USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

Table II-12-1. Precocious   Puberty

11–12   years

12–13   years

Figure II-12-1. Overview    of  Puberty

Incomplete isosexual precocious puberty

Incomplete isosexual precocious puberty involves only one change: thelarche,
adrenarche, or menarche. It is the result of either transient hormone elevation or
unusual end-organ sensitivity. Management is conservative.

Complete isosexual precocious puberty

Complete isosexual precocious puberty involves all changes of puberty,
including breast development, growth spurt, and menstrual bleeding. The
primary concern is premature closure of the distal epiphyses of the long bones,
resulting in short stature. Fertility and sexual response are not impaired.

Maximal growth

Growth  spurt

Menarche

Onset   of  first   menses