The FIRST physical sign of puberty in a normal boy is:
- A Pubic hair appearance
- B Testicular volume reaching 4 mL ✓
- C Peak height velocity
- D Axillary hair appearance
Correct answer: B. Testicular volume reaching 4 mL
Explanation
In boys, puberty begins with testicular enlargement to 4 mL or greater (Tanner genital stage 2), driven by rising FSH and LH stimulating Sertoli cells and Leydig cells respectively. This precedes pubic hair, which reflects adrenal androgen production, and precedes peak height velocity by roughly 1 to 2 years. Axillary hair appears later still, around Tanner stage 3 to 4. Peak height velocity is a mid-pubertal event, not the initial sign.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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