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Question

A chubby 6-month-old boy is noted by his father to have a "small" penis. He has been growing well and appears to be healthy otherwise.
Which of the following is the most appropriate first step in management of this child?

A. Surgical consultation

B. Evaluation after retracting the skin and fat lateral to the penile shaft

C. Ultrasound for uterus and ovaries

D. Weight loss

E. Serum testosterone levels

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Answer / Explanation:

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The answer is B , Evaluation after retracting the skin and fat lateral to the penile shaft.

Many boys, especially those who are chubby, have an inconspicuous penis; when skin and fat lateral to the penis shaft are retracted, a normally sized and shaped penis is revealed. If, after performing this maneuver, the penis is found to be more than 2.5 standard deviations below the mean in size for age, and especially if other physical examination findings are noted, then further evaluation would be initiated.
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