Puberty and Adolescence Flashcards
Average age for a girl to enter puberty
11 years (boys 6 months later on average)
NOTE: girls growth spurt at start of puberty, Boys tend to be more at the end (first signs we don’t see and that is increase in testicular volume (4 -> 12ml), they don’t tend to get the effects until 2-3 years later)
What are “gonadotrophins”?
FSH and LH - released from the hypothalamus
NOTE: Leptin increases release of gonadotrophins and leptin is released from fat, overweight children are more likely to get precocious puberty
What is precocious puberty?
True central precocious pubrety (TCPP) is normal puberty development ocuring abnormally early: <8 for girls, <9 for boys (Girls»Boys)
When is Puberty delayed?
Absence of secondary sexual development in a girl aged 13 or a boy aged 14 years. Boys»girls
What is the average height difference between males and females?
12.5-14cm
Thelarche
breast budding
Adrenarche
body hair and odour
Menarche
Start of periods (usually 2yrs post thelarche, range 1-5)
If there’s a growth problem, what investigations would you wan to carry out?
- Bloods: gonadotrophins. growth factors (IGF-1 not GH), testosterone/oestradiol, thyroid (undiagnosed hypothyroidism causes growth problems), karyotype (e.g. for undiagnosed turners syndrome), other pathology e.g. coeliac screen
- Bone age (X-ray of non-dominant wrist)
- Dynamic function tests: putting body under stress and record GH stimulation in response (tayside uses clonodine which induces hypotension and measures GH response rather than oral insulin tolerance test as it induces hypoglycaemia which isn’t as safe)
- MRI brain, USS uterus - if investigations above suggest needs more investigation/to confirm a diagnosis
Classifications of short stature
- Genetic short stature - short parents
- Constitutional growth delay - recognised diagnosis, children eventually catch up
- Dysmorphic syndromes e.g. down syndrome, turner syndrome (got their own growth charts)
- Endocrine disorders - problems with pituitary or adrenal
- Chronic diseases - coeliacs
- Psychosocial deprevation - multifactorial e.g. poor nutrition, not loved
WHO description of Adolescence
10-19 years
- Puberty & growth
- Lots of brain/CNS development at this time
- Abstract thinking develops at this time: thinking about the future and positive/negative consequences to things happening now and then acting on it (growing out of concrete thinking as in “oh I do this, this will happen NOW” and not about the long term effects aka not fully deeping it, ya feel me?)
WHO description of Youth
15-24 years
WHO description of Young people
10-24 years
How to assess developmental stage in adolescence?
STEP
- Sexual maturation and growth
- Thinking abstract or concrete?
- Education/employment
- Peers/partners (still reileing on parents?)
Define competence
A competent person should be able to:
- Understand simple terms and the nature, purpose and necessity for proposed treatment
- Understand the benefits, risks and effects of, as well as the alternatives to, non-treatment (like abstract thinking not concrete)
- Understand that the information applies to them
- Retain the information for long enough to make an informed choice
