Pedia Gynecology, Precocious Puberty Flashcards
Most common position for gynecologic exam
Frog leg
Position for gynecologic exam of older children
Also used for children with foreign body or discharge
Knee chest
Most common shape of hymen
Crescent
Most common gynecologic problem in prepubertal females
Vulvovaginitis
Most common cause of vulvovaginitis
Poor perineal hygiene
Pathognomonic sign of labial adhesion
Midline vertical line
Treatment for labial adhesion
Topical estrogen cream
Most common symptom of urethral prolapse
Prepubertal bleeding
Treatment for urethral prolapse
Topical estrogen cream
Thinning of vulvar epithelium with loss of rete pegs common in prepubertal and postmenopausal women
Lichen sclerosus
Treatment for lichen sclerosus
Avoid trauma or irritants
Topical steroids
Sitz bath
Majority of foreign body cases are within the ages of
3 and 9 years old
Classic symptom of foreign body in the vagina
Foul smelling bloody discharge
Treatment for vulvar lacerations
Bed rest for 24 hours
Ice pack
Analgesics
Treatment for vulvar hematoma if less than 4cm non expanding
Bed rest
Compress
Analgesic
Treatment for vulvar hematoma if more than 4cm and expanding
Evacuate clot
High index of suspicion for sexual abuse if the child presents with
Posterior fourchette injury
Hymenal laceration
Transections from 3 and 9 o clock position
Most common type of ovarian cysts
Functional cysts
Surgical intervention done if the patient has torsion of the ovarian cyst to preserve fertility
Cystectomy
Most common benign ovarian tumor
Teratoma
Most common malignant germ cell tumor of the ovary
Dysgerminoma
Goal of treatment in precocious puberty
Induce pseudomenopause
LH levels of ____ is diagnostic of precocious puberty
LH >5 mIU/ml
Most common cause of precocious puberty
Idiopathic
Most common ovarian tumor that can cause precocious puberty
Granulosa cell tumor
This syndrome causes precocious puberty due to mutation in G3 protein activating adenylate cyclase that leads to constant secretion of FSH, LH, TSH and GH
McCune Albright syndrome
First symptom of McCune Albright syndrome
Vaginal bleeding
Triad of McCune Albright
3 Ps- pigment, polyostotic, pockets
Cafe au lait spots
Polyostotic fibrous dysplasia
Cysts of skull and long bones
This test differentiates incomplete from true precocious puberty
GnRH agonist stimulation test
Indications for medical treatment of precocious puberty is when menarche happens before _____ or bone age is more than _____ of chronological age
Menarche <8 years old
Bone age >2 years of chronological age
GnRH dependent drug of choice in precocious puberty
Leuprolide
Excessive terminal hair growth is dependent on what hormones
Androgens
In females, testosterone is secreted by what organ?
Ovaries
In females, adrenal gland secretes this hormone
DHEAS
This disease occurs when you have bilaterally enlarged ovaries (5-7cm) with gradual onset
Theca cells produce testosterone and virilization happens around 4th decade of life
Stromal hyperthecosis
Drug of choice for hirsutism
Spironolactone
