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Paeds Casesadolescent-and-young-adult-medicine

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.

short case with communication station3 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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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

  1. Stage puberty accurately using Tanner criteria, measuring testicular volume with a Prader orchidometer. [1] [2]
  2. Recognise constitutional delay of growth and puberty by its pattern and counsel the young person and family. [4] [6]
  3. Identify the red flags of rapidly progressive precocious puberty and construct an urgent referral plan. [3] [5]
  4. Demonstrate a confidential, developmentally appropriate and consent-based examination. [8]
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References7ShowHide
  1. [1]Marshall WA, Tanner JM Variations in pattern of pubertal changes in girls. Archives of disease in childhood, 1969.PMID 5785179
  2. [2]Marshall WA, Tanner JM Variations in the pattern of pubertal changes in boys. Archives of disease in childhood, 1970.PMID 5440182
  3. [3]Carel JC, Léger J Clinical practice. Precocious puberty. The New England journal of medicine, 2008.PMID 18509122
  4. [4]Palmert MR, Dunkel L Clinical practice. Delayed puberty. The New England journal of medicine, 2012.PMID 22296078
  5. [5]Latronico AC, Brito VN, Carel JC Causes, diagnosis, and treatment of central precocious puberty. The lancet diabetes & endocrinology, 2016.PMID 26852255
  6. [6]Harrington J, Palmert MR An Approach to the Patient With Delayed Puberty. The Journal of clinical endocrinology and metabolism, 2022.PMID 35100608
  7. [8]Smith CE, Biro FM Pubertal Development: What's Normal/What's Not. Clinical obstetrics and gynecology, 2020.PMID 32482957
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