Which statement best describes a feature of central precocious puberty?

Which statement best describes a feature of central precocious puberty?

• A. Excess secretion of sex hormones
• B. Delay in bone age relative to chronological age
• C. Early activation of the HPG axis
• D. LH/FSH suppression

Answer: (C)

Central precocious puberty is driven by early firing of the hypothalamic-pituitary-gonadal axis. GnRH pulses start sooner than normal, prompting the pituitary to release LH and FSH earlier, which then stimulates the gonads to produce sex steroids and accelerate pubertal development. This premature axis activation also speeds up bone maturation, causing an advanced bone age relative to the child's calendar age. So the best way to describe the feature is the early activation of the HPG axis. The other ideas don’t fit as neatly: bone age would be advanced, not delayed; gonadotropins would not be suppressed—in central CPP they rise in response to the premature axis activation; and while sex hormones are elevated, the defining hallmark is the premature activation of the axis itself.

Central precocious puberty is driven by early firing of the hypothalamic-pituitary-gonadal axis. GnRH pulses start sooner than normal, prompting the pituitary to release LH and FSH earlier, which then stimulates the gonads to produce sex steroids and accelerate pubertal development. This premature axis activation also speeds up bone maturation, causing an advanced bone age relative to the child's calendar age. So the best way to describe the feature is the early activation of the HPG axis. The other ideas don’t fit as neatly: bone age would be advanced, not delayed; gonadotropins would not be suppressed—in central CPP they rise in response to the premature axis activation; and while sex hormones are elevated, the defining hallmark is the premature activation of the axis itself.