Common paeds histories - precocious puberty Flashcards
What is the order of pubertal development for boys?
- Testicular enlargement
- Pubic hair
- Penis enlargement
- Height spurt
What is the order of pubertal development in girls?
- Breast development
- Pubic/axillary hair
- Height spurt
- Menarche
What would you want to ask about precocious puberty?
- Order of development
- Previous growth/development
- Height/weight
- Nutrition
- Behavioural changes
- Parents - pubertal ages/height/maternal menaeche
What general symptoms would you want to ask about in a child with precocious puberty?
- Fever
- Behaviour
- Activity/apathy/alertness
- General health
- Symptoms of other disease - thyroid, CF, Anorexia, Crohns
What neurological synptoms would you want to ask about in a child presenting with precocious puberty?
- Fits/LOC
- Headache
- Dizziness
- Vision/hearing
- WEakness/wasting
What features of precocious puberty would suggest familial/idiopathic precocious puberty as a cause?
Most girls - check family age
What features associated with precocious puberty would suggest CNS abnormalities as a cause?
Relevant history of cause - e.g. hydrocephalus, hypoxic brain injury
What features associated with precocious puberty would suggest intracranial tumour as a cause?
Focal neurological features
What are gonadotrophin dependent (central) causes of precocious puberty?
- Familial/idiopathic
- CNS abnormalities
- Itnracranial tumour
What features associated with precocious puberty would suggest adrenal tumour/hyperplasia as a cause?
- Excessive pubic hair
- Penis/clitoris enlargement
- WEight gain
What age is precocious puberty in boys?
<9 years
What age is precocious puberty in girls?
< 8 years
What are gonadotrophin depenedent causes of precocious puberty?
- Familial/idiopathic
- CNS abnormalities - Hydrocephalus, Hypoxic brain injury
- Intracranial tumours
What are gonadotrophin independent causes of precocious puberty?
Sex hormones not under pituitary control
- Adrenal tumour/hyperplasia
- Ovarian/testicular tumour
- External sex hormones