Medical OSCES

Medical OSCES for medical students and PG Doctors

Menu
  • Home
  • Static Page
  • Radiology Cases
    • Neurology
    • Peadiactric
    • Chest
    • GIT
    • GUT
  • Radiology Notes
    • Neurology
    • Peadiactric
    • Chest
    • GIT
    • GUT
  • Lectures
    • Radiology
    • Anatomy
    • Physics
    • Radiography
  • Videos
  • Books
  • Surprise Me
Pediatric EMCQs Pediatric EMCQ 07 : PRECOCIOUS PUBERTY

Pediatric EMCQ 07 : PRECOCIOUS PUBERTY

image
Which is the most likely diagnosis in the following cases: 

 

A. Craniopharyngioma
B. Exaggerated adrenarche
C. McCune Albright syndrome
D. Hypothalamic hamartoma
E. Thelarche variant
F. Neurofibromatosis type 1
G. Granulosa-theca cell tumour
H. Hypothyroidism
I. Premature thelarche 
J. Congenital adrenal hyperplasia


1) A 5-year-old girl presents with rapid breast development, breast stage 4, over a few months and an abdominal mass. There was no pubic hair or cliteromegaly.       

2) An 8 year old boy presents with testicular volumes of 8 mls bilaterally, pubic hair stage 3 and genital stage 3. He has long-standing constipation, deteriorating school performance and increased weight.

3) A 2year old girl presents with isolated bilateral breast development. Examination is otherwise normal as is her height velocity. Subsequent investigation demonstrates undetectable oestradiol levels and a prepubertal response to an LHRH test.

 


 

 

Don’t look at the answer before answering

 

 


 

1)  G. Granulosa-theca cell tumour


The rapid onset of puberty is indicative of a tumour. In this case the alpha-fetoprotein tumour marker will be raised. Symptoms result from the very high oestradiol levels. 


2) H. Hypothyroidism


Long standing hypothyroidism can cause precocious puberty through high levels of TRH driving  gonadotrophin secretion and cross reactivity of the FSH receptor with TRH. 


3) Premature thelarche


There may be a slight FSH predominance on the basal gonadotrophin levels. Premature thelarche is self-limiting and thought to be the result of the body being exquisitely sensitive to low levels of oestradiol. 

Add Comment
Pediatric EMCQs
  • Tweet
  • Share
  • Share
  • Share
  • Share

Related Posts

Post a Comment

Total Tayangan Laman

  • …

  • …

Weekly Posts

  • Diffuse Axonal Injury
    Diffuse Axonal Injury
    Findings: Diffuse brain swelling Focal punctate hemorrhage scattered in the white matter, corpus callosum, and brain stem Right subgaleal...
  • SVC obstruction
    SVC obstruction
    •Findings: –Contrast-enhanced CT shows intense enhancement of the medial segment of the left lobe = “liver hot spot” sign –Collateral ve...
  • Name the arrowed structure ?
    Name the arrowed structure ?
    Left Ventricle
  • Adrenal adenoma
    Adrenal adenoma
    •Findings: –Large right adrenal lesion –Isointense to liver on in-phase scan –Hypointense to liver (signal loss) on out-of-phase scan ...

Label

  • Cardiology (12)
  • Chest x-ray (9)
  • CT Scans (6)
  • Dermatology (56)
  • ECG (2)
  • Endocrinology (10)
  • ENT (2)
  • Gastroenterology (15)
  • Genetics (6)
  • Gyn and Obs (5)
  • gynaecology (4)
  • Haematology (17)
  • Image Challenge (214)
  • Immunology (3)
  • infectious and parasitic disease (3)
  • Infectious disease (5)
  • Instruments (1)
  • Microbiology (2)
  • Musculoskeletal (3)
  • NEJ Cases (9)
  • Nephrology (2)
  • Neurology (15)
  • oncology (3)
  • Ophthalmology (13)
  • Orthopaedic (8)
  • Parasitology (4)
  • Peadiactrics (12)
  • Pediatric EMCQ (1)
  • Pediatric EMCQs (5)
  • Pharmacology (4)
  • Pulmonology (9)
  • Radiology (30)
  • Real Cases (5)
  • Rheumatology (7)
  • Skull X-ray (2)
  • Surgery (4)
  • Vascular surgery (1)
  • x-ray (6)

Contact

Name

Email *

Message *

Copyright © 2014 Medical OSCES All Right Reserved
Blogger Templates Created by Arlina Design