Paeds development

Question 1

What is Precocious Puberty?

Answer 1

When the secondary sexual characters appears early, < 8 in girls and < 9 in boys

Question 2

What are the 2 types ?

Answer 2

Central ( GDependentPP)
Peripheral (GIndependentPP)

Question 3

What is included in Central(GDPP)?

Answer 3

Idiopathic
Tumors
Brain damage such as Hydrocephalus
Post infections (Meningitis)
Traumatic Head injury

Question 4

What is included in Peripheral (GIPP)?

Answer 4

Gonadal Tumours
Adrenal or liver tumors
Congenital Adrenal Hyperplasia

Question 5

What are the symptoms ?

Answer 5

Early development of
secondary sexual
characteristics (such as

breast development in girls,

enlargement of the testicles

or penis in boys, and pubic

or underarm hair in both)

Also

Menstruation in girls
Acne
Adult body odour
Emotional and behavioural changes

Question 6

What are the investigation ?

Answer 6

Tanner staging system

Refer to pediatric

2 height measure must be done in 6 months apart

If they occur >75th centile then it is abnormal

Question 7

How to measure the bone age?

Answer 7

X-ray of the hand and wrist to assess the pace of growth

Question 8

What does blood investigation include?

Answer 8

FSH
LH
GNRH
Early morning Gnrh level is measured

If LH is raised, indicate the Central issue

MRI of the brain

Question 9

What is the management of Precocious Puberty ?

Answer 9

If Central, GnRH analogs to suppress puberty development is the mainstay of treatment

Question 10

If CNS tumor is the cause

Answer 10

Resect tumors

if possible, otherwise potentially chemotherapy/
radiotherapy?

Question 11

What if it is Peripheral cause

Answer 11

dependent on the underlying cause
If underlying pathology is controlled, development is typically halted and in some cases, it can regress