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Human Development > Puberty > Flashcards

Puberty Flashcards

1
Q

Gonadarche

A

Activation of the gonads by FSH-LH

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2
Q

Adrenarche

A

Increase in production of androgens by the adrenal cortex

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3
Q

Thelarche

A

Appearnce of breast tissue -> oestradiol

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4
Q

Menarche

A

First menstrual bleed - estradiol on endometrial lining - non ovulatory

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5
Q

Spermarche

A

First sperm produciton - nocturnal sperm emissions

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6
Q

Pubarche

A

Appearnce of pubic hair -> androgens from adrenal gland

First appearance of axillary hair, apocrine body odor and acne

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7
Q

What is acne caused by

A

Androgenic stimulation

Higher serum levles of DHEAS

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8
Q

What is precocious puberty in boys

A

Before 9 years - testicular volume goes from 3 to 4

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9
Q

What is precocious puberty in girls

A

Before 8 years - breast budding

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10
Q

Define true central precocious puberty

A

Gonadotropin dependent
Early maturation of the HPG axis
Sequential maturation
Sexual characteristics appropriate for the child’s gender

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11
Q

Define peripheral precocity

A

Gonadotropin independent
Excess of secretion of sex hormones - gonads, adrenal glands, exogenous sources of sex steroids, ectopic production of gonadotropin from a germ cell tumor
Non-sequential maturation
Isosexual or contrasexual

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12
Q

Define benign pubertal variants

A

Premature thelarche and adrenarche
Isolated androgen-mediated sexual characteristics
Isolated breast development/not beyond tanner stage 3
LH and FSH between normal range
Mild elevation in serum DHEAS

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13
Q

What are the signs of TCPP

A

Accelearted linear growth
Advanced bone age
Pubertal levels of LH and FSH

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14
Q

What are the causes of TCPP

A

Mostly idiopathic in boy
CNS lesions
Genetics - gain of KISS1 and KISS1R, lss of function in MKRNS (Prader-Willi syndrome)
McCune Albright

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15
Q

What are the causes of peripheral precocity in girls

A

Ovarian cysts (breast development, vaginal bleeding - ovarian torsian)
Granulosa cell tumours - isosexual precocity
Sertoli/leydig cell tumours -> contrasexual precocity (virilisation)

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16
Q

What are the causes of peripheral precocity in boys

A

Leydig cells tumours - asymmetric testicular enlargement
Germ cell tumours (secrete hCG) - hCG activates LH receptors on Leydig cells -> testosterone production
Familial (testotoxicosis) ->

17
Q

What does primary hypothyroidism cause

A

Early breast development, galactorrhoea, recurrent vaginal bleedingStimulation of the FSH receptor by high serum TSH levels - share common alpha subunit

18
Q

McCune Albright syndrome

A

Triad of peripheral precocious puberty, irregular cafe au lait spots, fibrous dysplasia of bone
Sequence of puberty progression may be abnormal, often presenting with bleeding

19
Q

What is the treatment for gonadotropin dependent precocious puberty

A

Block with GnRH analogues

20
Q

What is the treatment of gonadotropin independent precocious puberty

A

Anti-androgens/aromatase inhibitors

21
Q

What is delayed puberty in girls

A

13 years and no breast development. More than 5 years between thelarche and menarche. No pubic hair by 14, no menarche by 16 without secondary sexual characteristics

22
Q

What is delayed puberty in boys

A

testicular volume less than 4ml by 14
no pubic hair by 15
more than 5 years to finish penile and testicular growth

23
Q

What are the causes of hypogonadotropic hypogonadism

A

Kallman (very tall as grwoth plates not fused, no sense of smell)
Prader Willi
Cushing, hyperprolactinaemia, hypothyroidms
CNS tumours

24
Q

What are the causes of hypergonadotropic hypogonadism

A

Turner syndrome

Klinefelter syndrome

25
Q

What is the treatment for delayed puberty

A 
Anabolic steroids (Oxandralone): 
Boys <14 who are pre pubertal -> increased growth velocity
26
Q

How to correct gestational age

A

For babies born under 37 weeks, their measurements should be corrected until at least 1 yar old

27
Q

BMI centiles

A

Over 91 suggests overweight
Over 98 cinically obese
Under 2 may reflect undernutrition

28
Q

What is the definition of short stature

A

<2.5SD below mean (<0.4th centile)
Child who falls outside mid-parental height range
Growth of less than 4cm during mid childhood
Dropping more than two centile lines on a grwoth chart over 12 months
Monitor child over period of 6 months

29
Q

What is treatment with growth hormone licensed for

A 
Growth hormone deficiency
Turner's syndrome
Prader wili syndrome
SGA + poor catch up
Chronic renal failure
SHOX deficiency

Human Development (9 decks)

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