4 year old with breasts - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-02-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Question 4 year old with breasts

The mother of a 4 year old girl brings her daughter too your office because the girl developed breasts 6 months ago. The girl has no vaginal bleeding and there is no pubic hair. She takes no medication.
Which of the following is the most appropriate next diagnostic step?

A. Ultrasound of the pelvis
B. A pelvic examination under general anesthesia
C. Ct scan of the head
D. A serum estradiol concentration
E. A serum follicle-stimulating hormone (FSH) concentration
Reply With Quote Quick reply to this message



  #2  
Old 07-02-2011
Future Radiolog's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 29
Threads: 4
Thanked 17 Times in 11 Posts
Reputation: 27
Default

Answer is A
Reply With Quote Quick reply to this message
  #3  
Old 07-02-2011
dr.tasneem's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 29
Threads: 0
Thanked 7 Times in 6 Posts
Reputation: 17
Unhappy

may be C not sure....
Reply With Quote Quick reply to this message
  #4  
Old 07-02-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 33
Threads: 2
Thanked 7 Times in 6 Posts
Reputation: 17
Default

Precocious Puberty

D. A serum estradiol concentration

Since Vaginal bleeging is a late sign and pubic hair not necessarily appear with breast development..

Most cases of precosious puberty in girl are central so a baseline estradiol level and LH level would help..

Rite??
__________________
With Great Power Comes Great Responsibility...
Reply With Quote Quick reply to this message
  #5  
Old 07-02-2011
USMLE Forums Newbie
 
Steps History: CK Only
Posts: 5
Threads: 2
Thanked 0 Times in 0 Posts
Reputation: 10
Default

this is an incomplete precocious puberty, the best next step is an arranged visit in the next 6 months. Other wise a FSH level is the best next step, to differentiate central and peripheral causes of complete P.P.
Reply With Quote Quick reply to this message
  #6  
Old 07-02-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Default

Answer is D. Serum estradiol concentration._ Breast development in a child is a consequence of increased estrogen secretion, exposure to exogenous estrogen or increased response of breast tissue to prepubertal amounts of estrogen. After excluding exposure to estrogen, increased response to estrogen is more common than increased estrogen secretion from ovaries or adrenal glands; when breast development is the only sign. The serum estradiol in such case is usually normal.
Reply With Quote Quick reply to this message
The above post was thanked by:
docmd11 (07-02-2011), dr.tasneem (07-03-2011), Future Radiolog (07-03-2011)



Reply

Tags
Endocrinology-, Pediatrics-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
68-year-old man with BPH Seetal USMLE Step 2 CK Forum 9 03-20-2011 03:54 AM
Should I apply this year or next year is OK! Rishi IMG Residency Match Forum 3 07-19-2010 10:52 AM
29 year old G2 ..... achistikbenny USMLE Step 1 Forum 6 05-25-2010 02:11 PM
16-year-old boy Seetal USMLE Step 1 Forum 3 04-12-2010 08:44 AM
do we need to buy first aid new every year priyanka1 USMLE Step 1 Forum 2 03-28-2010 11:18 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)