Pediatrics Pubertal Development: Review Questions Frank J. Genuardi, MD, MPH Dr. Genuardi is Chief, Division of Adolescent Medicine, Department of Pediatrics, University of Florida Health Science Center, Jacksonville, FL; and a member of the Hospital Physician Editorial Board. Choose the single best answer for each question.
	1. Which of the following is the first physical change associated with puberty in girls? Areolar elevation Breast budding Height spurt Menarche Pubic hair development Click here to compare your answer. 2. A 16-year-old girl visits her physician out of concern that she has not yet begun menstruating. Each of the following should be considered in the differential diagnosis EXCEPT: Constitutional delay McCune-Albright syndrome Pregnancy Prolactinoma Turner’s syndrome Click here to compare your answer.		3. A 13-year-old girl has light downy pubic hair along her labia. This finding is most consistent with which Tanner stage of puberty? I II III IV V Click here to compare your answer. 4. Which of the following is the first physical change associated with puberty in boys? Height spurt Penile lengthening Pubic hair development Spermarche Testicular enlargement Click here to compare your answer. 5. A 3-year-old girl has bilateral breast buds. Performing which of the following will be most useful in assessing this patient? Bone age determination Breast biopsy Karyotype analysis Luteinizing hormone level measurement Pelvic examination Click here to compare your answer.
	Suggested Readings Emans SJH, Laufer MR, Goldstein DP, editors. Pediatric and adolescent gynecology. 4th ed. Philadelphia: Lippincott-Raven; 1998. Neinstein LS, editor. Adolescent health care: a practical guide. 3rd ed. Baltimore: Williams & Wilkins; 1996.
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