Pubertal Delay And Gonadal Dysgenesis

Question 0

Four stages of pubertal development?

Answer 0

Thelarche, pubarche/adrenarche, growth spurt, menarche

boobs, pubes, growth, squirt

Question 1

Delayed puberty (vs primary amenorrhea)? Most common cause?

Answer 1

No sexual secondary characteristics by age 14 (versus no menarche by age 16)

Gonadal dysgenesis – most commonly from Chromosome abnormality

Question 2

Hypergonadotropic hypogonadism – Hormone levels? Most common cause? Other causes?

Answer 2

High FSH, low estrogen

Turner syndrome

Radiation, chemotherapy, inflammation, torsion

Question 3

Patient Turner syndrome have what in place of ovaries?

Answer 3

Gonadal streak – fibrous band of tissues

Question 4

When to remove gonads in patient with gonadal dysgenesis to avoid neoplastic changes?

Answer 4

Gonadal dysgenesis with 46, XY

Question 5

Hypogonadotropic hypogonadism – hormone levels? Main cause? Other causes?

Answer 5

Low FSH, low estrogen

Hypothalamic defect (Eating disorders, chronic illness, extreme exercise)

Hypothyroidism, Cushing’s, pituitary adenoma’s, craniopharyngiomas

Question 6

Hypogonadotrophic hypogonadism – most commonly associated neoplasm?

Answer 6

Craniopharyngiomas

Question 7

Management goals for patients with delayed puberty? Tx?

Answer 7

1. Initiate sexual maturation
2. Prevent osteoporosis (from hypoestrogenism Lumia)
3. Promote full height potential

OCP

Question 8

LH/FSH ratio with gonadal dysgenesis?

Answer 8

Greater than one