My daughter is 7 year 9 months old. She has achieved thelarchy eight to ten months back. She has PV white discharge ( spots) since last fifteen days. she has no other secondary sexual characters developed. Her height is 128cm and her weight is 25kg. Paretns heights- mother- 148cm , father - 5'4" ) Her invistegatons were done recently TSH - 5.50mIU/L Prolactin 20.0 ng/ML Estradiol - 16.5 pg/ml Sonography Report - Uterine and ovarian morpholgy Length of corpus 3.2cm Length of the cervix - 1.8cm AP of fundus - 1.2cm AP of cervix - 0.6cm Uterus is pear shaped Right ovarian volume - 1.4X 0.9 X 1.2 = 0.7 Small folicides are seen in the right ovary and the largest measures .6cm . No adrenal mass. Her X-ray wrist suggests bone age 10 years. MRI – brain scan is normal . Pl. suggest proper treatment     Check out the answer

7yrs old girl,32kgs, 135cms at present with tanner's 3 thelarche and tanner's 2 adrenarche, not yet attained menarche. Bone age 11yrs. . Leuprolide stimulaion test is positive. Other hormonal assay, MRI brain USG abdomen are all normal. What would be the line of management? Should we start medroxy progesterone with leuprolide to prevent spotting as mother is anxious about the spotting? Id so what woulld be the correct dosage? Should GH be added with Leuprolide for full height potential? Will she attain the full expected height? What are the other problems to be expected?     Check out the answer