<prompt> Which of the following is the first sign of puberty in girls?PubarcheThelarcheMenarcheGrowth spurt  <response>: Ans. b Thelarche Ref OP Ghai 7th498PATTERNS OF PUBERTAL DEVELOPMENT Girls:- Starts at around the age of 10 yrs- Completes in 5 yrs- Sequence is TPM Thelarche -Pubarche -Menarche.- Menarche usually 2.5 yrs after thelarche. Boys:- Puberty starts at 11.5 yrsSequence is TPPS Testicular enlargement -Penile enlargement -Pubarche - Spermarche. 