Small Group: Puberty Cases Flashcards

1
Q

What is the early age limit for puberty in girls?

A

Blacks and Hispanics: 6.5 years

Caucasians: 8 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

An 8-year-old female presents with Tanner 2 breast development and pubic hair. Would you consider McCune-Albright as a cause?

A

Unlikely, because McCune-Albright presents with elevated estrogen only, so pubic hair would be absent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What would the gonadotropin response to GnRH be in a girl with McCune-Albright?

A

Suppressed/prepubertal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is central precocious puberty treated?

A

GnRH agonist to suppress the progression of puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give an example of an aromatase inhibitor?

A

Letrozole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the early age limit for puberty in boys?

A

9 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the sequence of pubertal events in boys?

A
THAPD
Testicular enlargement
Hair in pubic area and axillae
Acceleration of growth
Penile enlargement 
Deepening of voice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

True or false: in a boy with a tumor that secretes hCG, the testes will be small due to suppression of the HPG axis.

A

False. The testes will be large because of the excess testosterone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What will the testicles and penis be like in CAH?

A

Small in proportion to the degree of pubic hair present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How would you treat familial testotoxicosis?

A

With an aromatase inhibitor and androgen-receptor antagonist or ketoconazole to directly inhibit the production of testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can you typically distinguish CGD from pubertal disorders?

A

CGD presents with symmetrically delayed signs of puberty, so if a child has pubic hair but no breasts (in a girl) or penile enlargement (in a boy), then it is unlikely to be CGD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is functional gonadotropin deficiency?

A

Pubertal delays caused by environmental factors such as malnutrition, stress, or excessive exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Other than karyotyping, what signs or symptoms suggest Turner syndrome rather than functional gonadotropin deficiency?

A

Turner girls will be short their entire lives, so if you have a growth chart then they will most likely have a history of being less than the 1st percentile. Girls with functional gonadotropin deficiency, however, should only have impaired height for the duration that they’ve been experiencing the stressor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the generic names of Concerta, Ritalin, and Adderall?

A

Concerta and Ritalin: methylphenidate
Adderall: amphetamine

(Think: Adderall and amphetamine both start with A, and “RIddLes help My PHriends CONCEntrate.”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do boys with Klinefelter’s present?

A

They typically start puberty at the normal age but then develop abnormal signs such as female fat distribution and small, fibrotic testes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly