Androgens and Male Puberty Flashcards
__ is the period of transition bw __ and __
characterized by development of ___, ___ and attainment of ___
__ and ___ controlled by ___
__ req for activation of HPG axis
__, __ and __ factors contribute to regulate puberty initiation
hormones that contribute
L, I, G, I w effect
__ and _ play a role
puberty, child/adulthood
SSC, gonadal maturation, repro ability
puberty/repro, HPG axis
pulsatile GnRH
nutrition, enviro, genetics
leptin+, insulin, IGF +
Ghrelin -
Kiss1 and Kiss1R
Female puberty begins bw __ and __
PP < __
delayed > __
male begins bw __ and __
PP < __
delayed > ___
9-14yrs
8
13
9-14
9
14
Genital sexual maturity rating (tanner stages)
1
2 enlarged __, red/thin/enlarged __
3 __ enlarges, __ then __
4 continued enlargement of __ and __ and __, w ___
5 Normal adult __ and __ genitalia
Prepubertal
Enlarged testes, scrotum
penile, L/D
testes, scrotum, penis, glans
size, proportion
Prader orchidometer
tool to measure __ by comparing __ to standard bead
prepubertal is __ to __
pubertal __ and up
adult size > ___
Male characteristics related to pubertal development T P G Inc in change in \_\_\_ inc in \_\_ and first \_\_\_
teste volume, testes
1-3mL
4mL
12mL
teste enlarges pubic hair growth spurt lean body mass body comp penile length, ejac
Pubic hair sex maturity rating (tanner stage)
1
2 sparse __ at base of __
3 __ inc and becomes __
4 __ appearing hair throughout
5 inc in __ w spread to __
prepubetal
straight hair, penis
hair, darker/curlier
mature
hair, thighs
Hallmark of male puberty is __ or ___
should be __ cm or __mL
physio gynecomastia
__ condition
correlates w genital stage __ and peak ___
presence of palpable ___ tissue, beneath ___ and usually __
resolves w/in __, definitely by __
DDx K__ w small, firm testis
A
Chronic __
testicular volume, length
2.5cm, 3-4mL
common
4, height velocity
glandular breast tissue, areola, tender
6-18m, 2yrs
Klinefelter syndrome
anabolic steroids
chronic marijuana use
PP- onset of ___ greater than __ SD below mean age
Central cause: \_\_ inc due to stimulation from \_\_ \_\_ elevated Bone \_\_ Chronologic age random LH/FSH should be stimlated \_\_\_ at \_\_ level all boys w CPP need \_\_\_
Peripheral: testes < __ or have ___
Testosterone is ___
Bone age __ chrono age
LH/FSH are __/__
Boys w ___ are more likely than girls to have ___ abnorm
ssc, 2.5
Testicular size, LH testosterone greater normal/high LH, pubertal Brain MRI
2mL, minimal growth
inc
>
low/suppressed
CPP, CNS
possible CNS abnormalities
Congenital M, T, C___
such as __ or __ or __
Acquried ___
S, I, T, R, C
malformations, tumors, cyst of hypothalamus
hypothalamic hamartoma, arachnoid cyst, hydrocephalus
hypothalamic damage
surgery, infect, tumor, rad/chemo
Peripheral PP Origin
Adrenal gland overprodxn of __
such as __ or ___
M__
L__ secreting testosterone
Familial ___: mutated __ receptor in testes turned on
hCG secreting tumor, like ___ or ___
stimulates __ and prodxn of __ in leydig cells
androgens
CAH, adrenal tumors
Mccune Albright Syndrome
leydig cell
Testotoxicosis, LH receptor
hepatoblastoma, choriocarcinoma
LH, T
Isolated Precocious adrenarche
presents w ___, inc __ and mildly advanced ___
Constitutional delay in __/_
puberty starts bw _ and __
more freq in boys w __
CM A, P/A, A, Oily __/__
before age __
adrenal androgens prooduced in ___ of adrenal gland
include __ and __or __
rule out ___, true ___, __ tumor, exposure to __
axillary/pubic, adrenal androgens, bone age
growth/puberty
14-18
FH
adult odor, axillary/pubic hair, acne, hair/skin
9
ZR of adrenal gland
DHEA/DHEAS/normal to inc T
late onset CAH, PP, adrenal tumor, androgenic products
Delayed puberty
No pubertal changes at age > __ above mean
testis volume less than __ at age ___
majority of boys will have __
2.5SD
3-4mL, 14
constitutional delay
Hypogonadotropic Hypogonadism
low __ and __
could be congenital w __
can be __ hypo hypo (__ def, chronic __, m)
__
__
may be combined w other ___ dysfxn- H, H
Syndromes assc: P, LMB, C, G
FSH/LH
Kallmans syndrome
fxnal- GH defic, chronic dz, malnut
tumor
malformation
pituitary, hypopituitarism/holoprosencephaly
prader willi, laurence moon biedl, charge, gordons
Hypergonadotropic hypogonadism
assc w __ w genotype __
A__/__ dysgenesis
R___
constitutional delay of pubertal development
common findings
FH- dad continues __ after HS
Linear growth velocity is __ until just before usual age of __
growth spurt about __ than average
Bone age delayed __ yrs
complications: B, D, A, A, Poor __
Refer to __ for tx if __ significantly affected
tx w__
Klinefelters syndrome, XXY
anorchia/gonadal
radiation
grow
normal, puberty
2yrs
2+yrs
bullying depression anxiety absence poor self image
Peds ENDO, QOL
testosterone
Klinefelter syndrome
__ is possible
Most dx as ___ due to __
sx \_\_ absent poor \_\_\_ tendency to lose \_\_\_ \_\_ development O \_\_ pattern pubic hair small \_\_ \_\_ stature physique is \_\_ IQ is \_\_\_
mosaicism
adults, infertility
frontal baldness beard growth chest hair breast osteoporosis female pattern testes tall feminized slightly dec
spermarche occurs at age, along w
14, peak height velocity
