Recommended Components of a 16-Year-Old Female's Annual Physical Examination
The annual physical examination for a 16-year-old female should include a comprehensive health assessment focusing on age-appropriate screening, preventive care, and addressing adolescent-specific concerns to optimize morbidity, mortality, and quality of life outcomes.
Core Components
Medical History
- Complete review of systems
- Family history with attention to:
- Premature death or disability from heart disease in relatives under 50 years 1
- History of genetic/familial conditions (cancer syndromes, cardiovascular disorders)
- Mental health conditions
Physical Examination Elements
- Vital signs (blood pressure, heart rate, respiratory rate, temperature)
- Height, weight, and BMI calculation with growth chart plotting
- Complete physical examination including:
Reproductive Health
- External genital examination when appropriate
- Discussion of menstrual history and any concerns
- Pelvic examination only if clinically indicated (not routinely recommended at this age)
- Discussion of sexual activity, if applicable:
- Contraception options
- STI prevention
- Consent and healthy relationships
Preventive Screenings
- Vision screening
- Hearing screening if indicated
- Blood pressure screening
- Depression screening
- Substance use assessment (alcohol, tobacco, drugs)
Laboratory Testing
Laboratory testing should be targeted based on risk factors rather than performed routinely:
- Consider lipid screening if family history of premature cardiovascular disease
- Consider STI testing if sexually active
- Hemoglobin/hematocrit if risk factors for anemia are present
Immunizations
- Review and update immunization status according to current recommendations
- Offer HPV vaccination if not previously completed
Anticipatory Guidance and Counseling
Mental Health
- Screen for depression, anxiety, and suicidal ideation
- Discuss stress management and coping strategies
- Assess for signs of eating disorders
Health Behaviors
- Nutrition counseling
- Physical activity recommendations (60 minutes daily)
- Sleep hygiene
- Screen time limitations
- Injury prevention (seatbelts, helmets, sports safety)
Risk Behaviors
- Substance use prevention (alcohol, tobacco, vaping, drugs)
- Discussion about driving safety if applicable
- Violence prevention
Special Considerations
For Sexually Active Adolescents
- Confidential sexual health assessment
- STI screening as indicated 1
- Contraception counseling
- Discussion about healthy relationships and consent
For Athletes
- Additional screening using the 14-element AHA recommendations for cardiovascular screening 1
- Assessment for prior sports injuries
- Discussion about nutrition and hydration for athletic performance
Common Pitfalls to Avoid
- Overlooking confidentiality: Ensure private time with the adolescent separate from parents to discuss sensitive topics.
- Missing mental health concerns: Depression and anxiety are common in this age group and require screening.
- Focusing only on physical health: Address social determinants of health and psychosocial well-being.
- Performing unnecessary tests: Avoid routine laboratory screening without specific indications.
- Neglecting anticipatory guidance: Prevention counseling is a critical component of adolescent care.
The evidence suggests that while comprehensive annual physical examinations have been questioned for their value in detecting serious pathology in adolescents 2, they provide important opportunities for preventive care, health education, and establishing rapport with healthcare providers 3. The examination should be tailored to address age-appropriate concerns while respecting the adolescent's privacy and autonomy.