Growth and development: premature adrenarche: 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.

Try it

Pediatrics · Growth and development: premature adrenarche

Sample item

A 7.5-year-old girl has had pubic hair, axillary hair and body odour for six months. She has no breast buds, her growth velocity is normal, and bone age is only slightly advanced. Which mechanism best explains the findings?

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

The answer and the reasoning

B. Early maturation of adrenal zona reticularis with rising DHEA-S

Premature adrenarche is a benign variant in which adrenal androgens rise early. Pubic hair and odour appear without breast development or rapid growth, and bone age is mildly advanced at most. It is diagnosed after excluding virilising disorders.

Option by option

  • A. Early pulsatile GnRH release from the hypothalamus

    GnRH activation would produce breast development and accelerated growth, which are absent.

  • B. Early maturation of adrenal zona reticularis with rising DHEA-S (correct)

    Correct. Early adrenal androgen production gives pubarche without gonadal activation.

  • C. Autonomous oestrogen secretion by an ovarian cyst

    Ovarian oestrogen would cause breast enlargement, not isolated pubic hair.

  • D. Cortisol excess from an adrenal adenoma

    Cortisol excess causes weight gain, striae and growth failure, not isolated pubarche.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Early maturation of adrenal zona reticularis with rising DHEA-S. Premature adrenarche is a benign variant in which adrenal androgens rise early.

Why is "Early pulsatile GnRH release from the hypothalamus" not the answer?

GnRH activation would produce breast development and accelerated growth, which are absent.

Why is "Autonomous oestrogen secretion by an ovarian cyst" not the answer?

Ovarian oestrogen would cause breast enlargement, not isolated pubic hair.

Why is "Cortisol excess from an adrenal adenoma" not the answer?

Cortisol excess causes weight gain, striae and growth failure, not isolated pubarche.

What concept does this question test?

It tests Growth and development: premature adrenarche in Pediatrics. Pubic hair and odour appear without breast development or rapid growth, and bone age is mildly advanced at most. It is diagnosed after excluding virilising disorders.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 adrenarche?

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.