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A 15yo boy is brought to the office because of failure to develop 2nd sexual characteristics. He has no other symptoms and his PMH is NL without taking any meds. His dad reached puberty at 16yo. PE revealed a well developed, well nourished male in no acute distress. BP 120/80, Pulse 78/min and RR 17/min. His body proportion is NL and his height is at 25 percentile. FO NL bilaterally. He has no gynecomastia. His testes are soft and measured 2ml. He has no pubic or axillary hair. The rest of PE are NL. He has low FSH and LH, his testosterone level is 125 ng/dl (nl 300-1000). His bone age is 12 yrs
what is the most Dx?
A. Constitutional pubertal delay
B. Pituitary tumor
C. Kallman's Sx
D. Klinefelter's
E. Androgen resistance
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Most common cause is constitutional pubertal delay. so A.
You have there what you need to make the dx: bone age low, h/o father with delayed, low hormonal levels
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i thought that you are inviting for the "sex festival"
but disappointed to see the question.
anyway, it is A.
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i am not sure...but it seems to be some kind of syndrome....
the presenting complaint is failure to develop 2ndry sex characteristics...not "short stature"...
by age 14 the size of tetes should be 2.5ml...
and he should have pubic and axillary hair!
i think it's Klinefelter's syndrome.... as they are tall and thin...
eventually need testosterone replacement..........
Answer for me.... D.....
nopainnogain ... do post the correct answer!!
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lol...I am not serious about such a festival... I am looking for a partner though...
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make urself clear, r u looking for same-sex or opposite-sex partner, ot it does not matter ?
lol !!!
I think Britney Spears is also looking for a partner...
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Cricoid, I found some clues as bdj's teaching
1. A positive family history of either constitutional delay of puberty
2. The frequency of diagnoses has been examined in a retrospective study of 232 adolescents
(158 males, 74 females) presenting to an academic center [1]: Constitutional delay of puberty in 53 percent of subjects
3. Patients with constitutional delay of puberty typically have bone ages of 12 to 13.5 years but rarely progress beyond this age without the presence of pubertal levels of gonadal steroids as sex steroids are required for epiphyseal closure
4. baseline serum gonadotropin values are typically low in both constitutional delay of puberty and congenital GnRH deficiency
5. And non of other abn
Ans is A
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i hate this topic.......
NPNG,(my abbreviation for your long name)
thanks much...
