An 8-year-old girl is found to have female genital mutilation during an examination for recurrent urinary tract infections. The examination reveals that the vaginal opening has been narrowed by a covering seal (infibulation). She is currently asymptomatic other than the infections. When a deinfibulation procedure is typically recommended for a child in this situation?
A 6-year-old female presents with a pruritic, parchment-like, atrophic plaque in a keyhole distribution involving the vulvar and perianal skin. There are also areas of subepithelial hemorrhage. What is the most appropriate first-line therapy for this condition?
A 14-year-old female presents with primary amenorrhea and cyclic, monthly lower abdominal pain. On physical examination, a bulging, bluish membrane is visible at the introitus, and a pelvic mass is palpable. What is the definitive treatment for her condition?
A newborn is noted to have a palpable abdominal mass on examination. An ultrasound reveals a 6 cm complex ovarian cyst. What is the most appropriate next step in management?
A 7-year-old girl presents with unilateral breast development that began 6 months ago. She has no other signs of puberty, such as pubic hair or vaginal bleeding. Her growth velocity is normal for her age, and a bone age x-ray is consistent with her chronological age. What is the most appropriate next step in management?
A 4-year-old girl has had a persistent yellow-brown, sometimes malodorous, vaginal discharge for the past month. A course of oral antibiotics for nonspecific vulvovaginitis provided no relief. On examination, the vulva is erythematous. What should be the primary consideration in the differential diagnosis and the next step in evaluation?
A 16-year-old female presents with severe, cyclic dysmenorrhea and is found to have a 4 cm ovarian cyst on ultrasound with a homogeneous “ground glass” appearance. She is not sexually active. What is the recommended first-line management for her condition?
A 15-year-old female presents with breast asymmetry, with the left breast being significantly larger than the right. She is distressed by the appearance. An ultrasound of the left breast is normal. What is the first and most essential step in the evaluation of this patient?
