Growth and development: treatment of central precocious puberty: 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: treatment of central precocious puberty

Sample item

A 7-year-old girl has had breast development since age 6, a rapid growth rate and an advanced bone age. A GnRH stimulation test gives a pubertal LH peak, and the MRI of the brain is normal. What is the most appropriate treatment?

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

The answer and the reasoning

C. Depot GnRH agonist

A pubertal response to GnRH stimulation confirms central precocious puberty, and idiopathic disease is the commonest cause in girls. Long-acting GnRH agonists desensitise the pituitary, halt pubertal progression and slow bone-age advance, preserving adult height.

Option by option

  • A. Medroxyprogesterone acetate

    This only partly suppresses menses and breast growth and does not stop bone-age advance.

  • B. Oral dexamethasone

    Glucocorticoid suppression treats congenital adrenal hyperplasia, not central puberty.

  • C. Depot GnRH agonist (correct)

    Correct. Continuous GnRH agonist exposure suppresses gonadotropin release in gonadotropin-dependent puberty.

  • D. Letrozole

    Aromatase inhibitors are used in gonadotropin-independent forms such as McCune-Albright syndrome.

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 C, Depot GnRH agonist. A pubertal response to GnRH stimulation confirms central precocious puberty, and idiopathic disease is the commonest cause in girls.

Why is "Medroxyprogesterone acetate" not the answer?

This only partly suppresses menses and breast growth and does not stop bone-age advance.

Why is "Oral dexamethasone" not the answer?

Glucocorticoid suppression treats congenital adrenal hyperplasia, not central puberty.

Why is "Letrozole" not the answer?

Aromatase inhibitors are used in gonadotropin-independent forms such as McCune-Albright syndrome.

What concept does this question test?

It tests Growth and development: treatment of central precocious puberty in Pediatrics. Long-acting GnRH agonists desensitise the pituitary, halt pubertal progression and slow bone-age advance, preserving adult height.

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: treatment of central precocious puberty?

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.