Normal and Abnormal Puberty Flashcards
The presence of _____ or ______ ____ development prior to age six years in girls warrants thorough evaluation
The presence of breasts or pubic hair development prior to age six years in girls warrants thorough evaluation
The presence of breasts and pubic hair development prior to eight years in girls warrants evaluation with a ______, ______and a _____ ___ as the minimum evaluation
The presence of breasts and pubic hair development prior to eight years in girls warrants evaluation with a history, physical and a bone age as the minimum evaluation
The first stage of puberty in girls is…
Initiation of the growth spurt
Absence of secondary sex characteristics in girls by age __ warrants evaluation
14
Absence of ______in young women at age 16 years in the presence of ________ characteristics warrants evaluation
Absence of menstruation in young women at age 16 years in the presence of secondary characteristics warrants evaluation
What is the last stage of puberty in females?
Menstruation
What is the primary hormone responsible for breast development?
Estrogen
What causes development of pubic/axillary hair in females?
DHT (5α reductase)
What two structures are responsible for testosterone production in the female?
Testosterone production divided between adrenal gland and ovaries
Describe the origins of the two components of the developing vagina
How do they eventually form the vagina?
Upper 2/3 is of Mullerian origin; Lower 1/3 forms from the urogenital sinus
Both must fuse and the dividing membrane must undergo apoptosis
What is precocious puberty?
The occurrence of breasts, pubic/axillary hair, and or menstruation prior to 7-8 years of age
What are the two categories of precocious puberty?
Gonadotropin Independent
Gonadotropin Dependent
What is Gonadotropin independent precocious puberty and what are some examples?
Tumor processes in the ovary or adrenal gland or abnormal enzymatic process in hormone producing organs
Examples: CAH, McCune Albright, Adrenal tumor, ovary cell tumors
What causes gonadotropin dependent precocious puberty?
Premature activation of Hypothalamic-Pituitary-Ovarian axis or adrenal axis
What is the most important reason for evaluation of precocious puberty?
Child may be saddled with extremely short height due to premature closure of epiphyseal growth plate
What endocrine evaluation is associated with the premature presence of each of the following:
- Breasts:
- Pubic/axillary hair development:
- Menstruation:
- Breasts – Estrogen, FSH
- Pubic/axillary hair development – testosterone, LH
- Menstruation – estrogen, FSH, LH
What genetic disorder can cause a lack of ovaries in a female?
Turners syndrome
When a female presents with lack of menstruation, what is the most important diagnosis to rule out first?
How do you test for this?
Pregnancy
hCG levels
Lack of ovarian steroid production may be the result of… (3)
Absence of dysgenesis
Abnormal receptors
Abnormal steroidal production
What is bone age?
Measurement of the maturation of a child’s bones
