I: Puberty

Question 1

FSH/LH levels: Prepubertal: ___>___

Answer 1

FSH; LH

Question 2

FSH/LH levels: Pubertal: ___>___

Answer 2

LH; FSH

Question 3

______: caused by gonadal dysgenesis, galactosemia, radiation, chemotherapy, or autoimmune causes

Answer 3

Primary Ovarian Failure

Question 4

______: hyalinization and fibrosis of seminiferous tubules, microphallus, small testes, learning disabilities, infertility, gynecomastia

Answer 4

Klinefelter Syndrome

Question 5

______: idiopathic hypogonadotropic hypogonadism and anosmia/hyposmia

Answer 5

Kallman syndrome

Question 6

______: primary ovarian failure with dysmorphic facies, hx of otitis, CV defects, thyroiditis

Answer 6

Turner Syndrome

Question 7

_____: activating mutation in GPCR of LH receptor

Answer 7

McCune Albright Syndrome

Question 8

_____: early development of pubic/axillary hair, body odor, acne

Answer 8

Early adrenarche

Question 9

_____: Most common cause of hypogonadotropic hypogonadism

Answer 9

Constitutional Growth Delay

Question 10

_____: mutation in LH receptor, causing it to be constitutively activated

Answer 10

Familial Testotoxocosis

Question 11

_____: precocious puberty, café au lait spots, polyostotic fibrous dysplasia

Answer 11

McCune Albright Syndrome

Question 12

_____: premature breast development without growth acceleration, bone age advancement, or other pubertal changes

Answer 12

Early thelarche

Question 13

_____: testes enlarged but not to the extent expected by virilization

Answer 13

Familial Testotoxocosis

Question 14

Increase in LH in a GnRH stimulation test suggests ______ precocious puberty

Answer 14

Central

Question 15

Name 3 signs of adrenarche.

Answer 15

Hair growth, body odor, acne

Question 16

Name the early and mean age of girls beginning puberty (Tanner 2 breast development).

Answer 16

8, 10.4 (Caucasian); 6.6, 9.5 (Black)

Question 17

Name the early and mean age of menarche.

Answer 17

10.6, 12.5 (Caucasian); 9.7, 12 (Black)

Question 18

Name the mean ages at which boys attain 3ml testes, acquire pubic hair, show penile enlargement, and reach peak growth velocity

Answer 18

11.8, 12, 13, 14

Question 19

Name two genetic causes of hypogonadotropic hypogonadism.

Answer 19

Septo-optic dysplasia, Prader-Willi Syndrome

Question 20

Treatment for Constitutional Growth Delay

Answer 20

Consider short course of testosterone or estrogen treatment

Question 21

Treatment for primary gonadal failure

Answer 21

Testosterone or estrogen followed by estrogen/progesterone cyclic therapy

Question 22

Treatment of central precocious puberty

Answer 22

GnRH analogue

Question 23

Treatment of Familial Testotoxicosis

Answer 23

Aromatase Inhibitor + Androgen blocker

Question 24

Treatment of McCune Albright Syndrome

Answer 24

Aromatase Inhibitor

Question 25

Which age defines delayed puberty?

Answer 25

Girls: 13, Boys: 14