies.  Temperature is 36.7 C (98 F), blood pressure is 110/70 mm Hg, and pulse is 78/min.  Physical examination shows a nontender abdomen.  Pelvic examination reveals mucopurulent discharge at the cervical os; there is no cervical motion or adnexal tenderness.  Urine pregnancy test is negative.  The patient is prescribed the appropriate treatment and leaves the office.  Several hours later, the patient's mother comes to the office asking for an explanation for the visit and for the antibiotic prescription.  Which of the following is the most appropriate response?

Quizplus · Accepted Answer

11ec25c8_d66e_b862_bc81_dfe3600e97cb_MD0003_00 This patient has acute cervicitis (eg, mucopurulent cervical discharge, vaginal spotting), a cause by a sexually transmitted infection (eg, Neisseria gonorrhoeae, Chlamydia trachomatis). Minors (age <18) may be treated without parental consent for a variety of medical conditions, including sexually transmitted infections. In addition to appropriate medical care, this patient also has the right to confidential treatment; her personal health information cannot be disclosed without the patient's permission. Maintaining patient confidentiality establishes a trusting relationship between the minor and the health care provider. This allows the minor to seek and access treatment for sensitive health concerns (eg, sexually transmitted infections, pregnancy) without embarrassment or fear of retribution. (Choices A and C) Although encouraging open communication within the family is appropriate, the direct inquiry from the patient's mother needs to be addressed, rather than evading the question. (Choice D) Another appointment may be appropriate for consultation and education purposes but may be scheduled only after the patient gives permission to share the information with her parent. (Choice E) A minor has the same right to privacy as an adult, and privileged information (eg, diagnosis, treatment) may not be shared without the patient's permission, including with the patient's parents. Educational objective: Patients age <18 may be treated for sexually transmitted infections without parental consent. Confidentiality should be maintained, and details of the visit cannot be shared with others without the patient's permission. References: Physician knowledge and attitudes around confidential care for minor patients. (http://www.ncbi.nlm.nih.gov/pubmed/26024938)

A 15-Year-Old Girl Comes to the Office Due to Yellow