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Y4R1 - Pediatrics I 👶 > L5: Puberty > Flashcards

L5: Puberty Flashcards

1
Q

Def of Puberty

A
  • Period during which individuals become capable of sexual reproduction.
  • The series of biological changes that lead to reproductive capabilities.
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2
Q

Def of Adrenarche

A
  • Activation of the adrenal cortex for the production of adrenal androgens.
  • Becomes biochemically apparent at age of 6 years in both girls and boys
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3
Q

Def of Gonadarche

A

Activation of the gonads by the pituitary hormones FSH & LH

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4
Q

Def of Pubarche

A
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5
Q

Def of Thelarce

A
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6
Q

Def of Menarche

A
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7
Q

Def of Spermarche

A
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8
Q

Detection of Adrenarche

A

becomes biochemically apparent at about 6 years of age in both girls & boys.

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9
Q

Relation of Adrenarche to HPG Axis

A
  • It seems to be unrelated to the pubertal maturation of the HPG axis.
  • It generally precedes activation of the HPG axis, or gonadarche by 2-3 years.
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10
Q

When Does Gonadarche start?

A
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11
Q

Puberty in Males

  • Age
A

11-12 years of age

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12
Q

Puberty in Males

  • Events
A
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13
Q

Puberty in Males

  • Completion at the age of …..
A

16-17 years

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14
Q

Puberty in Females

  • Age
A

10-11 years

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15
Q

Puberty in Females

  • Events
A
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16
Q

Puberty in Females

  • Completed by age …..
A

15 - 16 years

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17
Q

Tanner Staging of puberty by gondal Development

A
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17
Q

Tanner Staging of puberty

A

Tanner stage is assigned independently to genitalia, pubic hair, and breast (e.g., a person can have Tanner stage 2 genitalia, Tanner stage 3 pubic hair).

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18
Q

Tanner Staging of puberty by gondal Development

  • Stage I
A
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19
Q

Tanner Staging of puberty by gondal Development

Stage II

A
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20
Q

Tanner Staging of puberty by gondal Development

  • Stage III
A
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21
Q

Tanner Staging of puberty by gondal Development

  • IV
A
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22
Q

Tanner Staging of puberty by gondal Development

  • V
A
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23
Q

Tanner Staging of puberty by Breast Development

A
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24
Q

Tanner Staging of puberty by Breast Development

  • I
A
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25
Q

Tanner Staging of puberty by Breast Development

  • II
A
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26
Q

Tanner Staging of puberty by Breast Development

  • III
A
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27
Q

Tanner Staging of puberty by Breast Development

  • IV
A
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28
Q

Tanner Staging of puberty by Breast Development

  • V
A
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29
Q

Tanner Staging of puberty by pubic Hair Development

  • Stage I
A
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30
Q

Tanner Staging of puberty by pubic Hair Development

  • Stage II
A
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31
Q

Tanner Staging of puberty by pubic Hair Development

  • III
A
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32
Q

Tanner Staging of puberty by pubic Hair Development

  • IV
A
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33
Q

Tanner Staging of puberty by pubic Hair Development

  • V
A
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34
Q

Triggering factors of puberty

A
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35
Q

Factors affecting the timing of puberty

A
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36
Q

Assessment of pubertal development

A
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37
Q

Assessment of Testicular Volume

A

Testicular volume is measured using Prader orchidometer

  • A series of 3D ellipsoids with volume from 1 - 25 ml or more.
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38
Q

Assessment of Penile Length

A
  • Penile length is measured from pubic ramus till the tip of glans.
  • Mean stretched penile stretch length at 1 year = 3.75 cm (+- 0.54 cm)
  • late childhood = increase to 4.84 CM
  • late puberty = increase to 9.5 cm (+- 1.12 cm)
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39
Q

Male hypothalamic maturation occurs …… female.

A

1- 2 years after

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40
Q

Night time levels of testesterone are ….. than daytime.

A

higher

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41
Q
  • Estradiol mediates the growth spurt, bone maturation and epiphyseal closure in boys just as in girls.
  • Estradiol also induces at least modest development of breast tissue (gynecomastia) in a large portion of boys.
A

…

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42
Q

Girls complete puberty by ages 15 - 16 while boys by ages 16 - 17.

A

..

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43
Q

Sequence of Puberty

  • In Boys
A
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44
Q

Sequence of Puberty

  • In Girls
A
45
Q

Def of Delayed Puberty

A
46
Q

Classification of Delayed Puberty

A
47
Q

Causes of Temporary delays of puberty

A
48
Q

Causes of Temporary delays of puberty

  • Constitutional delay
A
49
Q

Causes of Temporary delays of puberty

  • Chronic Illness
A
50
Q

Causes of Temporary delays of puberty

  • Nutritional Disorders
A
51
Q

Causes of Temporary delays of puberty

  • Endocrinopathies
A
52
Q

Causes of Hypogonadotropic hypogonadism (2ry hypogonadism)

A
53
Q

Causes of Hypogonadotropic hypogonadism (2ry hypogonadism)

  • Pathophysiology
A
  • hypothalamic-pituitary
  • Low FSH and LH = low serum testosterone or estrogen
54
Q

Causes of Hypogonadotropic hypogonadism (2ry hypogonadism)

  • Congenital
A
55
Q

Causes of Hypogonadotropic hypogonadism (2ry hypogonadism)

  • Acquired
A
56
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism)

A
57
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism)

  • Pathophysiology
A
  • gonads
  • low serum testosterone or estrogen = High FSH and LH + lack of pubertal development
58
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism) in Males

A
59
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism) in Males

  • Congenital
A
60
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism) in Males

  • Acquired
A
61
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism) in Females

A
62
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism) in Females

  • Congenital
A
63
Q

Causes of Hypergonadotropic hypogonadism (1ry hypogonadism) in Females

  • Acquired
A
64
Q

Characters of Constitulional delay of puberty

A
65
Q

Characters of Idiopathic hypogonadotropic hypogonadism

A
66
Q

Characters of Kallman syndrome

A

Gonadotropin deficiency accompanied
anosmia

67
Q

Compare between Klienfelter Syndrome & Turner Syndrome in terms of:

  • Incidence
  • Karyotype
  • Caused by
  • CP
A
68
Q

Dx of Delayed Puberty

A
  • Hx
  • Labs
  • Rads
69
Q

Dx of Delayed Puberty

  • Medical History
A

++ family history of delayed onset of puberty, tanner staging.

70
Q

Dx of Delayed Puberty

  • Labs
A
71
Q

Dx of Delayed Puberty

  • Rads
A

X-ray of the non-dominant hand and wrist (bone age).
- A skeletal age of 10 in girls & 12.5 in boys correlates with onset of pubertal development.

72
Q

TTT of Delayed Puberty

A
  • Constitutional growth delay
  • Other pathologies
73
Q

TTT of Delayed Puberty

  • Constitutional Delay
A
74
Q

TTT of Delayed Puberty

  • Other pathologies
A
  • TTT Underlying Cause
  • Hormonal Therapy
75
Q

TTT of Delayed Puberty

  • Hormonal therapy
A
  • TST
  • estradiol
  • GnRH & Gonadotropins
76
Q

TTT of Delayed Puberty

  • testosterone
A
77
Q

TTT of Delayed Puberty

  • estradiol
A
78
Q

TTT of Delayed Puberty

  • GnRH & Gonadotropin
A
79
Q

Def of Precocious Puberty

A

It is the onset of puberty is < 8 years in girls and < 9 years in boys.

80
Q

Factors affecting Precocious Puberty

A
81
Q

Types of Precocious Puberty

A
82
Q

Types of Benign or non-progressive pubertal variants

A
  • Premature thelarche
  • Premature adrenarche
  • Premature menarche
83
Q

Def of Premature thelarche

A

Isolated breast development, either unilateral or bilateral.

84
Q

Characters of Premature thelarche

A
85
Q

Dx of Premature thelarche

A

Serum (LH) and estradiol concentrations are typically in the prepubertal range

86
Q

Age of Premature thelarche

A

Occurs in two peaks:

  • 1st 2 years of life
  • 6-8 years
87
Q

Def of Premature adrenarche

A
  • The early development of pubic hair at 8 in girls and 9 in boys with or without axillary hair and odor, and/or small amount of acne.
88
Q

Etiology of Premature adrenarche

A
  • Increased Production of adrenal androgens at an earlier than normal age
  • Hypersensitivity of pilosebaceous to androgen
89
Q

INVx for Premature adrenarche

A
90
Q

BA & Height in Premature adrenarche

A

There is slight advance in Height and Bone age.

91
Q

atypical premature adrenarche

A
92
Q

Def of Premature menarche (vaginal bleeding)

A

The presence of isolated, self-limited vaginal bleeding in the absence of other secondary sexual characteristics prior to the age of 8 years.

93
Q

Etiology of Premature menarche (vaginal bleeding)

A
94
Q

Dx of Premature menarche (vaginal bleeding)

A

By Exclusion

95
Q

DDx of Premature menarche (vaginal bleeding)

A

Consider a foreign body, local masses, and McCune-Albright syndrome

96
Q

Labs in Premature Adrenarche

A
97
Q

Labs in CAH

A
98
Q

Labs in Adrenal Tumor

A
99
Q

Labs in Ovarian Tumor

A
100
Q

approach to the diagnostic evaluation for isolated premature pubarche

A
101
Q

Mechanism of Central (True) Precocious Puberty (Gonadotropin-dependent)

A

From activation of the HPG axis at an earlier-than normal age.

102
Q

Characters of Central (True) Precocious Puberty (Gonadotropin-dependent)

A
103
Q

Etiology of Central (True) Precocious Puberty (Gonadotropin-dependent)

A
104
Q

Central (True) Precocious Puberty (Gonadotropin-dependent)

  • INVx
A
105
Q

Central (True) Precocious Puberty (Gonadotropin-dependent)

  • TTT
A

GnRH agonist (To prevent premature closure of epiphyseal plate)

106
Q

Def of Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)

A

It refers to gonadal or adrenal sex steroid secretion or from exogenous sources not resulting from activation of HPG axis

107
Q

Characters of Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)

A

Isosexual or contrasexual.

108
Q

Etiology of Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)

A
109
Q

INVx for Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)

A

LH & FSH levels are suppressed.
- Not increase substantially with (GRH) stimulation.

110
Q

TTT of Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)

A
111
Q

Evaluation of Precocious Puberty

A

Y4R1 - Pediatrics I 👶 (32 decks)

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