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Endo/Repro: Week 4 > Hellkatz: Physiology of Puberty > Flashcards

Hellkatz: Physiology of Puberty Flashcards

1
Q

Puberty

A

the final stage of maturation of the HPGA culminating in the adult phenotype> development of gonadal function and attainment of full sexual maturity and fertility

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2
Q

6-8 week period when the HPGA is biologically active and sex steroids are comparable w/ levels in early-mid puberty but there are NO peripheral effects

A

Mini-puberty in infancy

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3
Q

What causes the long period of pre-puberty state?

A

HPG suppression

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4
Q

When do children enter puberty?

A

when HPG suppression is released

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5
Q

What activates steroid production in the gonads during puberty?

A

Increase in pulsatile GnRH and FSH/LH>
leads to an increase in circulating estrogen (F) and testosterone (M)

**specifically diurnal changes in LH stimulate steroidgenesis in the gonads> leading to maturation of HPG axis > establishes NFB mechanism

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6
Q

How do height and weight affect onset of puberty?

A

Increased BMI/height> earlier onset

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7
Q

When does menarche occur during puberty?

A

near the end
height in middle
breasts/pubic hair early

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8
Q

pubic hair growth in response to development of adrenal zona reticularis> production of androstenedione and DHEA

A

Adrenarche

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9
Q

beast development d/t estrogens

A

thelarche

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10
Q

production of ovarian hormones and mature gamates

A

gonadarche

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11
Q

uterine response to ovarian hormones

A

menarche

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12
Q

When does growth velocity peak in F?

A

age 14

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13
Q

When is the peak velocity of growth in Males?

A

13-14

Completion 15.5 (later than girls)

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14
Q

precocious puberty

A

puberty in children 5-8

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15
Q

Why are children who have experienced precocious puberty shorter than average?

A

estrogen has a biphasic effect on epiphyseal growth

LOW levels of E2 favor growth spurt but HIGH fuse the epiphyses

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16
Q

2 types of precocious puberty

A

GDPP

GIPP

17
Q

An idiopathic/CNS related cause leads to early activity of pulsatile acitivty of the HPG axis > Puberty EARLIER than expected and all signs are matched

A

GDPP

18
Q

How do you dx GDPP?

A

GnRH stimulation test

If GnRH leads to increased LH > than it’s GDPP

If levels DONT increase than its GIPP

19
Q

LH levels of .3 or more is indicative of…

A

PUBERTY

pre-puberty is less than .1

20
Q

How do you treat GDPP?

A

medical castration:

  1. GnRH agonists/antagonists
  2. anti-estrogens/androgens
  3. GLUCOCORTICOIDS in a pt w/ adrenal hyperplasia
21
Q

What causes GIPP?

A

ovarian cysts, leydig cell tumors, exogneous estrogen, pituitary tumors…. a lot of stuff

22
Q

What is the pathogenesis of GIPP?

A

cause> one/TWO signs of puberty with no others (signs of stages are dissimilar)

23
Q

Adrenarche can be a sign of…

A

tumor of hte adrenal gland

CAH (21-hydroxylase def)> DHEA and 17oh progesterone are increased

24
Q

a display of bone age older than chronological age along with adrenarche in boys and thelarche in girls may be indicative of…

A
  1. tumors tha tsecrete hCG> bind LH> stimulate gonadal sex steroid synthesis
  2. Gonadal tumors> increase sex steroids but not gonadotropins
  3. exposure to sex steroid hromones
25
Q

When is the bipotential stage of fetal development?

A

6 weeks

26
Q

directs medulla of bipotential gonad to develop testis

A

SRY protein

27
Q

Hormone from testis that causes mullerian ducts to DEGENERATE

A

anti-mullerian hormones

28
Q

Converts wolffian duct to seminal vesicle, vas deferens and epidiymis

A

Testosterone

29
Q

Gonadal cortex becomes ovary in the absence of this protein

A

SRY protein

30
Q

Absence of this hormone caues wolffian duct to degenerate

A

testosterone

31
Q

absence of this hormone allows mullerian duct to become fallopian tube, uterus and upper part of vagina

A

anti-mullerian

32
Q

What organs are DHT sensitive?

A

penis and prostate

w/out DHT you can get a micropenis

33
Q

causes of sexual ambiguity

A

hypogonadism, muatations in hormone production/receptors/signaling., sex chromosome loss, and mosaic individuals

Endo/Repro: Week 4 (14 decks)

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