Endocrine

Question 1

Onset of secondary sex characteristics in females <8yrs and males < 9yrs is called:

Answer 1

precocious puberty

Question 2

Precocious puberty is more common in males. True or false?

Answer 2

False.
F>M
5:1
Females = more likely benign, males = more likely pathological

Question 3

Central Precocious puberty is more common in girls. True of false?

Answer 3

True.
Central is less likely to be pathological.
Most likely Idiopathic (constitutional, functional).

Question 4

What are 4 causes of Secondary Central Precocious Puberty?

Answer 4

1. Hypothalmic Hamartoma (secretes GnRH, 2-4yr F’s)
2. Tumours (TS, astrocytoma, ependymomas, Optic gliomas, pineal tumours, germinomas (M>F))
3. Hydrocephalus
4. Irradiation of the brain

Question 5

What are the differences in central + peripheral Precocious puberty?

Answer 5

Central:

1. Gonadotropin dependent
2. Raised FSH/LH
3. Synchronous (follows normal puberty progression)

Peripheral:
1. Gonadotropin independent ( stimulated by oestrogen + testosterone).
2. FSH/LH low in GnRH stimulation test (HT not fully matured)
3. Not synchronous (iso-sexual development = develop sex characteristics phenotypically appropriate to of the opposite sex).
May get a mixed picture in treated CAH, McCune Albright, Familial male PP.

Question 6

What are signs of hypothalamic lesion?

Answer 6

1. Hyperthermia
2. Diabetes Insipidus
3. Cachexia or obesity
4. Galastic Seizures