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Endocrine > 190. Puberty > Flashcards

190. Puberty Flashcards

1
Q

Stage of pubic hair development in women:

The hair extends to the medial surface of the thighs and is distributed as an inverse triangle

A

Tanner 5

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2
Q

Stage with hair spreading to the inner thighs for men

A

Tanner 5

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3
Q

Breast bud develops

A

Tanner 2

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4
Q

Puberty in girls:

  • average pubertal onset at __ years old
  • Range of normal: 8-13 years old
  • Menarche average at __ years old
  • Peak growth rate occurs during Tanner __-__
  • Menarche: Tanner __ breast development
A

10
12.5
2-3
4

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5
Q

Eating disorder that provides inadequate energy balance that suppresses production of GnRH, LH, and FSH
- no leptin activity

A

Anorexia nervosa

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6
Q

Pubic hair, axillary hair, body odor, and acne are signs of __

Girls: predominantly adrenal androgens
Boys: some from gonadal testosterone

A

Adrenarche

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7
Q

Stage of pubic hair development in women:

The hair spreads covering the pubis

A

Tanner 4

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8
Q

Mature adult phallus and scrotum

A

Tanner 5

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9
Q

Mutations in __ leads to hypogonadism then “reversal” in adulthood

A

Neurokinin B

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10
Q

In addition to neuropeptides, __ __ also regulates puberty

Need to be able to provide the necessary power to fuel someone to go through puberty

A

Energy balance

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11
Q

Stage of pubic hair development in women:

Sparse growth of long slightly pigmented hair straight or only slightly curly mainly along the labia

A

Tanner 2

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12
Q

Delayed puberty begins at > __ years in girls and > __ in boys
- delayed puberty is also defined by an elapsed time of 4-5 years from the onset of puberty to menarche or full testicular development

A

13

15

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13
Q

Mutation in Gs protein that leads to peripheral precocious puberty

Will see girls with recurring ovarian cysts

Cafe au lait spots

Fibrooptic dysplasia

A

McCune-Albright Syndrome

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14
Q

Acts upstream to release kisspeptin
- controls GnRH neurons –> encodes its receptor that then release LH and FSH

Important neuropeptide for puberty, not for reproduction

A

Neurokinin B

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15
Q

During infancy to late childhood/adolescence there is __ inhibition of the GnRH pulse generator
- initial “mini-puberty” after birth that lasts 6 months in boys and 12 months in girls then __ inhibition begins

A

CNS

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16
Q

GnRH-dependent (from hypothalamus) triggering of early puberty

  • Idiopathic (more common in girls)
  • CNS abnormalities
    • Acquired (inflammation, surgery, trauma)
    • Congenital (hydrocephalus, hypothalamic hamartoma)
    • Tumors
    • Chronic exposure to sex steroids (CAH)
A

Central Precocious Puberty

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17
Q

First signs of central puberty (Gonadarche):

  • Girls: __
  • Boys: __ __
A

Thelarche

Testicular enlargement

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18
Q

Enlargement of breast and areola with no separation of the contours

A

Tanner 3

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19
Q

Testis and scrotum enlarge further

- the penis grows mainly in length but also in breadth

A

Tanner 3

20
Q

The hair spreads covering the pubis

A

Tanner 4

21
Q

Most common mutation in Kallmann’s syndrome is in __

A

KAL1/ANOS1

22
Q

__ GnRH-producing neurons:

  • Leptin
  • Kiss1, GPR54
  • Neurokinin B
  • Adequate energy balance
A

Excitatory

23
Q

Neuropeptide that is released from adipose tissue when the body has enough body fat to provide the energy needed for puberty to take place

A

Leptin

24
Q

Scrotum, testis, and penis grow further with development of the glans and further darkening of the scrotal skin

A

Tanner 4

25
Q

Mutation in this maternally imprinted gene leads to precocious puberty

Protein blocks (inhibits) the release of GnRH from the hypothalamus, thus holding off the onset of puberty

A

MKRN3

26
Q

Maturation of the hypothalamic-pituitary-adrenal axis

Adrenal androgens increase

  • DHEA
  • DHEA-S
  • Androstenedione

Independent of puberty

A

Adrenarche

27
Q

The hair is darker, coarser and curlier and spreads over the junction of the pubis

A

Tanner 3

28
Q

Gonadarche

Transition period from the sexually immature state to the potentially fertile stage during which secondary sexual characteristics appear

Maturation of the hypothalamic-pituitary-gonadal axis
- increase in GnRH, LH, FSH, and testosterone or estrogen/estradiol

A

Puberty

29
Q

Mature breast with slightly larger nipple and recession of the areola to the general contour of the breast with projection of the papilla only

A

Tanner 5

30
Q

__ levels increase at pubertal onset

- administration of __ advances the timing of puberty

A

Kisspeptin

31
Q

Delayed puberty:
__gonodatotropic = central, hypothalamic, pituitary
- Acquired - autoimmune, radiation, tumor
- Congenital - Kallmann, septo-optic dysplasia
- Malnutrition - Anorexia
- Chronic illness
- Excessive exercise
- Endocrinopathies - hyperprolactinemia, Cushing Syndrome

A

Hypo

32
Q

Kiss1 protein activates __ which is needed to express GnRH neurons

Knockout mice have normal GnRH neurons, but gonadotropin deficiency and no puberty

A

Kiss1 receptor

33
Q

Sparse growth of pigmented hair straight or slightly curly mainly at the base of the penis

A

Tanner 2

34
Q

First menstrual period

A

Menarche

35
Q

First appearance of breast tissue

A

Thelarche

36
Q

Puberty in boys:

  • Average onset at __ years old
  • Range of normal onset: 9-15 years old
  • Gynecomastia: Tanner 2-3
  • Voice change: Tanner __-__
  • Peak growth rate: Tanner __
  • Spermarche: Tanner __-__
  • Facial hair: Tanner __-__
A 
11.5 
Tanner 3-4 
Tanner 4 
Tanner 3-4 
Tanner 4-5
37
Q

Precocious puberty begins < __ years old in girls and < __ years in boys

A

8 (7 in black girls)

9

38
Q

First appearance of pubic hair

A

Pubarche

39
Q

__ GnRH-producing neurons:

  • GABA
  • B-endorphin
  • MKRN3
A

Inhibitory

40
Q

GnRH-independent triggering of early puberty

  • Genetic (LH receptor-activating mutation, McCune-Albright Syndrome)
  • Tumors (adrenal, ovarian, testicular, gonadotropin producing)
  • Other (Hypothyroidism (Van Wyk Grumbach syndrome), exogenous sex steroids, ovarian cysts)

Boys w/ penis size enlargement w/o testicle enlargement

A

Peripheral precious puberty

41
Q

Delayed puberty:
__gonadotropic = primary, gonadal
- Acquired - autoimmune, chemo, radiation, testicular torsion, infection (MUMPS)
- Congenital - Klinefelter Syndrome (47 XXY), gonadal dysgenesis

LH and FSH are high but T will be low

A

Hyper

42
Q

Late bloomers suffer from

A

Constitutional delay of puberty

43
Q

Stage of pubic hair development in women:

The hair is darker, coarser and curlier and spreads over the junction of the pubis

A

Tanner 3

44
Q

The testis and scrotum enlarge and the skin of the scrotum shows some reddening and change in texture

A

Tanner 2

45
Q

Gatekeepers of puberty

A

NKB and kisspeptin

46
Q

Projection of areola and papilla to form a secondary mound above the level of the breast

A

Tanner 4

47
Q

__ begins with an increase in GnRH pulsatility and subsequent increase in gonadotropin production
- increased frequency and amplitude, initially at night

A

Puberty

Endocrine (26 decks)

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