In a 16-year-old female patient with bruises, which area is least important to evaluate during the physical exam?

In evaluating a 16-year-old female patient with bruises, assessing the Tanner stage is least important compared to the other options. The Tanner stage is a measure of pubertal development and growth that indicates physical maturation, which can provide some context for the patient's overall development. However, when the focus is on the presence of bruising, it is crucial to understand the potential causes and implications behind that symptom.

Depression is significant because it can contribute to self-harm or be indicative of abuse, both of which can lead to unexplained bruising. An understanding of the patient's emotional and psychological state is vital in these cases. Similarly, obtaining sexual history is important as it can uncover risks for abuse or potential involvement in situations leading to injury. Knowledge of STDs is also pertinent in a sexual health context, particularly if there is a concern for potential abuse, which may statistically correlate with a risk of sexually transmitted infections.

Thus, while Tanner staging provides useful developmental information, in the context of bruising, the evaluation of mental health, sexual history, and the risk of STDs holds more immediate clinical relevance.