Prepubertal small penis
Tanner stage I
Penis length remains unchange
Tanner stage II
Penis begins to Lengthen
Tanner stage III
Penis increases in circumference, scrotum, and penis are mature size
Tanner stage IV
Characterized by bilateral pain over the tibial tuberosity upon palpation, along with knee pain and edema with exercise
Osgood Schlatter disease
Females is noted for breast and papilla elevated as a small mound and increase breast buds. pubic hair for females is sparse, straight hair along the medial border of the labia
Tanner stage II
Three primary ways for a minor to become emancipated
Marriage, court order, military service
True or false
Minors do not require parental consent to receive contraception, treatment for STD, or care related pregnancy,
True
Define as no menses for more than three cycles or six months in a female patient who already has a menstrual cycle
Secondary amenorrhea
Most common cause of secondary amenorrhea
Pregnancy
Less common causes of secondary amenorrhea
Ovarian disorders, stress, anorexia, PCOS
Delayed puberty and menarche
Primary amenorrhea
Associated with scrotal edema, redness, transverse lie testicle that is painful and loss of cremasteric reflex
Testicular torsion 
Associated with torsion of the appendix testis, while a palpable scrotum mass is more likely to be testicular cancer 
Blue dot sign
For primary amenorrhea what is the lab test after to rule out hypogonadism
FSH, LH and TSH
Genetic causes of primary hypogonadism or a deficiency in testosterone which leads to delay pubertal maturation
KLINEFELTER SYNDROME
Turner symdrome
Identified by complete or partial absence of second sex chromosomes in females and associated with short stature, webbed neck, high arched palate, and primary ovarian failure
