B is the correct answer

Explanation:

Puberty is an important developmental milestone. It is a physiologic sequence of events that results in the development of secondary sexual characteristics and growth in stature, but it is also accompanied by cognitive and psychosocial maturation.

Disorders of puberty include its early occurrence. Precocious puberty is defined as puberty that starts 2 to 2.5 standard deviations below the mean age of onset. In females, the mean age of puberty is 10.5 years, so evaluation is warranted if secondary sexual characteristics develop prior to 8 years of age.

Central precocious puberty or idiopathic precocious puberty is the most common etiology of precocious puberty in both sexes. Other causes, such as peripheral precocity, should be ruled out. A basal luteinizing hormone is the best test to differentiate between the two since levels are decreased in the setting of peripheral precocity, and female hormones are primarily secreted from the gonads, while basal luteinizing hormone levels are increased with central precocious puberty.

 

 

 

Adrenarche (A) is present with both conditions and does not help differentiate the two etiologies of precocious puberty. Bone age (C) measurement ≥ 2 years more than chronological age is used to determine if evaluation for precocious puberty is warranted but does help to identify the etiology. Early development of secondary sexual characteristics (D) occurs in both central and peripheral precocious puberty.

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