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Pediatri > Pubertet - Amboss > Flashcards

Pubertet - Amboss Flashcards

1
Q

Hva er definisjonen på pubertet?

A
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2
Q

Hvilke faser forekommer puberteten inn i?

A
This phase precedes the rest of the pubertal changes in both sexes. Adrenarche is independent of the hypothalamic-pituitary-gonadal axis and may manifest in the form of early appearance of axillary and pubic hair.
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3
Q

Hvilke fysiologiske endringer forekommer ved puberteten?

A
The cause of the GnRH rise is unknown. However, leptin is suspected to play a role, as puberty does not begin in adolescents who are deficient in leptin.

https://www.ncbi.nlm.nih.gov/books/NBK534827/

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4
Q

Hvilke faktorer påvirker pubertstart?

A
Puberty is often delayed in children with low body fat percentages (e.g., children who are athletes involved in extensive competitive training, those who have an eating disorder, and those who are malnourished).
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5
Q

Når start puberteten hos jenter, og i hvilken rekkefølge kommer fasene i?

A

The first visible sign of puberty in females it is breast development.

Menarche age varies by race and ethnicity. In African-American females, for example, it tends to occur earlier.
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6
Q

Når starter puberteten hos gutter, og i hvilken rekkefølge kommer den i?

A
↑ Testicular volume (≥ 4 mL) and length (≥ 2.5 cm). Other areas that respond to androgens: axillary, periareolar, upper lip, preauricular, and beard regions.
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7
Q

Hva er Tanner stadier?

A
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8
Q

Hvilke Tanner-stadier deler man brystutviklingen inn i?

Hos jenter

A
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9
Q

Hvilke Tanner-stadier deler man gutters genitalia inn i?

A
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10
Q

Hvilke Tanner-stadier deler man kjønnshårvekst inn i?

Gutter og jenter

A
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11
Q

Tegn en figur for Tanner-stadier

A
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12
Q

Hva skjer med brystene til gutter under puberteten?

A
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13
Q

Hvilken vekstspurt forekommer i puberteten?

A
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14
Q

Hvilken beinvekst forekommer under puberteten?

A
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15
Q

Hvordan blir kroppsvekten- og sammensetning påvirket av puberteten?

A
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16
Q

Hvilke dermatologiske forandringer forekommer ved puberteten?

A
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17
Q

Hvilke øyeforandringer forekommer under puberteten? Hvilken tilstand rammer jenter hyppig?

A
Associated with poor intake of iron and menstruation.
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18
Q

Ved 10-14 årsalder, hvilke endringer forekommer ved hhv.:
- Fysisk utvikling
- Kognitiv utvikling
- Psykososial utvikling
- Seksual- og relasjonsutvikling

A
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19
Q

Ved 15-16 årsalder, hvilke endringer forekommer ved hhv.:
- Fysisk utvikling
- Kognitiv utvikling
- Psykososial utvikling
- Seksual- og relasjonsutvikling

A
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20
Q

Ved ≥ 17 år, hvilke endringer forekommer ved hhv.:
- Fysisk utvikling
- Kognitiv utvikling
- Psykososial utvikling
- Seksual- og relasjonsutvikling

A
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21
Q

Hvilke utfordringer og råd bør man gi til barn/ungdom og foreldre som opplever puberteten?

A
Adolescence comes with an increased desire for independence, exploration of self and relationships with others, and experimentation with lifestyle choices. Adolescents are more likely to engage in unprotected sex because of limited knowledge about safer sexual practices and impulsiveness.
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22
Q

Hvilken definisjon tidlig pubertet?

Pubertas preacox

A
Specifically, breast development before the age of 8 in girls and testicular enlargement before the age of 9 in boys (these ages are two standard deviations below the mean age of puberty onset).
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23
Q

Hvordan er de epidemiologiske tallene på pubertas preacox?

A
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24
Q

Hvordan klassifiserer man pubertas praecox?

A
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25
Q

Hva er definisjonen av sentral pubertas praecox?

A
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26
Q

Hvilken etiologi har sentral pubertas praecox?

A
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27
Q

Hva er patofysiologien til sentral pubertas praecox?

28
Q

Hvilke kliniske trekk forekommer ved sentral pubertas praecox?

29
Q

Hvilke labtester er akt. ved mistenkt sentral pubertas praecox?

A
LH levels are considered of higher diagnostic value because they indicate activation of the hypothalamic-pituitary-gonadal axis and allow the differentiation of central precocious puberty from peripheral precocious puberty. Associated with elevated basal LH levels (pubertal values), which increase 2–3 fold after GnRH administration.
30
Q

Hvilken bildediagnostikk kan være indisert ved sentral pubertas praecox?

31
Q

Fyll inn utredningen for mistenkt pubertas praecox?

32
Q

Hvordan behandler man sentral pubertas praecox?

A
Important to consider if impending short stature is suspected.
33
Q

Hva er definisjonen på perifer pubertas praecox?

34
Q

Hvilken etiologi kan perifer pubertas praecox ha?

35
Q

Hvilke kliniske trekk forekommer ved perifer pubertas praecox?

36
Q

Hvilke labtester tar man ved perifer pubertas praecox?

A
Gonadotropin release is suppressed as a result of increased testosterone/estrogen.
37
Q

Hvilken bildediagnostikk er akt. ved perifer pubertas praecox?

38
Q

Hvordan behandler man perifer pubertas praecox?

39
Q

Gi en beskrivelse av prematur adrenarke?

A
Due to this association, the classification of premature adrenarche as a benign pubertal variant is debatable.
40
Q

Hvilke kliniske kjennetegn har prematur adrenarke, og hvilke parametre kan man bruke til diagnostikk?

A

DHEA-S

A weak androgen produced by the adrenal gland that can be interconverted to dehydroepiandrosterone (DHEA) by sulfotransferases in the adrenal gland, liver, and intestines. Used as a marker for adrenal androgen secretion (e.g., due to adrenal tumors or functional adrenal hyperandrogenism from polycystic ovary syndrome).

Significantly advanced bone age is seen in some patients but is more common in central or peripheral precocious puberty.
41
Q

Gi en beskrivelse av idiopatisk prematur pubarke?

42
Q

Hvilken klinikk forekommer ved idiopatisk prematur pubarke, og hvordan kan det diagnostiseres?

43
Q

Ved benign tidlig telarke (benign precocious thelarche), gi hhv. en:
- Beskrivelse
- Kliniske tegn
- Diagnostiske verdier

A
Central precocious puberty may initially manifest with isolated breast development.
44
Q

Ved benign tidlig menarke/vaginal blødning, nevn hhv.:
- Beskrivelse
- Klinikk
- Diagnostikk

45
Q

Hva er definisjonen på fedmerelatert tidlig seksualutvikling (obesity-related precocius sexual development)?

A
However, obesity can also lead to delayed puberty as well due to hypogonadotropic hypogonadism caused by increased aromatization of androgens to estrogens, and subsequent feedback inhibition of gonadotropin secretion.
46
Q

Hvordan er patofysiologien ved fedmerelatert tidlig seksualutvikling?

A
Precocious puberty caused by increased leptin levels is complete. It is characterized by adrenarche, thelarche, and gonadarche. Insulin does not cause a rise in GnRH pulsatility. Gonadal maturity (menarche, spermarche) is not seen in precocious puberty purely due to hyperinsulinemia.
47
Q

Hva er definisjonen på McCune-Albright syndrom?

48
Q

Hvordan er epidemiologien til McCune-Albright syndrom?

49
Q

Hvilken etiologi har McCune-Albright syndrom?

A
The mutation is not present in all tissues, which results in varying manifestations of the clinical phenotype among individuals.
50
Q

Hvilken patofysiologi har McCune-Albright syndrom?

51
Q

Hvilken klinikk forekommer ved McCune-Albright syndrom?

A
The café-au-lait spots usually occur on the same side as the bony lesions. These hyperpigmented macules can also be seen in individuals with neurofibromatosis. However, in the case of neurofibromatosis, they have smooth borders (“coast of California” appearance), those associated with fibrous dysplasia have rough, serpiginous borders (“coast of Maine” appearance). Bone lesions usually occur on one side of the body.
52
Q

Hva viser bildet?

A
Café-au-lait spot; There is a flat, hyperpigmented, irregularly shaped macule visible on the patient's forearm. These macules are also known as “café-au-lait spots.” Unilateral café-au-lait spots in patients with precocious onset of puberty suggest McCune-Albright syndrome.
53
Q

Hva viser bildet?

A
McCune-Albright syndrome; Photograph of the torso of a 5-year-old girl: Multiple large, hyperpigmented lesions (café-au-lait spots) can be seen on the face, the left hemithorax, and the left arm. The borders of the lesions are jagged (coast-of-Maine appearance) and barely cross the midline. Café-au-lait spots are characteristic findings in McCune-Albright syndrome.
54
Q

Hvilke labtester bruker man ved mistenkt McCune-Albright syndrom?

55
Q

Hvilke typer bildemodalitet kan man bruke ved McCune-Albright syndrom?

56
Q

Hva viser bildet?

A
Fibrous dysplasia in McCune Albright syndrome; X-ray calcaneus (lateral view): A mixed density lesion (green overlay) with ground glass and sclerotic components is present in the body of the calcaneus extending to the articular surface of the subtalar joint. The calcaneus is a rare location for fibrous dysplasia. The appearance suggests fibrous dysplasia in a patient with McCune-Albright syndrome.
57
Q

Hvordan behandler man McCune-Albright syndrom?

58
Q

Hvilke diff.diagnoser har man til McCune-Albright syndrom?

59
Q

Hvordan er prognosen til pas. med McCune-Albright syndrom?

60
Q

Hva er definisjonen på pubertas tarda?

A
Specifically, this refers to no testicular enlargement by age 14 in boys and the absence of breast development or pubic hair by age 13 in girls.
61
Q

Hvilken etiologi kan pubertas tarda ha?

A
Because of a delay in the onset of the pubertal growth spurt, the growth curve of the child stays two standard deviations behind other children of the same age and sex, but stays consistent. Poor nutritional status can also arise from chronic diseases and delay puberty by causing impaired GnRH release.
62
Q

Hvilke kliniske trekk forekommer ved pubertas tarda?

A
Anosmia (absent sense of smell) is strongly associated with Kallman syndrome.
63
Q

Hvilke anamnestiske opplysninger må man ha med ved diagnostisering av pubertas tarda?

A

Positive family history of delayed onset of puberty, tanner staging, BMI).

64
Q

Hvilke rutineprøver tar man ved pubertas tarda?

A
Differentiating constitutional growth delay from isolated GnRH deficiency is often complicated and needs time and serial monitoring.
65
Q

Hvilke tilleggstester, basert på etiologien til forsinket pubertet kan man ta?

66
Q

Hvordan behandler man konstitusjonell vekstforsinkelse?

67
Q

Ved mistanke om patologisk årsak til forsinket pubertet, hvordan kan man behandle dette?

Pediatri (34 decks)

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