400 Obstetrics and Gynecology Board Review •••
❍ What is the most frequent gynecologic disease of children?
Vulvovaginitis.
❍ What percentage of all neoplasms in premenarcheal children are ovarian tumors?
1%.
❍ Seventy-five percent of ovarian neoplasms in children that necessitate surgery are found to have what
pathologic diagnosis?
Benign teratoma.
❍ Precocious puberty is defined as the appearance of any sign of secondary sexual maturation at age of more
than how many standard deviations below the mean?
2.5 standard deviations.
❍ Which type of precocious puberty involves premature maturation of hypothalamic pituitary ovarian axis
and includes normal menses, ovulation, and the possibility of pregnancy?
GnRH-dependent precocious puberty.
❍ Which type of precocious puberty involves premature female sexual maturation and uterine bleeding but
without associated ovulation?
GnRH-independent precocious puberty.
❍ Breast hyperplasia is a normal physiologic phenomenon in the neonatal period and may persist for how
many months?
Up to six months of age.
❍ Anatomically, most central nervous lesions associated with precocious puberty are located in what region of
the brain?
Hypothalamus in the region of the third ventricle, tuber cinereum, or mammillary bodies.
❍ What blood tests would be appropriate in the evaluation of a female child with precocious puberty?
Serum level of follicle-stimulating hormone (FSH), LH prolactin, TSH, estradiol, testosterone,
dehydroepiandrosterone sulfate (DHEAS), hCG, androstenedione, 17-hydroxyprogesterone, triiodothyronine,
and thyroxine.
❍ In childhood, what percentage of ovarian neoplasms necessitating surgery are benign?
75% to 85%
❍ What percentage of cases of true precocious puberty are secondary to a life-threatening central nervous
system disease?
30%.