Mehl. pubertal development + nbme 10 1Q, 2Q. Flashcards
1Q and 2Q = normal puberty, menarche
Mehl. What tanner ,,menarche is imminent.”?
Tanner stage 3
Mehl.
Menarche is imminent = tanner 3.
hat is an answer straight-up on one of the 2CK Obgyn forms, but there are also various Repro Qs where mom will bring in her daughter who’s 13/14, who’s never had a menstrual period, and they’ll say she’s either Tanner stage 2 or 3, and the answer is just “schedule follow-up in 6 months.”
.
Mehl. Turner breast tanner stage?
Tanner stage 1-2 breasts
Mehl. Turner pubic hair tanner stage?
4-5 pubic/axillary hair.
Mehl. Why tuner pubic hair tanner stage is 4-5?
The latter are due to the effects of adrenal, rather than ovarian, androgens. In other words, don’t be confused if you get a Turner syndrome Q and they say Tanner stage 4 pubic hair.
Mehl. In androgen insensitivity syndrome (46XY karyotype, but female phenotype), breast development is ???
Normal (i.e., Tanner 4-5)
Mehl. In androgen insensitivity syndrome (46XY karyotype, but female phenotype), pubic/axillary hair tanner stage?
Tanner stage 1 (i.e., scant/absent).
Mehl. Bone age refers to what?
Bone age refers to degree of maturation of a child’s bones via radiographic examination.
Mehl. USMLE wants you to know that bone age < chronologic age means the short child will catch up (i.e., the growth chart is merely right-shfited). how is called?
constitutional short stature
Mehl. For constitutional short stature, sometimes instead of mentioning bone age, they’ll mention Tanner stage.
For example, a 14-yr-old boy is shortest in his class + pubic hair is Tanner stage 2. The implication is he’s still very early in development and will probably catch up.
Mehl. Bone age = chronologic age means …?
Genuine short stature
I’ve seen this in Turner syndrome Qs, where the female is usually < 5 feet.
Mehl. What is Thelarche?
Onset of breast development
Mehl. What is adrenarche?
Adrenarche: production of adrenal androgens, leading to the development of pubic and axillary hair.
Mehl. What is Pubarche?
Pubarche: Pubic hair growth
Mehl. What is Menarche?
Menarche: Onset of menstruation.
Mehl. USMLE asks straight-up what is most likely to occur first in a pre-pubescent female?
breast bud development.
NBME 10. 1Q.
Puberty in girls typically follows a predictable course of?
thelarche -> pubarche (pubic hair) -> growth spurt -> menarche.
NBME 10. 1Q.
Mild unilateral or bilateral breast swelling can be normal in early puberty because of the ….??
increased production of estrogen and the growth of mammary tissue
There may be asymmetry in development of the breast tissue. Thus, this patient and her mother can be reassured that this is likely a normal finding of the initial stage of puberty rather than a sign of pathology.
NBME 10. 1Q.
when need to re-evaluate?
the patient should be examined again in 6 months to ensure that no concerning features have developed.
NBME 10. 2Q.
The first menstrual period is related to estradiol stimulation of the endometrial lining rather than ovulation and may be accompanied by prolonged vaginal spotting.
.
NBME 10. 2Q.
There is considerable variability between girls during the first few years after menarche. In nearly two-thirds of girls, regular ovulatory cycles do not take place for over …..
a year after menarche.
NBME 10. 2Q.
With maturation, increasingly regular menstrual periods result from ovulation and last an average of 28 days. However, intermittent anovulatory cycles may continue to cause abnormal uterine bleeding through adolescence.
The patient should be examined again in 6 months to ensure that her menstrual cycles are becoming more regular and to begin establishing a healthy physician-patient relationship with an adolescent patient.
