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#ir #peds

  • 13yo ♀, no onset of menarche. What questions would you ask on Hx (6)? What would you do O/E? When and how would you investigate?

  • Hx: Breast development, weight loss, pubic hair development, short stature, FHx, athlete, medical illness, high performance athlete

  • O/E: assess nutritional status, dysmorphism, evidence of chronic disease, signs of abuse or neglect, sexual development (“boobs→pubes→grow→flow”)

  • Ix (if no menarche >16 or pubertal >12): always (bone age, CBC/lytes, CRP, FSH/LH, EST/TEST, TSH/T4, IGF, U/A), consider (IBD panel, Celiac panel, etc.)

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endo (day 8)
Diabetes mellitus Best marker for insulin resistance? MCQ: acanthosis nigricans Puberty <span>13yo ♀, no onset of menarche. What questions would you ask on Hx (6)? What would you do O/E? When and how would you investigate? Hx: Breast development, weight loss, pubic hair development, short stature, FHx, athlete, medical illness, high performance athlete O/E: assess nutritional status, dysmorphism, evidence of chronic disease, signs of abuse or neglect, sexual development (“boobs→pubes→grow→flow”) Ix (if no menarche >16 or pubertal >12): always (bone age, CBC/lytes, CRP, FSH/LH, EST/TEST, TSH/T4, IGF, U/A), consider (IBD panel, Celiac panel, etc.) Precocious puberty in ♀: when are you worried and which tests would you order? Ix (if bone age > height age, <6, OR psychological issues


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