Which of the following statements best describes the difference between precocious pseudopuberty and true precocious puberty?
a. In precocious pseudopuberty, the maturational changes are not real and are only in the imagination of the child or parents.
b. In precocious pseudopuberty, there is an initial activation of reproductive-related hormones, but it is a false start and soon deactivates.
c. In precocious pseudopuberty, there is early pseudo menses not connected with ovulation, whereas in true precocious puberty menses is associated with ovulation.
d. In precocious pseudopuberty, there is breast or sexual hair growth but no activation of the hypothalamic-pituitary-gonadal axis.
D
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A Incorrect. The statement, "the maturational changes are not real and are only in the imagination of the child or parents" does not best describe the difference between precocious pseudopuberty and true precocious puberty.
B Incorrect. The statement, "there is an initial activation of reproductive-related hormones, but it is a false start and soon deactivates" does not best describe the difference between precocious pseudopuberty and true precocious puberty.
C Incorrect. The statement, "there is early pseudo menses not connected with ovulation, whereas in true precocious puberty menses is associated with ovulation" does not best describe the difference between precocious pseudopuberty and true precocious puberty.
D Correct. True or central precocious puberty can be distinguished from precocious pseudopuberty. True precocious puberty results from premature activation of the hypothalamic-pituitary-gonadal axis, with GnRH, LH, FSH, and estrogen or testosterone produced. Precocious pseudopuberty occurs when there is evidence of secondary sexual characteristics (breast or sexual hair growth) but not activation of the axis (normal levels of GnRH, LH, and FSH).
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