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History taking > Common paeds histories - precocious puberty > Flashcards

Common paeds histories - precocious puberty Flashcards

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1
Q

What is the order of pubertal development for boys?

A
  1. Testicular enlargement
  2. Pubic hair
  3. Penis enlargement
  4. Height spurt
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2
Q

What is the order of pubertal development in girls?

A
  • Breast development
  • Pubic/axillary hair
  • Height spurt
  • Menarche
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3
Q

What would you want to ask about precocious puberty?

A
  • Order of development
  • Previous growth/development
  • Height/weight
  • Nutrition
  • Behavioural changes
  • Parents - pubertal ages/height/maternal menaeche
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4
Q

What general symptoms would you want to ask about in a child with precocious puberty?

A
  • Fever
  • Behaviour
  • Activity/apathy/alertness
  • General health
  • Symptoms of other disease - thyroid, CF, Anorexia, Crohns
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5
Q

What neurological synptoms would you want to ask about in a child presenting with precocious puberty?

A
  • Fits/LOC
  • Headache
  • Dizziness
  • Vision/hearing
  • WEakness/wasting
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6
Q

What features of precocious puberty would suggest familial/idiopathic precocious puberty as a cause?

A

Most girls - check family age

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7
Q

What features associated with precocious puberty would suggest CNS abnormalities as a cause?

A

Relevant history of cause - e.g. hydrocephalus, hypoxic brain injury

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8
Q

What features associated with precocious puberty would suggest intracranial tumour as a cause?

A

Focal neurological features

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9
Q

What are gonadotrophin dependent (central) causes of precocious puberty?

A
  • Familial/idiopathic
  • CNS abnormalities
  • Itnracranial tumour
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10
Q

What features associated with precocious puberty would suggest adrenal tumour/hyperplasia as a cause?

A
  • Excessive pubic hair
  • Penis/clitoris enlargement
  • WEight gain
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11
Q

What age is precocious puberty in boys?

A

<9 years

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12
Q

What age is precocious puberty in girls?

A

< 8 years

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13
Q

What are gonadotrophin depenedent causes of precocious puberty?

A
  • Familial/idiopathic
  • CNS abnormalities - Hydrocephalus, Hypoxic brain injury
  • Intracranial tumours
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14
Q

What are gonadotrophin independent causes of precocious puberty?

A

Sex hormones not under pituitary control

  • Adrenal tumour/hyperplasia
  • Ovarian/testicular tumour
  • External sex hormones
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