nbme 2 3 5 - jhcmd

[ArchivalUser]

An otherwise healthy 15-year-old girl is brought to the physician because she has never had a menstrual period. She reports that breast development started 1 year ago and pubic and axillary hair development began 6 months ago. Examination shows normal genitalia. Breast development is Tanner stage 4, and pubic hair development is Tanner stage 3. Which of the following is the most appropriate next step in management?

A) Reexamination in 1 year if the patient has not had menarche
B) Measurement of serum follicle-stimulating hormone and luteinizing hormone levels
C) Measurement of serum thyroid-stimulating hormone and prolactin levels
D) Karyotype analysis
E) Progesterone withdrawal test
F) Pelvic ultrasonographypolypeptide levels

[ArchivalUser]

Should this young lady get reexamined in one year, or should she get something done immediately? Thanks for your input.

[ArchivalUser]

Rexamine in 1 year (A), because it is normal in females up to age 16 not to have had a menstrual period. She's just a late bloomer.

[ArchivalUser]

re examine her 1 year bcoz menarche is the last thing to happen in puberty

[ArchivalUser]

Aaaaaaaaaaaa

[ArchivalUser]

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