Paeds Cases · adolescent-and-young-adult-medicine
Normal puberty and adolescent development — short case and counselling station
Observed structured encounter testing pubertal staging, recognition of a normal variant, counselling on timing, and safe identification of a presentation that requires referral.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 14-year-old boy with constitutional delay of growth and puberty requiring staging, counselling and a management plan. Station B is a 7-year-old girl with rapidly progressive precocious puberty requiring recognition of the red flags and an urgent referral plan.
Station objectives
- Stage puberty accurately using Tanner criteria, measuring testicular volume with a Prader orchidometer. [1] [2]
- Recognise constitutional delay of growth and puberty by its pattern and counsel the young person and family. [4] [6]
- Identify the red flags of rapidly progressive precocious puberty and construct an urgent referral plan. [3] [5]
- Demonstrate a confidential, developmentally appropriate and consent-based examination. [8]
References7ShowHide
- [1]Marshall WA, Tanner JM Variations in pattern of pubertal changes in girls. Archives of disease in childhood, 1969.PMID 5785179
- [2]Marshall WA, Tanner JM Variations in the pattern of pubertal changes in boys. Archives of disease in childhood, 1970.PMID 5440182
- [3]Carel JC, Léger J Clinical practice. Precocious puberty. The New England journal of medicine, 2008.PMID 18509122
- [4]Palmert MR, Dunkel L Clinical practice. Delayed puberty. The New England journal of medicine, 2012.PMID 22296078
- [5]Latronico AC, Brito VN, Carel JC Causes, diagnosis, and treatment of central precocious puberty. The lancet diabetes & endocrinology, 2016.PMID 26852255
- [6]Harrington J, Palmert MR An Approach to the Patient With Delayed Puberty. The Journal of clinical endocrinology and metabolism, 2022.PMID 35100608
- [8]Smith CE, Biro FM Pubertal Development: What's Normal/What's Not. Clinical obstetrics and gynecology, 2020.PMID 32482957