A 6-year-old girl is brought to the off ce for evaluation of breast and pubic hair development. Her parents noticed
that she started developing breasts several months ago, and she recently started growing coarse axillary and pubic
hair. The patient has had no changes in her behavior or school performance. She has no headaches, visual
changes, vomiting, or vaginal bleeding. The patient has no chronic medical conditions and no previous surgery.
She takes no daily medications and has no known allergies. BMI is at the 50th percentile for age. Physical
examination reveals axillary hair; pubic hair is Tanner stage 3, and breasts are Tanner stage 3. The remainder of
the examination is unremarkable. Bone age is consistent with age 8. Basal LH level is high. Which of the
following is the best next step in evaluation of this patient?
- 0 A. Adrenal CT scan
- 0 B. Dexamethasone suppression test
- 0 C. Karyotype analysis
- Q D. MRI of the brain
- 0 E. Pelvic ultrasound
- 0 F. Reassurance and follow-up in 6 months
0 voters