Choose the correct answer


  •    four year  old girl presented with bilateral breasts development

The cause may be all of the following except

  • Premature thelarche
  • Idiopathic precocious puberty
  • Thelarche variant
  • Classic congenital adrenal hyperplasia
  • McCune-Albright syndrome


  •   Eleven year old boy presented with short stature and delayed puberty

The first investigation to do for him is

  • Growth hormone stimulation test
  • Thyroid function tests
  • LHRH stimulation test
  • Bone age x-ray
  • Celiac antibodies screening



  •   Eight year old girl presented with short stature. Her height is below 3rd centile, while mid-parental height is on 50th Her clinical examination show bilateral short arms, hands and feet with mild scoliosis. Her CBC, serum calcium, serum phosphate, thyroid function tests were all normal.

The most important investigation to do at this point is

  • Karyotyping
  • Growth hormone stimulation test
  • Skeletal survey
  • Celiac antibodies screening
  • Brain MRI



  •  One day  old newborn referred to neonatal unit with ambiguous genitalia

The first investigation to do upon admission is

  • (O(17-(OH)- progesterone
  • Serum sodium and potassium
  • Serum estradiol and testosterone
  • Basal FSH and LH
  • Karyotyping
  •  fifteen year old girl presented with delayed onset of menarche. Her weight and height were on 75th Her Tanner staging was B4, P1, A1. Her clinical examination was otherwise normal. Pelvic ultrasound showed absent uterus and fallopian tubes

All of the following investigations are further required to make the diagnosis with the exception of

  • Serum Testosterone and DHT
  • Karyotyping
  • Brain MRI
  • Genital skin biopsy
  • Pelvic CT


  •  Ten year old girl presented with polyuria and polydipsia. Her weight and height were both on 90th Her examination was normal apart from darkening of skin at the sides of the neck and at both axillae. Her fasting blood glucose was 175, while postprandial blood glucose was 259. Hb A1C was 7.2%

The best regimen of treatment to start with her is

  • Metformin with diet control
  • Sulfonylurea with diet control
  • Diet control only
  • Basal/Bolus insulin therapy with carbohydrate counting
  • Insulin pump therapy with carbohydrate counting


  •  Nine year old girl was found to have Turner syndrome and autoimmune hypothyroidism during investigation for short stature. She was referred for Pediatric Endocrinology clinic to start hormonal therapy

The best course of actions to do with her at this moment is 

  • Start thyroid replacement therapy alone
  • Start thyroid replacement therapy and Growth hormone together
  • Start thyroid replacement therapy , Growth hormone and Estrogen together
  • Start Growth hormone therapy alone
  • Start Growth hormone and Estrogen together


  •  Eleven year old boy diagnosed with type 1 diabetes mellitus at age of 5 years. He was control on basal/bolus insulin regimen. In the last few weeks he had several attacks of hypoglycemia. The mother noted that his skin color was darkening over the last few months and that he was always complaining of anorexia and easy fatigability. His insulin dose was gradually reduced over the last few weeks however, hypoglycemic attacks still present.

Which of the following investigations should be done immediately at this moment


  • Fasting serum C-peptide
  • Serum ACTH and cortisol at 8 am and 11 pm
  • Thyroid function tests
  • Celiac antibodies screening
  • Hb A1c


  •  two year old boy presented with pubic hair development. His penile length was increased while testicular volume was normal for age. Both FSH and LH were within prepubertal level before and after stimulation. Serum testosterone, androstendione, dehydroepianstrosterone (DHEA) and dehyproepiandrosterone sulfate (DHEA-S) were markedly elevated

The most probable cause for his precocious puberty is

  • Hypothalamic tumour
  • Pituitary tumour
  • Hebatoblastoma
  • Testicular tumour
  • Adrenal tumour


  •  Ten year old boy presented with short stature. His height was on 3rd centile while mid-parental height was on 5th On examination he was prepubertal with otherwise normal examination. Bone age x-ray was around 10 years of age.

What would you advice that family at this moment

  • Reassure them that this is a familial short stature
  • Order basic investigations to look for the cause of short stature
  • Arrange for Growth hormone stimulation test
  • Start Growth hormone therapy
  • Give Testosterone therapy to induce puberty