Puberty

Question 1

What causes precocious pseudopuberty?

Answer 1

Sex hormones produced not by GnRH from tumours in gonads, brain, liver etc

Question 2

How would you distinguish between pseudo and real puberty?

Answer 2

Lh:FSH ratio-
>1 is true
<1 is pseudo

Question 3

How do you manage precocious pseudo-puberty?

Answer 3

GnRH analogues

Question 4

What causes pseudo-puberty?

Answer 4

Increased androgen secretion:
CAH, Neoplasm, Familial male precocious puberty
GNRH secreting tumours
McCune Albright syndrome
Ovarian cyst
Hypothyroidism
Iatrogenic exogenous sex hormones

Question 5

What causes ‘true’ GnRH precocious puberty?

Answer 5

Idiopathic

CNS disorders: hydrocephalus, vascular lesion, encephalitis

Question 6

What causes delayed puberty?

Answer 6

Idiopathic
Hypogonadotrophic hypogonadism (GnRH deficiency)
Hypergonadotrophic hypogonadism (Gonodal problems)

Question 7

What are causes of hypogonadotrophic hypogonadmism?

Answer 7

CNS disorders: tumours, langerhans, post infectious, head trauma, congenital malformations
Isolated: KALLMAN’S syndrome (hyposmia), LHRH receptor mutation, CAH, Isolated FSH or LH deficiency

Question 8

What are causes of hypergonadotrophic hypogonadism?

Answer 8

Males: KLINEFELTER (47XXY), chemo/radio/trauma, Noonan’s
Females: TURNERS (45XO), PCOS, Noonan’, chemo/radio/trauma