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s4 - Repro, Develop, Ageing, Pharm > REPRO - Puberty > Flashcards

REPRO - Puberty Flashcards

1
Q

What is adrenarche instigated by?

What does it result in?

A
  • by awakening of adrenal viaz.reticuarlis cx maturation

- androgen secretion –> pubarche (hair) due to DHEA/DHEAS (dehydroepiandosterone)

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2
Q

What is Gonadarche the re-awakening of? What are the results of increased LH/FSH?

A
  • HPG axis, LH causes steroid synthesis in gonads

- FSH causes this + growth of testis/folliculogenesis

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3
Q

When is Adrenarche?

A

From about 10yrs increases, peaks mid 20s then declines “adrenopause”

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4
Q

What are DHEAS in the circulation converted to at target tissues?

A

Testosterone/DHT

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5
Q

When is pubarche said to be precocious?

A

Girls=before 8yrs

Boys=before 9yrs

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6
Q

What is pubarche associated with?

A
  • increased sebum production, acne, infection, abnormal keratinisation
  • pilosebaceous units (PSUs) deposit sebum on the hairs
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7
Q

When is the HPG axis first activated? Until when? Then GnRH neurones are ‘restrained’ until…

A
  • 16wk gestation to 1 or 2yrs postnatally

- about 10yrs old, pulsatile GnRH in gonadarche reactivates it

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8
Q

In terms of bones, the initial low levels of oestrogen as the HPG A. reawakens promotes..

A

..linear growth and causes the initial rapid growth spurt (2yrs earlier in girls)

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9
Q

As oestrogen levels are higher you get…

A

epiphyseal fusion and growth stops

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10
Q

What is consonance?

A

a smooth ordered progression of changes regardless of length

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11
Q

Name 5 male physical changes in puberty..

A
  • ext genitalia: 4ml testicular vol, scrotal growth and skin change. Vas def. lumen increases
  • seminal vesicles and prostate - mature
  • larynx: enlarges, thyroid cartilage protudes, voice deepens
  • height 10cm/yr reached 14yrs
  • Shoulders and chest broaden > hip
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12
Q

Name 5 female physical changes in puberty..

A
  • Thelarche (1st sign of E2 hence HPG reawakening)
  • Hips widen
  • Height 9cm/yr reached at 12yrs
  • Uterus enlarges, myometrium responds to E2
  • Endometrium, tubes, cervix mature
  • Menarche late in puberty
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13
Q

Fertility differences by sex:

A 
Male = immediate fertility. Testosterone stimulates meiosis and spermatogenesis in Sertoli cells
Female = later, first yr of menarche 80% cycles are anovulatory/irregular
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14
Q

3 psychological changes in puberty are:

A
  • need for independence
  • more sexual awareness
  • sexual personality develops
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15
Q

Central Precocious puberty is gonadotrophin dependent. Consonance is maintained. Causes?

A
  • excess GnRH idiopathic or secondary

- secondary may be from a pituitary tumour

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16
Q

Central Precocious Puberty signs..

A
  • accelerated linear growth
  • advanced bone age
  • increased FSH/LH/E2/testosterone
17
Q

Central Precocious Puberty poss treatments?

A
  • GnRH analougues to suppress puberty until 12
  • surgery, radio/chemotherapy
  • case by case
18
Q

What do 33% of Central Precocious Puberty cases have a..

A

-hypothalamic harmatoma (most benign) a focal malformation resembling a neoplasm

19
Q

Peripheral Precocious Puberty is gonadotrophin independent and there is a loss of consonance. Hormone levels?

A
  • less FSH/LH

- more E2/testosterone

20
Q

Name 3 causes of Peripheral Precocious Puberty aka pseudo

A
  • testotoxicosis: activating mutation of the LH receptor hence early androgen production. No FSH increase (no spermatogenesis)
  • Sex steroid secreting tumour/exogenous intake
  • CAH - adrenal androgens excess
  • Mc Cune Albright S.
21
Q

-Mc Cune Albright S. is a rare genetic condition. Is a constiutive activation of…
Symptoms..

A

Adenyl cylase, you get hyperactivity of signalling pathways

-cafe au lait skin, fibrous dysplasia of bone, hormone issues

22
Q

Pubertal Delay no secondary sexual maturation by..

A

-14 in boys, 13 in girls/no period by 18

23
Q

What is the commonest cause (90%) of pubertal delay?

A

-constitutional delay (affects growth and puberty. 10x more common in boys. Often hereditary. Can be 2rdry to disease.

24
Q

What is hypogondaotrophic hypogonadism? Causes?

A
  • low FSH/LH.

- hypopituitarism, impaired gonadotrophins, opiod use, steroid use, genetic causes

25
Q

Explain a genetic Cause of Hypogondaotrophic hypogonadism?

A

Kallman’s syndrome. X linked KAL gene–>impaired GnRH migration neurone. Anosmia also presents.

26
Q

What is hypergondaotrophic hypogonadism? Give an example of a condition with this of each sex, and name one viral cause.

A
  • Gonadal dysgenesis, low steroid levels, low negative feedback so gonadotrophins increase a lot
  • Congenital Klienfelters (XXY) 1:500 males
  • Turner’s (XO) 1:3000 females
  • Viral = Mumps

s4 - Repro, Develop, Ageing, Pharm (14 decks)

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