25)A mother brings her 12-year-old daughter to the - alveoli

[ArchivalUser]

25)A mother brings her 12-year-old daughter to the physician because the mother is concerned that her child has
delayed physical development. In particular, the mother is concerned because her daughter has not yet had a
menstrual period. The daughter began developing breasts at age 10, but has not had her first period. The
daughter has no medical problems and takes no medications. Examination shows developing breasts and
normal external female genitalia. Which of the following is the most appropriate response to the mother?


A. Breast development at age 10 is abnormally early.

B. Breast development at age 10 is abnormally late.

C. Evaluation for late menses should be started immediately.

D. Evaluation for late menses should be started at age 15.

E. Her child's sexual development is none of her business.

[ArchivalUser]

ddddddd

[ArchivalUser]

d.

[ArchivalUser]

agreed....

[ArchivalUser]

D

[ArchivalUser]

D.

[ArchivalUser]

yes DD.

[ArchivalUser]

Yessssssssssssssss!!!!

Explanation:

The correct answer is D.


Sexual development is variable from woman to woman, although there are certain
ranges of normal. Thelarche, also known as breast-budding, is usually the first sign of secondary sexual
development and this occurs on average between the ages of 8 and 10 years of age. The growth spurt usually
follows after breast budding and menarche is one of the last stages, occurring, on average, between the ages
of 12 and 13. This young woman began developing breasts at age 10, which is entirely appropriate. That she
has not had her first menstrual period yet is not abnormal. The general rule is that evaluation for delayed
sexual development should be started if there is no breast development by the age of 13 or menses by the
age of 15. This general rule can be adapted to fit the circumstances if there are tempo or sequence
abnormalities. In this case, with breast development occurring normally and development appearing to
proceed in a standard fashion, the mother can be reassured and evaluation for late menses delayed until age
15, if it has not come before that time.