Obesity (pediatrics) Quiz: Ace Your Exams

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A 14-year-old girl presents to clinic with concerns regarding irregular menstrual cycles and excessive hair growth over her face and abdomen. Menarche occurred at age 12, but only 4 to 5 periods have occurred per year since then. She has had unintentional weight gain over the past two years and progressively worsening acne despite over-the-counter treatments. She has not had any headaches, visual changes, or galactorrhea. Family history is notable for type 2 diabetes and obesity in multiple relatives. Body mass index (BMI) is at the 96^th percentile for age and sex. Coarse hair is present on the upper lip and lower abdomen. There is mild inflammatory acne and acanthosis nigricans over the neck. Which of the following is the best next step in diagnosis?

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Thyroid function tests

Serum androgen levels and pelvic ultrasound

Liver function testing

Oral glucose tolerance test (OGTT)

Serum prolactin and brain magnetic resonance imaging (MRI)