Growth and development: premature thelarche: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Growth and development: premature thelarche

Sample item

A 2-year-old girl has bilateral breast enlargement with no pubic hair, normal growth velocity, and a prepubertal bone age. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Reassure and observe

Premature thelarche and adrenarche are benign variants without growth acceleration or advanced bone age. Observation with follow-up is adequate, and treatment is not needed.

Option by option

  • A. Start oestrogen blocker

    Anti-oestrogen therapy is not indicated in a benign variant.

  • B. Start GnRH analogue

    GnRH analogue is for central precocious puberty with accelerated growth and bone age.

  • C. Order MRI brain urgently

    MRI is reserved for central precocious puberty in young girls with progression.

  • D. Reassure and observe (correct)

    Correct. Isolated thelarche with normal growth needs observation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Reassure and observe. Premature thelarche and adrenarche are benign variants without growth acceleration or advanced bone age.

Why is "Start oestrogen blocker" not the answer?

Anti-oestrogen therapy is not indicated in a benign variant.

Why is "Start GnRH analogue" not the answer?

GnRH analogue is for central precocious puberty with accelerated growth and bone age.

Why is "Order MRI brain urgently" not the answer?

MRI is reserved for central precocious puberty in young girls with progression.

What concept does this question test?

It tests Growth and development: premature thelarche in Pediatrics. Observation with follow-up is adequate, and treatment is not needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Growth and development: premature thelarche?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.