AFP: American Family Physician Podcast Episode 241 -- November 2025 -- Part 1 AFP: American Family Physician
Nov 17, 2025
Dive into the complexities of puberty as experts discuss normal milestones, distinguishing precocious from delayed cases, and the reasons behind each. Learn how caregiver-targeted interventions can reduce childhood caries and the effectiveness of a new solution for dry eyes. Explore the nuances of diagnosing iron deficiency anemia, including when to consider GI issues. Plus, discover a study showing amiloride's efficacy against resistant hypertension with fewer side effects. Finally, hear about trauma-informed care strategies to enhance patient support.
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Defining Abnormal Puberty
- Precocious puberty is before age 8 in girls and before age 9 in boys, while delayed puberty is absent secondary sexual development by expected ages.
- Evaluate growth, bone age, labs, and refer to pediatric endocrinology for unclear, progressive, or pathologic cases.
Monitor Benign Early Variations
- Monitor benign early variations like isolated premature thelarche or adrenarche every three to six months unless rapid progression occurs.
- Order labs and a left-hand bone age x-ray if findings are inconsistent with benign patterns.
Different Causes Of Precocious Puberty
- Central precocious puberty is often idiopathic in girls but more often pathologic in boys.
- Peripheral causes include congenital adrenal hyperplasia, tumors, McCune-Albright, or exogenous steroids.