pearljam59
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A 15-year-old girl is brought to the physician for a well-child examination. She is upset because her right breast is larger than the left, and she will not attend physical education classes because she is embarrassed to undress. Breast development began 2 years ago. Menarche has not yet occurred. Examination shows the right breast to be twice as large as the left; the right breast is Tanner stage 4, and the left breast is Tanner stage 3. Which of the following is the most appropriate intervention?
A. Reassurance
B. Psychological evaluation
C. Estrogen therapy
D. Progesterone therapy
E. Operative treatment
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| druas
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A...
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| pacanth
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I'll go with A too
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| huzefa
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Is it C? she's 15 without menarche.
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| meroon
Forum Senior
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Can it be D as estrogen can cause furtur enlargement of breast.I am confudes here.
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| meroon
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Sorry for spelling mistakes.I meant furthur enlargement. and confused about the ans.
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| robin082006
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I go with A too,
It may be normal in adolescent females.
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| yasmeen
Forum Guru
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i think its D 15 IS LATE FOR MENARCHE.WE CAN TRY PROGESTERONE FOR WITHDRAWL BLEEDING.
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| pearljam59
Forum Guru
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I thought menarche can start as late as 16?
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| humpf!!
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hey guys, bumping this one up...i really want to know what you think. i was thinking D...
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| MannMD
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16 is very late, i would go with C.
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| mjl1717
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Id check hormone and gonadotropic levels and possibly give a steroid most likely estrogen. reassurance and psyche probably wont do it this time. and figure she cant afford breast surgery .
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| Slacker
Forum Elite
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B. I think Psychological evaluation should be done because she probably has some stress in her life that is delaying her menarche. But if there is not stress then drug therapies can be tried. This is a guess...!!!!
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| barukdaddy
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15 is indeed late for menarche. Perhaps simple late onset puberty is the only issue here. I found this in an article from pubmed:
"Short- and long-term psychosocial effects of precocious or early normal puberty are probably more important for individuals than the moderate losses in final height they experience." So I might have to also go with B.
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| Diego Casali
Forum Elite
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I'll go with A. I remember a similar question in Webpath, which was about virginal hypertrophy of the breast.
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| study_ing
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a
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| Diego Casali
Forum Elite
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This is a question from Webpath:
"A 15-year-old healthy girl of normal height and weight for age is concerned because her right breast has developed to twice the size of her left breast since the onset of puberty at age 12. On physical examination both breasts have a similar consistency on palpation, and there is no tenderness. The nipples and areolae appear normally formed. Which of the following is the most likely cause for these findings?
A. Cystosarcoma phylloides
B. An ovarian tumor
C. Virginal hypertrophy
D. Fibrocystic disease
E. Infiltrating ductal carcinoma
The correct answer is C. This is a problem that can be easily remedied with plastic surgery."
End of story, guys!
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