Precocious puberty

Question 1

Definition

Answer 1

Development of secondary sexual characteristics before 8 years in females and 9 in males

More common in females. Usually idiopathic or familial and follows normal sequence of puberty.

Males - uncommon and usually has an organic cause

Question 2

Terms

Answer 2

Thelarche - the first stage of breast development

Adrenarche - the first stage of pubic hair development

Question 3

May be classified into:

Answer 3

1. Gonadotrophin dependent (‘central’, ‘true’) - due to premature activation of the hypothalamic pituitary gonodal axis, FSH and LH raised
2. Gonadotrophin independent (‘pseudo’, ‘false’) - due to excess sex hormones, FSH and LH low

Question 4

Testes

Answer 4

Bilateral enlargement = gonadotrophin release from intracranial lesion

Unilateral enlargement = gonadal tumour

Small testes = adrenal cause (tumour or adrenal hyperplasia)

Question 5

Organic causes

Answer 5

Rare
Associated with rapid onset, neuro symptoms and signs and dissonance
e.g. McCune Albright syndrome