Repeated USMLE Questions Step 2 CK- 423

A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal.

What is the most likely diagnosis?

A-Precocious puberty

B-Isolated premature thelarche

C-Pituitary adenoma

D-Androgen insensitivity syndrome

E-Congenital adrenal hyperplasia


This is a typical case of isolated premature thelarche. Precocious puberty is incorrect as it is characterized by premature menstruation and appearance of pubic and axillary hair in addition to enlarged breasts. It is a normal condition occurs in 40% of girls under the age of 8. There is no other symptoms suggesting any abnormality so, other options are all incorrect.

The correct answer is B

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