Which of the following are true about precocious puberty? (Select all that apply, some, one, or none)

A. 60–89 mL/min/1.73m²: This range indicates mildly decreased GFR, often classified as Stage 2 chronic kidney disease. Renal function is still relatively preserved and not considered renal failure at this stage.

B. 30–59 mL/min/1.73m²: This reflects a moderate decrease in GFR, typically Stage 3 CKD. Although kidney function is significantly impaired, it is not yet categorized as renal failure.

C. 15–29 mL/min/1.73m²: This GFR indicates severe kidney impairment and is classified as Stage 4 CKD. While this stage shows significant dysfunction, renal failure is generally diagnosed at lower values.

D. <15 mL/min/1.73m²: A GFR below 15 signals end-stage renal disease (ESRD), also referred to as renal failure. At this stage, dialysis or kidney transplantation is usually necessary to sustain life.

A. Transient Ischemic Attack (TIA): A TIA presents with stroke-like symptoms that resolve within minutes to hours without permanent damage. Ms. Lauren’s symptom resolution within 6 hours and return to baseline strongly suggests a TIA. Prompt recognition is essential, as TIAs are often precursors to future strokes and require further evaluation.

B. Hemorrhagic Stroke: Hemorrhagic strokes typically present with sudden, severe symptoms such as intense headache, vomiting, or rapid loss of consciousness. These symptoms usually do not resolve quickly. Ms. Lauren’s gradual symptom resolution and stable vital signs are not consistent with this type of stroke.

C. Severe vision loss in both eyes: While visual disturbances can occur during strokes, bilateral severe vision loss is less common and would typically be seen in strokes involving the occipital lobes or vertebrobasilar system. Ms. Lauren’s case does not provide evidence of this symptom, hence an unlikely feature here.

D. Sudden loss of consciousness: Loss of consciousness is more common in massive strokes, particularly hemorrhagic ones or those involving the brainstem. Ms. Lauren remained awake and was able to report symptoms and anxiety, which rules out this presentation.

E. Sudden severe headache with vomiting: This symptom combination is more typical of a hemorrhagic stroke or subarachnoid hemorrhage. Ms. Lauren did not report a headache or vomiting, which makes this an unlikely symptom in her current presentation.

F. Ischemic Stroke: Ischemic strokes result in prolonged neurological deficits lasting more than 24 hours. Since Ms. Lauren’s symptoms are resolving within a short window and she is returning to baseline, this is less likely than a TIA in her situation.

G. Sudden weakness or numbness, often on one side of the body: This is a hallmark sign of a TIA or stroke. Ms. Lauren’s initial symptoms were stroke-like and likely included unilateral weakness or numbness, which are classic indicators of a TIA.