L5: Puberty Flashcards
(112 cards)
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.
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
3
Q
Def of Gonadarche
A
Activation of the gonads by the pituitary hormones FSH & LH
4
Q
Def of Pubarche
A
5
Q
Def of Thelarce
A
6
Q
Def of Menarche
A
7
Q
Def of Spermarche
A
8
Q
Detection of Adrenarche
A
becomes biochemically apparent at about 6 years of age in both girls & boys.
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.
10
Q
When Does Gonadarche start?
A
11
Q
Puberty in Males
- Age
A
11-12 years of age
12
Q
Puberty in Males
- Events
A
13
Q
Puberty in Males
- Completion at the age of …..
A
16-17 years
14
Q
Puberty in Females
- Age
A
10-11 years
15
Q
Puberty in Females
- Events
A
16
Q
Puberty in Females
- Completed by age …..
A
15 - 16 years
17
Q
Tanner Staging of puberty by gondal Development
A
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).
18
Q
Tanner Staging of puberty by gondal Development
- Stage I
A
19
Q
Tanner Staging of puberty by gondal Development
Stage II
A
20
Q
Tanner Staging of puberty by gondal Development
- Stage III
A
21
Q
Tanner Staging of puberty by gondal Development
- IV
A
22
Q
Tanner Staging of puberty by gondal Development
- V
A
23
Q
Tanner Staging of puberty by Breast Development
A
24
Tanner Staging of puberty by Breast Development
- I
25
Tanner Staging of puberty by Breast Development
- II
26
Tanner Staging of puberty by Breast Development
- III
27
Tanner Staging of puberty by Breast Development
- IV
28
Tanner Staging of puberty by Breast Development
- V
29
Tanner Staging of puberty by pubic Hair Development
- Stage I
30
Tanner Staging of puberty by pubic Hair Development
- Stage II
31
Tanner Staging of puberty by pubic Hair Development
- III
32
Tanner Staging of puberty by pubic Hair Development
- IV
33
Tanner Staging of puberty by pubic Hair Development
- V
34
Triggering factors of puberty
35
Factors affecting the timing of puberty
36
Assessment of pubertal development
37
Assessment of Testicular Volume
Testicular volume is measured using **Prader orchidometer**
- A series of 3D ellipsoids with volume from 1 - 25 ml or more.
38
Assessment of Penile Length
- 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)
39
Male hypothalamic maturation occurs ...... female.
1- 2 years after
40
Night time levels of testesterone are ..... than daytime.
higher
41
- 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.
...
42
Girls complete puberty by ages 15 - 16 while boys by ages 16 - 17.
..
43
Sequence of Puberty
- In Boys
44
Sequence of Puberty
- In Girls
45
Def of **Delayed Puberty**
46
Classification of **Delayed Puberty**
47
Causes of **Temporary delays of puberty**
48
Causes of **Temporary delays of puberty**
- Constitutional delay
49
Causes of **Temporary delays of puberty**
- Chronic Illness
50
Causes of **Temporary delays of puberty**
- Nutritional Disorders
51
Causes of **Temporary delays of puberty**
- Endocrinopathies
52
Causes of **Hypogonadotropic hypogonadism (2ry hypogonadism)**
53
Causes of **Hypogonadotropic hypogonadism (2ry hypogonadism)**
- Pathophysiology
- hypothalamic-pituitary
- Low FSH and LH = low serum testosterone or estrogen
54
Causes of **Hypogonadotropic hypogonadism (2ry hypogonadism)**
- Congenital
55
Causes of **Hypogonadotropic hypogonadism (2ry hypogonadism)**
- Acquired
56
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)**
57
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)**
- Pathophysiology
- gonads
- low serum testosterone or estrogen = High FSH and LH + lack of pubertal development
58
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)** in Males
59
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)** in Males
- Congenital
60
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)** in Males
- Acquired
61
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)** in Females
62
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)** in Females
- Congenital
63
Causes of **Hypergonadotropic hypogonadism (1ry hypogonadism)** in Females
- Acquired
64
Characters of **Constitulional delay of puberty**
65
Characters of **Idiopathic hypogonadotropic hypogonadism**
66
Characters of **Kallman syndrome**
Gonadotropin deficiency accompanied
anosmia
67
Compare between Klienfelter Syndrome & Turner Syndrome in terms of:
- Incidence
- Karyotype
- Caused by
- CP
68
Dx of **Delayed Puberty**
- Hx
- Labs
- Rads
69
Dx of **Delayed Puberty**
- Medical History
++ family history of delayed onset of puberty, tanner staging.
70
Dx of **Delayed Puberty**
- Labs
71
Dx of **Delayed Puberty**
- Rads
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
TTT of **Delayed Puberty**
- Constitutional growth delay
- Other pathologies
73
TTT of **Delayed Puberty**
- Constitutional Delay
74
TTT of **Delayed Puberty**
- Other pathologies
- TTT Underlying Cause
- Hormonal Therapy
75
TTT of **Delayed Puberty**
- Hormonal therapy
- TST
- estradiol
- GnRH & Gonadotropins
76
TTT of **Delayed Puberty**
- testosterone
77
TTT of **Delayed Puberty**
- estradiol
78
TTT of **Delayed Puberty**
- GnRH & Gonadotropin
79
Def of **Precocious Puberty**
It is the onset of puberty is < 8 years in girls and < 9 years in boys.
80
Factors affecting **Precocious Puberty**
81
Types of **Precocious Puberty**
82
Types of **Benign or non-progressive pubertal variants**
* Premature thelarche
* Premature adrenarche
- Premature menarche
83
Def of **Premature thelarche**
Isolated breast development, either unilateral or bilateral.
84
Characters of **Premature thelarche**
85
Dx of **Premature thelarche**
Serum (LH) and estradiol concentrations are typically in the prepubertal range
86
Age of **Premature thelarche**
Occurs in two peaks:
- 1st 2 years of life
- 6-8 years
87
Def of **Premature adrenarche**
- 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
Etiology of **Premature adrenarche**
- Increased Production of adrenal androgens at an earlier than normal age
- Hypersensitivity of pilosebaceous to androgen
89
INVx for **Premature adrenarche**
90
BA & Height in **Premature adrenarche**
There is slight advance in Height and Bone age.
91
atypical premature adrenarche
92
Def of **Premature menarche (vaginal bleeding)**
The presence of isolated, self-limited vaginal bleeding in the absence of other secondary sexual characteristics prior to the age of 8 years.
93
Etiology of **Premature menarche (vaginal bleeding)**
94
Dx of **Premature menarche (vaginal bleeding)**
By Exclusion
95
DDx of **Premature menarche (vaginal bleeding)**
Consider a foreign body, local masses, and McCune-Albright syndrome
96
Labs in **Premature Adrenarche**
97
Labs in **CAH**
98
Labs in **Adrenal Tumor**
99
Labs in **Ovarian Tumor**
100
approach to the diagnostic evaluation for isolated premature pubarche
101
Mechanism of **Central (True) Precocious Puberty (Gonadotropin-dependent)**
From activation of the HPG axis at an earlier-than normal age.
102
Characters of **Central (True) Precocious Puberty (Gonadotropin-dependent)**
103
Etiology of **Central (True) Precocious Puberty (Gonadotropin-dependent)**
104
**Central (True) Precocious Puberty (Gonadotropin-dependent)**
- INVx
105
**Central (True) Precocious Puberty (Gonadotropin-dependent)**
- TTT
GnRH agonist (To prevent premature closure of epiphyseal plate)
106
Def of **Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)**
It refers to gonadal or adrenal sex steroid secretion or from exogenous sources not resulting from activation of HPG axis
107
Characters of **Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)**
Isosexual or contrasexual.
108
Etiology of **Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)**
109
INVx for **Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)**
LH & FSH levels are suppressed.
- Not increase substantially with (GRH) stimulation.
110
TTT of **Peripheral (pseudo) Precocious Puberty (Gonadotropin independent)**
111
Evaluation of **Precocious Puberty**
