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Year 2 > Puberty > Flashcards

Puberty Flashcards

1
Q

Define puberty

A

Describe the physiological, morphological and behavioural changes as the gonads switch from infantiles to adult forms

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2
Q

What is the first sign of girls going through puberty

A

Menarche (first menstrual bleeding)

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3
Q

What is the first sign of puberty in boys

A

First ejaculation, often nocturnal

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4
Q

What hormone regulates the growth of female and breast genitalia

A

Ovarian oestrogen

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5
Q

What hormones control public and axillary hair

A

Ovarian and adrenal androgens

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6
Q

What hormones control the development of external genitalis and pubic hair growth + enlargement of larynx and laryngeal muscles (voice deepening)

A

Tetsicular androgens

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7
Q

Describe the tanner stages of development for males

A

Stage 1:
No pubic hair
Testicular length: <2.5 cm
Testicular volume: <3.0 mL

Stage 2:
Sparse growth of curly pubic hair at base of penis
Testes > 3mL
Scrotum thinning and reddening

Stage 3:
Thicker, curlier hair spreads to mons pubis
Growth of penis in width and length: further growth of testes

Stage 4:
Adult-type hair, not spread to medial surfaces of the thigh
Penis further enlarged; testes larger, darker scrotal skin colour

Stage 5:
Adult-type hair spread to medial surface of thighs
Genital adult size and shape

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8
Q

Describe the tanner stages of development for females

A

Stage 1:
Prepubertal: No pubic hair
Elevation of papilla only
Stage 2: Sparse growth of long, straight minimally pigmented, mainly on labia
Breast bud palpable: enlargement of areola
Stage 3: Darker, coarser hair spreading over mons pubis
Further enlargement of breast and areola with no separation of contours

Stage 4:
Thick adult-type hair, not yet spread to medial surface of thighs
Projection of areola and papilla to form secondary mound above level of breast

Stage 5: Hair adult-type and distributed in classic inverse triangle
Adult contour breast with projection of papilla only

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9
Q

How long does breast development take

A

3 years

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10
Q

3 effects of oestrogen on the breast

A
  1. Ductal proliferation
  2. Site specific adipose deposition
  3. Enlargement of the areola and nipple
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11
Q

What three other hormones than oestrogen are involved in breast development

A
  1. Prolactin
  2. Glucocorticoids
  3. Insulin
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12
Q

How does the corpus:cervix ration change from prepubertal to pubertal

A

From 1:2 to 2:1

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13
Q

How does the shape of the uterus change from prepubertal to pubertal

A

Tubular shape to pear shape

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14
Q

Length change of the uterus

A

From 2-3 cm to 5-8cm

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15
Q

How does the volume of the uterus change

A

0.4-1.6 ml to 3-15ml

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16
Q

How does the endometrium change in the uterus

A

From single layer of cuboidal cells it increases in thickness

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17
Q

What three things does a doctor look out for in a pelvic ultrasound to ensure pubic development is occurring

A
  1. Are the Mullein structures present
  2. Morphology of the uterus
  3. Morphology of the ovaries
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18
Q

What is the vagina lined by prepubertally

A

Thin columnar epithelium

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19
Q

What is the vagina lined by post puberty

A

Thickening of the epithelium - stratified squamous epithelium formation

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20
Q

How does the pH in the vagina change

A

pH neutral to 3.8

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21
Q

What happens to the length of the vagina

A

3.5cm to 8cm

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22
Q

How does oestrogen effect the maturation of external genitalia

A
  1. Labia majora and minor increase in size and thickness
  2. Rogation and change in colour of major
  3. Hymen Thickens
  4. Clitoris enlarged
  5. Vestibular glands begin secretion
23
Q

What is precocious puberty

A

Onset of secondary sexual characteristics before 8 (girls) and 9(boys)

24
Q

What is delayed puberty

A

Absence of secondary sexual characteristics by 14 (girls) and 16 (boys)

25
Q

Complications of delayed puberty

A

Reduced peak bone mass and osteoporosis

26
Q

Where is inhibit produced

A

Females - pituitary gland, corpus luteum

Males - Sertoli cells

27
Q

Role of inhibin

A

Surpresses FSH

28
Q

What inhibits inhibin

A

GnRH (enhanced by insulin-like growth factor-1)

29
Q

How is FSH and LH secretion regulated

A

Circadian rhythms (pulse like)

30
Q

When during the day is LH produced during early stages of puberty

A

Sleep

31
Q

When is LH produced in late puberty

A

During the day

32
Q

What is the hypothalamic maturation hypothesis

A
  1. Puberty only requires increased hypothalamic GnRH
  2. Emphasises direct link in CNA and pituitary/hypothalamic GnRH neutrons
  3. Supporting evidence from rhesus macaque
33
Q

Role of Kisspeptin

A

Stimulates primary puberty by releasing GnRH at the hypothalamus

34
Q

What happens to the level of glutamate and kisspeptin at the start of puberty

A

Increased

35
Q

What levels decrease at the start of puberty

A

Secretions of GABA and opioidergic neutrons (decreases inhibitory tones)

36
Q

What is Adrenarche

A

Maturational process of adrenal gland

37
Q

What happens during adrenarche

A

Developmental process where a specialised subset of cells arises forming the androgen-producing zona reticularis

38
Q

What happens to the levels of hormones produced in adrenal glands during adrenarche

A

Increased DHEA, DHEA-S

39
Q

Signs of adrenarche

A

Body odour
Oily Skin
Mild Acne
Axillary hair

40
Q

What is Pubarche

A

Result of androgen action (andrenarche) on the pilosebaceous unit transforming vellus hair into terminal hair in hair-growth prone parts of the skin

41
Q

Name the g-couples receptor that kisspeptin binds o

A

GPR54

42
Q

How common is precocious puberty

A

1 in 5,000

43
Q

What sex is precocious puberty most common in

A

90% of females

44
Q

What should we rule out before suspecting precocious puberty

A

Ruling out brain tumour

45
Q

What is precocious pseudo puberty

A

Secondary sexual development induced by sex steroids from abnormal sources (adrenal glands)

46
Q

How do we differentiate between Precocious puberty and precocious pseudo puberty

A

LH:FSH ratio > 1 - precocious puberty

LH:FSH < 1 - precocious pseudo puberty

47
Q

How is precocious puberty treated

A

GnRH super-agonist to suppress pulsatility of GnRH secretion

48
Q

What are the causes of precocious puberty (GnRH dependant)

A
  1. Idiopathic precocious puberty
  2. CNS tumours
  3. CNS disorders
  4. Secondary central precocious puberty
  5. Psychosocial
49
Q

What are the causes of precocious pseudo-puberty

A
  1. Increased androgen secretion
  2. Gonadotropin secreting tumours
  3. McCune-Albright Syndrome
  4. Ovarian cyst
  5. Oestrogen secreting neoplasm
  6. Iatrogenic or exogenous sex hormones
50
Q

What 3 causes are there of delayed puberty

A
  1. Delayed activation of the hypothalamic pulse generator
  2. Hypogonadotrophic hypogonadism
  3. Hypergonadotrophic hypogonadism
51
Q

How does delay in puberty effect repodocution and bone mass

A

Reproduction defects

Reduced peak bone mass

52
Q

What are indications for delayed puberty in girls

A
  1. Lack of breast development by 13
  2. More than 5 years between breast development and Menarche
  3. Lackof pubic hair by 14
  4. Absent menarche by 15-16
53
Q

What are indications for delayed puberty in boys

A
  1. Lack of testicular enlargement by 14
  2. Lack of pubic hair by 15
  3. More than 5 years to complete genital enlargement

Year 2 (155 decks)

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