A 16-year-old girl, accompanied by her mother, is in your office for a well-adolescent visit. The mother asks about drug and alcohol abuse. You explain that the warning signs of abuse include which of the following?

  1. Excessive concern for weight and body configuration
  2. Improved school performance
  3. Recent changes from age-appropriate, acceptable friends to younger associates
  4. Deterioration in personal habits, hygiene, dress, grooming, speech patterns, and fluency of expression
  5. Improvement in relationships with adults, siblings, and authority figures

the answer is below…

The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.

The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.

This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.

The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.

All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.

Medical doctors with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States of America

The answer is d, Deterioration in personal habits, hygiene, dress, grooming, speech patterns, and fluency of expression. [7-9]

When an adolescent shows evidence of declining school performance or truancy, a change for the worse in personal habits and grooming, exaggerated mood swings, change in friends to an older and unacceptable group, and frequent hostile reactions in relationships with others, the possibility that he or she is abusing drugs or alcohol, or both, should be considered strongly. Dependence on drugs is a progressive disorder; therefore, prompt identification and intervention are required if serious complications are to be avoided. Routine health assessment of adolescents should include inquiry about the use of cigarettes, alcohol, and other drugs, and about school performance and family and peer relationships.