Late Childhood Development & Puberty - Test 2

Question 1

Connection between the ________ _______ and _____ _______ does not fully mature until mid 20s

Answer 1

Connection between the prefrontal cortex and limbic system does not fully mature until mid 20s

Question 2

Because the connection between the prefrontal cortex and limbic system does not fully mature until mid 20s, what does this mean for teens?

Answer 2

Teenagers will act based on their emotions rather than their logic

Question 3

What are some characteristics of an early adolescent (10-14)?

Answer 3

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

Question 4

What are some characteristics of a middle adolescent (14-17)?

Answer 4

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)

Question 5

What are some characteristics of a late adolescent (17+)?

Answer 5

Identity is becoming stronger and youth may turn back to family values

Question 6

Is depression higher in girl or boy adolescents? What about suicide?

Answer 6

girls have a higher rate of depression

boys have a higher rate of suicide

Question 7

What is HEADSS?

Answer 7

Tool used in the clinic to generally assess an adolescent

Home

Education

Activity (exercise/eating)

Drugs

Sex

Suicide

Question 8

What two substances are commonly used by adolescents?

Answer 8

Alcohol and marijuana

Question 9

Do eating disorders often display their onset during adolescence?

Answer 9

they sure do

Question 10

What is the CRAFFT tool?

Answer 10

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?

Question 11

What is the PHQ-9 used for?

Answer 11

screening tool for depression

Question 12

What is the GAD-7 used for?

Answer 12

screening tool for anxiety

Question 13

Describe the hypothalamic-GH-IGF-1 axis

Answer 13

Question 14

How is GH measured in serume?

Answer 14

Indirectly through IGF-1 levels

Question 15

What are the three categories of abnormal growth?

Answer 15

normal variants

primary growth abnormalities

secondary growth disorders

Question 16

Describe two causes of normal variant of abnormal growth

Answer 16

familial short stature

constitutional delay of growth (aka late bloomer)

Question 17

What is an example of primary growth abnormality?

Answer 17

Turner syndrome

Down syndrome

Achondroplasia

Intrauterine growth restriction

Question 18

What are some secondary growth disorders?

Answer 18

Malnutrition

Malabsorption

Chronic disease

Endocrine disorders

Question 19

Does GnRH secretion occur shortly after the baby is born?

Answer 19

yes, but then is becomes dormant until puberty

Question 20

If you’re fat, what happens to your timing of puberty? What about if you’re malnourished?

Answer 20

fat = early

malnourished = delayed

Question 21

What is the sequence of somatic changes during pubertal development in girls?

Answer 21

Breast budding and progression (thelarche)

Pubarche

Peak growth velocity

Menarche

Full secondary sexual maturation

Question 22

What is the sequence of somatic changes during pubertal development in boys?

Answer 22

Increase in testicular volume

Enlargement of the penis

Pubarche

Peak growth velocity

Sperm becomes detectable in urine and nocturnal emissions

Question 23

is male puberty predominantly driven by DHT or testosterone?

Answer 23

testosterone

Question 24

What is precocious puberty?

Answer 24

premature initiation of puberty

Question 25

What are the types of precocious puberty?

Answer 25

central

peripheral

incomplete

Question 26

describe central precocious puberty

Answer 26

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

Question 27

how do you treat central precocious puberty?

Answer 27

GnRH agonists

Question 28

describe peripheral precocious puberty

Answer 28

early onset of puberty due to secretion of sex hormones independent of GnRH stimulation.

Question 29

How do you treat peripheral precocious puberty?

Answer 29

treat the underlying condition (CAH, adrenal tumors, ovaria tumor, primary hyperthyroidism, etc)

Question 30

What are some causes of delayed puberty?

Answer 30

Constitutional delay of growth and puberty (CDGP)

Hypogonadotropic hypogonadism

Hypergonadotropic hypogonadism

Question 31

What is hypogonadotropic hypogonadism?

Answer 31

low gonadotropins (especially FSH). This is due to an issue in the CNS (e.g. Kallman syndrome, pituitary disease)

Question 32

What is hypergonadotropic hypogonadism? What are sme examples?

Answer 32

High gonadotropin levels (especially FSH)

Turner syndrome, Klinefelter syndrome

Question 33

What is the difference between primary and secndary amenorrhea?

Answer 33

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

Question 34

How do you treat hypergonadotropic hypogonadism in boys?

Answer 34

intramuscular testosterone

Question 35

How do you treat hypergonadotropic hypogonadism in girls?

Answer 35

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

Question 36

What is gender dysphoria?

Answer 36

Gender dysphoria is when an individual feels conflict between his or her biological or physical sex and the gender with which the person identifies

Question 37

What drug can help prevent puberty in individuals with gender dysphoria?

Answer 37

GnRH agonists