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RDS Test 2 > B8-060 Delayed Puberty > Flashcards

B8-060 Delayed Puberty Flashcards

1
Q

[hormone] stimulates the development of secondary sex characteristics in females

A

estrogen

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2
Q

[hormone] is mildly anabolic and stimulates calcification

A

estrogen

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3
Q

[hormone] regulates behavior and secretion of gonadotropins

A

estrogen

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4
Q

[hormone] induce body hair

A

androgens

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5
Q

[hormone] influences sexual behavior

A

androgens

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6
Q

[hormone] promotes protein anabolism, somatic growth, and ossificaiton

A

androgens

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7
Q

[…] can be a significant source of androgen production in females

A

adrenal cortex

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8
Q

during puberty, […] provides negative feedback on the hypothalamus, leading to low levels of LH/FSH

A

estrogen

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9
Q

adrenarche refers to the production of […] a couple years prior to puberty

A

DHEA

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10
Q

one of the first changes occurring pre-puberty is the nocturnal rise in […]

A

GnRH

(leads to increased LH)

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11
Q

in childhood, high amounts of [neurontransmitter] inhibit GnRH neurons

A

GABA

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12
Q

during puberty, inhibitory GABA decreases and excitatory […] increases GnRH [3]

A

glutamate
NMDA
kisspeptin

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13
Q

how does the negative feedback of estrogen change throughout life?

A

in childhood, low levels of estrogen are needed to suppress GnRH

however, with age those low levels are no longer enough. Requires higher levels of estrogen to maintain LH/FSH

(decreasing sensitivity)

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14
Q

in hypogonadotropic hypogonadism, LH and FSH will be

A

low

(problem at level of pituitary)

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15
Q

in hypergonadotropic hypogonadism, LH and FSH will be

A

high

(problem at level of gonads)

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16
Q

Kallmans is […]gonadotropic hypogonadism

A

hypo

(neurons fail to migrate, anosmia)

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17
Q

Klinefelter’s is […]gonadotropic hypogonadism

A

hyper

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18
Q

Turner’s is […]gonadotropic hypogonadism

A

hyper

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19
Q

[what Turner stage]

no sexual hair
flat-appearing chest with raised nipples in females

A

stage 1

(pre-pubertal)

20
Q

[what Turner stage]
pubic hair appears
testicular enlargement
breast buds form

A

Stage 2

(8-11.5 years)

21
Q

[what Turner stage]
coarsening of pubic hair
penis size increases
breast enlarges

A

Stage 3

(11.5-13 years)

22
Q

[what Turner stage]
coarse hair across pubis sparing thigh
penis width/glans increases in size
breast enlarges, raised areola

A

Stage 4

(13-15 years)

23
Q

[what Turner stage]
coarse hair across pubis and thigh
penis/testis reach adult size
adult breast contour, areola flattens

A

Stage 5

> 15 years

24
Q

earliest detectable secondary sexual characteristic is […] in females, and […] in males

A

breast bud development
testicular enlargement

25
Q

precocious puberty is the appearance of secondary sexual characteristics under age […] in females and […] in males

A

8 in females
9 in males

26
Q

central precocious puberty is caused by an increase in […] secretion

A

GnRH

(can be idiopathic or due to CNS tumors)

27
Q

peripheral precocious puberty is […] independent

A

GnRH

due to increased sex hormone production of exposure to exogenous sex steroids

28
Q

causes of peripheral precocious puberty

A

congenital adrenal hyperplasia
granulosa/leydig cell tumors

29
Q

delayed puberty is defined as the absence of secondary sex characteristics by age […] in females and […] in males

A

13 in females
14 in males

30
Q

chemotherapy/radiation would cause […]gonadotropic hypogonadism

A

hyper

31
Q

male
47 XXY

A

klinefelters

32
Q

small firm testis
infertility
tall stature
gynecomastia
female hair pattern

A

klinefelters

33
Q

female 45 XO

A

Turners

34
Q

short stature
streak ovary
broad chest, widely spaced nipples
webbed neck

A

Turners

35
Q

defective migration of neurons and subsequent failure of olfactory bulbs to develop due to defective NCAM

A

Kallmanns

36
Q

inheritance pattern of Kallmanns

A

X linked

(can be dominant or recessive)

37
Q

what causes peak height velocity near puberty?

A

increased production of gonadal steroids

increased secretion of GH and IGF1

38
Q

what causes the sharp decline in peak height velocity near puberty?

A

increased production of gonadal steroids also promotes calcification and closure of epiphyseal plates

39
Q

homozygous mutation causing loss of ESR1 function causes

A

estrogen resistance

symptoms: amenorrhea, lack of breast development, epiphyseal plates don’t close

40
Q

adverse effects of androgen therapy in adolescents

A

premature closure of epiphyseal plates
polycythemia
decreased spermatogenesis
increased LCL
male pattern baldness

41
Q

growth spurt in girls typically corresponds to Tanner Stage […]

A

3

42
Q

defect in androgen receptor resulting in female appearing genetic male

A

androgen insensitivity syndrome

43
Q

female external genitalia with scant axillary or pubic hair
rudimentary vagina
uterus/fallopian tubes absent

A

androgen insensitivity syndrome

(patients develop normally functioning testis)

44
Q

female phenotype
absent uterus
presence of breast development

A

androgen insensitivity syndrome in genotypic male

(T can be aromatized to estrogen allowing for breast development)

45
Q

female presenting with:
primary amenorrhea
reduced/absent body hair
absent breast development
developmental delay

A

Kallmann syndrome

(vs Turners: normal intelligence and have some body hair/breast development)

46
Q

what factors contribute to the “juvenille hiatus” [4]

A

elevated sensitivity of the hypothalamus to estrogen

high levels of inhibitory GABA in hypothalamus

low levels of kisspeptin secreted

secretion of estrogen from the ovary in females

RDS Test 2 (21 decks)

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