Small Group: Puberty Cases Flashcards
What is the early age limit for puberty in girls?
Blacks and Hispanics: 6.5 years
Caucasians: 8 years
An 8-year-old female presents with Tanner 2 breast development and pubic hair. Would you consider McCune-Albright as a cause?
Unlikely, because McCune-Albright presents with elevated estrogen only, so pubic hair would be absent.
What would the gonadotropin response to GnRH be in a girl with McCune-Albright?
Suppressed/prepubertal
How is central precocious puberty treated?
GnRH agonist to suppress the progression of puberty
Give an example of an aromatase inhibitor?
Letrozole
What is the early age limit for puberty in boys?
9 years
What is the sequence of pubertal events in boys?
THAPD Testicular enlargement Hair in pubic area and axillae Acceleration of growth Penile enlargement Deepening of voice
True or false: in a boy with a tumor that secretes hCG, the testes will be small due to suppression of the HPG axis.
False. The testes will be large because of the excess testosterone.
What will the testicles and penis be like in CAH?
Small in proportion to the degree of pubic hair present
How would you treat familial testotoxicosis?
With an aromatase inhibitor and androgen-receptor antagonist or ketoconazole to directly inhibit the production of testosterone
How can you typically distinguish constitutional growth delay from pubertal disorders?
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.
What is functional gonadotropin deficiency?
Pubertal delays caused by environmental factors such as malnutrition, stress, or excessive exercise
Other than karyotyping, what signs or symptoms suggest Turner syndrome rather than functional gonadotropin deficiency?
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.
What are the generic names of Concerta, Ritalin, and Adderall?
Concerta and Ritalin: methylphenidate
Adderall: amphetamine
(Think: Adderall and amphetamine both start with A, and “RIddLes help My PHriends CONCEntrate.”)
How do boys with Klinefelter’s present?
They typically start puberty at the normal age but then develop abnormal signs such as female fat distribution and small, fibrotic testes.
