6 - Puberty and the HPG Axis Flashcards

1
Q

What is puberty and what are some processes that occur during this?

A

Preparation for sexual maturity to enable us to reproduce, creates distinct differences between sexes.

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2
Q

What factors affect the start of puberty?

A

- Age variable but once starts sequence of changes constant

    • Pineal gland* has some influence with light as issues e.g tumours, with this lead to precocious puberty
  • In girls body weight, nutrition and leptin, critical weight being 47kg
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3
Q

How do you assess what level of puberty an adolescent is at?

A

Tanner Scale

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4
Q

What is the difference between primary and secondary sexual characteristics?

A

Primary - At birth, internal and external genitalia

Secondary - Those that develop after puberty, e.g pubic hair, breat development, menstruation

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5
Q

What is the sequence of events in female puberty?

A

Starts around 8-13

1. Thelarche

2. Pubic hair (testosterone)

3. Growth spurt (GH and oestrogen ending)

4. Menarche

5. Coarser pubic hair and anatomical spread

6. Breast development

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6
Q

What is the sequence of events in male puberty?

A

Starts around 10-14

  1. Testicular enlargement

2. Pubic hair growth (testosterone)

3. Spermatogenesis

4. Growth spurt (later than girls)

5. Testes and penis growth

6. Pubic hair coarser and anatomical spread

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7
Q

Why do boys grow taller than girls even though they have a growth spurt at a later stage?

A
  • Boys have less oestrogen and it is oestrogen that causes epiphyseal growth plates to fuse
  • Growth depends on IGF, GH and oestrogen
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8
Q

Complete the following table.

A
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9
Q

What can be the consequence of precocious puberty?

A
  • Short stature as the levels of oestrogen rise earlier
  • More common in obese adolescents, girls and Afro-Caribbeans
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10
Q

What process occurs endogenously in the body to signal the start of puberty?

A

- GnRH produced in hypothalamus, stimulated by leptin

  • Pulsatile release, mainly nocturnal
  • GnRH causes release of LH and FSH from anterior pituitary
  • Final hormones from gonads drive secondary characteristics
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11
Q

What parts of the gonads to FSH and LH work on?

A
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12
Q

What is the relationship between the hypothalamus and the anterior pituitary gland?

A

Connected by superior hypophyseal artery

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13
Q

Why is sleep important in children at puberty age?

A
  • GnRH released every 1-3hrs mainly at night into hypophyseal portal system
  • Ensures there is sufficient LH and FSH levels to initiate gonadal development
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14
Q

How does negative feedback occur in the HPG axis?

A

- GnRH feedsback on itself along with every other hormone

  • When follicles (gametes) stimulated they release inhibin to negatively feedback on FSH to stop further production and maturation
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15
Q

What effect does FSH and LH on male gonads?

A

LH:

  • Stimulates Leydig cells to produce testosterone

FSH:

  • Increases sperm production on Sertoli (support) cells. This cause inhibin release to stop FSH
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16
Q

When looking histologically where would you find sertoli and leydig cells?

A
  • Sertoli cells have large nucleus
  • Leydig cells in interstitium
17
Q

What effect does FSH and LH on female gonads?

A
  • Act via Gs receptors and stimulate oestrogen, inhibin and progesterone release
18
Q

What effect does oestrogen have on GnRH secretion?

A

- Small titres reduce GnRH and have negative feedback

- High titres promote GnRH and have positive feedback leading to LH surge

19
Q

What affect does progesterone have on GnRH secretion?

A
  • Increases oestrogens inhibitory effects when moderate oestrogen
  • Prevents positive feedback of high oestrogen so no LH surge and no ovulation which is why can be OC pill

-

20
Q

Where is inhibin released from in females and what does it cause?

A
  • From granulosa cells of corpus luteum
  • Inhibts secretion of FSH
  • Tiny inhibitory effect on LH
21
Q

What are the hormonal changes that occur in the HPG that lead to a growth spurt?

A
22
Q

What effect does leptin have on the reproductive system?

A
  • Derived from adipocytes and signals to CNS about energy stores in body
  • Pulsatile release similar to LH
  • Can regulate GnRH secretion. (critical weight 47kg, without will stop menstruation)
23
Q

Fill in the following table with range ages in girls:

A
24
Q

What is the definition of precocious puberty and why can meningitis lead to this?

A
  • Physical signs of sexual maturation before 8 years or menarche before 10 years
  • Meningitis leads to increased ICP. This can push on hypothalamus and cause it to release GnRH. Same scenario with pineal gland tumour and thyroid issues in boys
25
Q

What feedback is occuring on the HPG during ovulation?

A
  • Raised oestrogen is raising LH levels but not FSH as inhibin is present
26
Q

How can you delay precocious puberty?

A

Give GnRH agonist to desensitise receptors

27
Q

What percentage of 14 year old boys show no signs of puberty and what would this be called?

A
  • 5%
  • Constitutional delay
28
Q

When does the growth spurt occur in boys in relation to other events?

A

After pubic hair growth (get chart)