Performance-enhancing substances in young athletes — branching viva

Outpatient clinic: a fifteen-year-old boy who has gained nine kilograms of lean mass over a term and who, seen alone, discloses four months of injectable testosterone and an oral steroid bought online. The examiner asks: describe your diagnostic approach and the framework that governs this, give the likely class of substance and its pathophysiological harm to the still-growing adolescent, and outline the counselling-first management, then branches to the psychiatric risk of unsupported withdrawal, the strict-liability and contaminated-supplement inadvertent-doping scenario, and the ATLAS prevention evidence.