A 6-year-old boy presents with progressive pubertal changes: testicular volume 8 mL bilaterally, pubic hair Tanner stage 2, and accelerated linear growth. GnRH stimulation shows a pubertal LH response. Compared with girls, the additional investigation considered essential in boys with gonadotropin-dependent precocious puberty is:
- A Bone densitometry
- B Testicular biopsy
- C MRI of the brain ✓
- D Overnight sleep study
Correct answer: C. MRI of the brain
Explanation
Central (gonadotropin-dependent) precocious puberty in boys carries a substantially higher likelihood of an underlying structural CNS lesion such as hypothalamic hamartoma, glioma, or other intracranial pathology compared with girls, in whom most cases are idiopathic. Brain MRI is therefore considered essential in all boys with central precocious puberty, particularly those younger than 9 years. Testicular biopsy has no role, and bone densitometry and sleep studies add nothing to etiologic assessment.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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