Puberty Flashcards
What is puberty
the transition from primary characteristics (at birth) to secondary characteristics.
there is an andolscent growth spert and profound physiological and psychological changes.
What are mature gametes called? (2)
spermatazoa and oocytes
What is thelarche and what ages does it occur in?
breast development
9-13
What is adrenarche?
secretion of adrenal androgens (DHEA, DHEA-S)
What does adrenarche do?
1) growth of pubic /axillary hair
2) growth in height
What happens in adrenarche in females with Addison’s disease?
have minimal pubic hair whilse the rest of puberty progresses
What happens to females iwth Turner’s syndrome (45XO) in adrenarche
normal adrenarche /pubarche but abnormal menarche due to defective ovaries
When does menarche become regular?
As oestrogen continues to rise
What is the first sign of puberty for males?
testicular growth at 12 years (10-15 years)
if testicular volume > 4 ml it indicates onset of puberty
At what age is the maximum height spurt for males
at 14
What is the first sign of puberty in females?
breast development at around 11.5 years (9-13)
When does height spurt as females?
before menarche
there is only about 4% of height following menarche
What are 3 normal changes in puberty?
- gynaecomastia may develop in boys
- asymmetrical breasts can grown
- diffuse enlargement of the thyroid gland may be seen
What is the definition of precocious puberty?
onset of secondary sexual characterstic before age 8 in girls or 9 in boys.
it is more common in females
What is gonadotrophin dependant precocious puberty also known as? (3)
‘central’
‘true’
consonance maintained
What is gonadotrophin independant precocious puberty also known as?
‘pseudo’
‘false’
loss of consonance
What is true or central precosious puberty
caused by excess GnRH secretion
idiopathic = common in females secondary = trauma, radiotherapy, intracranial tumour or CNS damage
FSH and LH is raised
What is gonadotrophin independant precoscious puberty also known as?
loss of consonance
due to excess sex hormones
Low FSH and LH due to negative feedback
what is pseudo or false precosious puberty caused by (6)
- ovarian: tumours
- testicular: tumours activating LH mutations on leyding cells which release testosterone
- adrenal: CAH in males
- primary hypothyroidism: high levels of TSH acts on LH/FSH receptors causing a release of sex steroids
- McCine-Albright syndrome (cafe au lait spots)
- exposure to exogenous steroids
What are the 4 investigations to measure precosious puberty
- Auxology (accurate measurements of height, body proportions + weight
- pubertal staging
- bone age estimation
measuring adrneal steriods - increased in tumours + in CAH the precursors of androgens
What are hte scoring systems used for pubertal staging?
Tanner stage
Ferriman scoring system
Gallwey scoring system for hirusitism
What are the treatments invovled to dampen down the effects of sex steroids in precocisou puberty?
- anti-androgens
- 5-alpha reducatse inhibitors
- aromatase inhibitors (inhibits conversion of testosterone to oestrogen)
- long acting GnRH analogues
What is delayed puberty defined as?
lack of any pubertal signs by the age of 13 years in girls and 14 years in boys
What are the causes of delayed puberty? (2)
- consituitional delay
2. Organic Cuases
