What this deck covers
Puberty: Precocious and Delayed in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- What comes in what order
- The first thing that changes
- Where the line is drawn
- Central or coming from below
- A young boy starting early
- Does she need the scanner
- Slowing the clock down
- A brown patch and a broken bone
- Hair and voice, but small gonads
- Breasts in a toddler
- Body odour but nothing else
- Bleeding with nothing else
- Sore chest in a teenage boy
- Splitting the causes in two
- Tall, with small firm gonads
- One question in the history
- Training hard, periods stopped
- Giving nature a nudge
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: Periods first, then breast development, Deepening of the voice, There is no agreed age threshold in either sex, A GnRH stimulation test, Reassurance with a review appointment in one year, Imaging of the pelvis replaces imaging of the head, A GnRH analogue to suppress the axis, A granulosa cell tumour of the ovary, Central precocious puberty, Congenital adrenal hyperplasia presenting late, An androgen-secreting tumour, Excluding abuse and a local cause, It always requires surgical removal, A karyotype in every case.
Clinical pearls from this deck
- Girls grow early in puberty and boys grow late. That one difference explains a lot of charts.
- Always measure the testes. Their size is what tells you where the hormone is coming from.
- Early puberty in a girl is usually nothing. Early puberty in a boy usually has a cause.
- One test, one question: has the pituitary switched on, or is something else making the hormone.
- A normal neurological examination has never excluded a hamartoma. Scan the boy.
- Every boy gets scanned. An older girl with slow progression often does not need it.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all Endocrinology Board Questions case decks · pediatric reference values.
