Late Childhood Development & Puberty - Test 2 Flashcards
Connection between the ________ _______ and _____ _______ does not fully mature until mid 20s
Connection between the prefrontal cortex and limbic system does not fully mature until mid 20s
Because the connection between the prefrontal cortex and limbic system does not fully mature until mid 20s, what does this mean for teens?
Teenagers will act based on their emotions rather than their logic
What are some characteristics of an early adolescent (10-14)?
Begin puberty during this time
Starting to separate from parents/family
Increased emphasis on same-sex peers
May start to have crushes and may engage in sexual activity
What are some characteristics of a middle adolescent (14-17)?
Puberty endsduring this time
Increased independence and conflict with parents/family
More intense romantic relationships
Can imagine consequences of actions, but don’t fully understand. Therefore, they may engage in risky behaviors (sex, drugs, etc)
What are some characteristics of a late adolescent (17+)?
Identity is becoming stronger and youth may turn back to family values
Is depression higher in girl or boy adolescents? What about suicide?
girls have a higher rate of depression
boys have a higher rate of suicide
What is HEADSS?
Tool used in the clinic to generally assess an adolescent
Home
Education
Activity (exercise/eating)
Drugs
Sex
Suicide
What two substances are commonly used by adolescents?
Alcohol and marijuana
Do eating disorders often display their onset during adolescence?
they sure do
What is the CRAFFT tool?
Substance abuse screening tool
- Ridden in a Car with someone (including self) who was under the influence
- Do you use to Relax?
- Do you use Alone?
- Do you Forget things when you use?
- Do your Friends tell you to cut back?
- Have you gotten in Trouble while using?
What is the PHQ-9 used for?
screening tool for depression
What is the GAD-7 used for?
screening tool for anxiety
Describe the hypothalamic-GH-IGF-1 axis
How is GH measured in serume?
Indirectly through IGF-1 levels
What are the three categories of abnormal growth?
normal variants
primary growth abnormalities
secondary growth disorders
Describe two causes of normal variant of abnormal growth
familial short stature
constitutional delay of growth (aka late bloomer)
What is an example of primary growth abnormality?
Turner syndrome
Down syndrome
Achondroplasia
Intrauterine growth restriction
What are some secondary growth disorders?
Malnutrition
Malabsorption
Chronic disease
Endocrine disorders
Does GnRH secretion occur shortly after the baby is born?
yes, but then is becomes dormant until puberty
If you’re fat, what happens to your timing of puberty? What about if you’re malnourished?
fat = early
malnourished = delayed
What is the sequence of somatic changes during pubertal development in girls?
Breast budding and progression (thelarche)
Pubarche
Peak growth velocity
Menarche
Full secondary sexual maturation
What is the sequence of somatic changes during pubertal development in boys?
Increase in testicular volume
Enlargement of the penis
Pubarche
Peak growth velocity
Sperm becomes detectable in urine and nocturnal emissions
is male puberty predominantly driven by DHT or testosterone?
testosterone
What is precocious puberty?
premature initiation of puberty
What are the types of precocious puberty?
central
peripheral
incomplete
describe central precocious puberty
Children with central precocious puberty experience normal progression and development, just at an earlier age than normal. This is due to the early GnRH secretion
Majority of cases in girls are idiopathic (80-90%), whereas in boys a clear etiology often emerges with diagnostic tests
how do you treat central precocious puberty?
GnRH agonists
describe peripheral precocious puberty
early onset of puberty due to secretion of sex hormones independent of GnRH stimulation.
How do you treat peripheral precocious puberty?
treat the underlying condition (CAH, adrenal tumors, ovaria tumor, primary hyperthyroidism, etc)
What are some causes of delayed puberty?
Constitutional delay of growth and puberty (CDGP)
Hypogonadotropic hypogonadism
Hypergonadotropic hypogonadism
What is hypogonadotropic hypogonadism?
low gonadotropins (especially FSH). This is due to an issue in the CNS (e.g. Kallman syndrome, pituitary disease)
What is hypergonadotropic hypogonadism? What are sme examples?
High gonadotropin levels (especially FSH)
Turner syndrome, Klinefelter syndrome
What is the difference between primary and secndary amenorrhea?
Primary Amenorrhea: Absence of menses by 16— or 14 if no 2° sex characteristics (breasts)
Secondary Amenorrhea: Absence of menses for > than 3 cycles or 6 months, in women who previously had menses
How do you treat hypergonadotropic hypogonadism in boys?
intramuscular testosterone
How do you treat hypergonadotropic hypogonadism in girls?
Phase 1
Induction of breast development via low dose estrogen
Phase 2
Establishment of normal menses and bone mineralization by gradually increasing estrogen dose and then adding progesterone
Phase 3
Long-term maintenance (can be done through a contraceptive pill or patch
What is gender dysphoria?
Gender dysphoria is when an individual feels conflict between his or her biological or physical sex and the gender with which the person identifies
What drug can help prevent puberty in individuals with gender dysphoria?
GnRH agonists
