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203: Reproductive system, fetal development, pregnancy and birth > Puberty > Flashcards

Puberty Flashcards

1
Q

Growth spurt

  • Age
  • Growth velocity
  • Duration
A

8-14yrs girls
9-14 yrs boy

6-10cm/year

2.5 yrs duration

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2
Q

Thelarche

A

Start of breast development

8-13 yrs (11 average)

First sign of puberty (after growth spurt)

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3
Q

Pubarche

A

Start of pubic hair development

9-13 yrs in girls
- First sign of puberty in 25%

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4
Q

Adrenarche

A

Axillary/puberty hair formation
- ACTH stimulates zona reticularis

In girls
- 9.5-15 yrs

Causes of early adrenarche

  • Ethnicity (Afro, middle east)
  • XS androgen (i.e simple virilising CAH)
  • Precocious puberty
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5
Q

Menarche

A

Start of menstruation
- Final phase of puberty in girl

10-16
- 13 average

Good percentage of fat required
- 16-24%

Good weight required
- 47.8Kg

Delayed menarche

  • Athletes
  • Menarche
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6
Q

Testicular volume

A

First sign of puberty in boys
- over 4ml= puberty

10-12mls
- Growth spurt

> 20 ml= adult testicles

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7
Q

Voice deepening

A

Last stage of puberty in boys

- Occurs 12-17 yrs

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8
Q

Timeline of female puberty

A

Average length is 2-3 years

  1. Growth spurt
  2. Thelarche
  3. Pubic hair
  4. Axillary hair
  5. Menarche
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9
Q

Mini puberty

A

GnRH nocturnal pulsation

  • 6-9 yrs
  • Occurs every 90-120mins

GnRH increases FSH and LH

Positive/negative feedback developed finally.

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10
Q

Endocrinology behind pubic and axillary hair development

A

ACTH increase stimulates adrenal glands

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11
Q

Urinary steroid profile

A

Steroid profiles in urine monitored.

Analyses adrenarche

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12
Q

Testes development

A

Sperm production
- FSH–> sertoli

Increased testosterone
- Leydig/ Adrenals

Testo—> DHT—> target tissue

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13
Q

Progression of puberty in boys

A

Total length
3-5 years

  1. Testicular volume
  2. Penile length
  3. Pubic hair
  4. Growth spurt
  5. Axillary/ pubertal hair
  6. Deep voice
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14
Q

Central/true precocious puberty

A

Gonadotrophin dependant early activation of gondal axis
- Puberty <8 in girls, <9 in boys.

Girls

  • Mainly idiopathic
  • Hypothalamic hamartoma

Boys
- Mainly hypothalamic tumour (hamartoma)

Other causes

  • Brain trauma
  • Cerebral palsy
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15
Q

Delayed puberty

A

Onset of puberty >14

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16
Q

Peripheral/ pseudo-precocious pubery

A

Early activation of the gonads/ adrenals that activate the axis
- Gonadotrophin independent

Examples

  • CAH
  • McCune-Albright
  • Ovarian/ testicular/Adrenal tumour
17
Q

CAH treatment

A

Hydrocortisone
- Compensates for lack of cortisol

LHRH analog
- Blocks LH/ FSH receptors

18
Q

Hypothalamic hamartoma

A

Benign tumour that grows

Possible Effects

  • Seizures
  • Behavioural changes
19
Q

Delayed puberty treatment

A

Testosterone for boys
- Given over a long period

Oestrogen for girls then progesterone

20
Q

Kallmann syndrome

A

Genetic condition
- Hypogonadotrophic hypogonadism

Characterised by

  • Delayed puberty
  • Reduced sense of smell
  • Can be infertile with increased risk of osteoporosis
21
Q

Isosexual, feminising/ masculinising cause of pseudo-precocious puberty in females and males

A

Females:

  • McCune Albright syndrome
  • Ovarian tumour
  • Adrenal tumour

Males:

  • CAH
  • Adrenal tumour
  • Leydig tumour
22
Q

Heterosexual, feminising/ masculinising cause of pseudo-precocious puberty in males and females

A

Females

  • CAH
  • Ovarian tumour
  • Adrenal tumour

Males
- Adrenal tumours

23
Q

Turner syndrome

  • Incidence
  • Triad of signs
A

1 in 2000 live female births

Signs

  • Short stature
  • Streak gonads (gonadal dysgenesis)
  • Primary amenorrhoea
24
Q

Turner syndrome

  • Dysmorphic features
  • Organ abnormalities
A

Dysmorphic features

  • Webbing of neck
  • Cubitus valgus

Organs

  • Coarctation of aorta
  • Horse shoe kidneys

Lymphedema.

25
Q

Turner syndrome treatment

A

GH therapy

Induction of puberty
- HRT

Monitoring, looking out for co-moribities

Assisted conception

203: Reproductive system, fetal development, pregnancy and birth (23 decks)

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