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CMN572 > U4: puberty > Flashcards

U4: puberty Flashcards

1
Q

puberty patho in girls: hypothalamus releases _____ which stimulates the AP glad to produce ______ which stimulates the ovarian follices to release ______ which has a negative feedback on hypothalamus & AP

A
  • gonadotrophin releasing hormones (GnRH)
  • LH/FSH
  • estrogen
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2
Q

puberty patho in boys: hypothalamus releases ______ which stimulates the AP glad to produce ______ which stimulates the testicles to release _______ which has a negative effect on the hypothalamus & AP

A
  • gonadotrophin releasing hormones (GnRH)
  • LH
  • testosterone
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3
Q

what lab should also be checked in children with precocious/delayed puberty?

A

thyroid studies

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4
Q

puberty is considered precocious under what age in boys and girls?

A

<8y girls

<9y boys

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5
Q

puberty is considered delayed in girls with no signs by age _____ or no menarche by age _______

A
  • 13y with no signs

* 16y with no period

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6
Q

puberty is considered delayed in boys with no signs by age _____ or over ______y elapsed since _______

A
  • 14y with no signs

* 5y since first sign of puberty

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7
Q

precocious puberty can be classified as: (2)

A
  • central

* peripheral

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8
Q

central PP is an issue at what organ on the HPO axis?

A

*brain/pituitary

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9
Q

what labs correlate with central PP?

A
  • increased LH/FSH

* increased estradiol & testosterone

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10
Q

peripheral PP is an issue at what organ on the HPO axis?

A

*adrenal gland/ovaries/testes

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11
Q

how do GnRH analogues work?

A

*GnRH agonist acts EXACTLY like GnRH hormones and stimulate LARGE amount of LH/FSH&raquo_space; flair of sex hormones

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12
Q

what are GnRH analgoues used for?

A

endometriosis

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13
Q

GnRH analogue meds (2)

A
  • Goserelin/Zoladex

* Leuprorelin/Prostap

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14
Q

central PP is missing what hormone which therefore must be supplemented

A
  • GnRH
  • “leuprolide” IM QM
  • “histrelin implant QY
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15
Q

in central PP the ________ is not stimulated to to release _______

A
  • hypothalamus

* GnRH

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16
Q

without GnRH the anterior pituitary still produces ______ & ______ which signal the gonads to release ________… this leads to high levels in the blood- a diagnostic feature of ______

A
  • FH
  • LSH
  • sex hormones
  • central PP
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17
Q

basically…. in central PP which HPO axis organs are on and which are off?

A
  • ON = anterior pituitary and gonads

* OFF = hypothalamus

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18
Q

basically in peripheral PP which HPO axis organs are on and which are off?

A
  • ON = gonads (and adrenals)

* OFF = hypothalamus & anterior pituitary

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19
Q

in peripheral PP the _____ are stimulated by the _______ to release ______

A
  • gonads
  • adrenal glands
  • sex hormones
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20
Q

boys with central PP must obtain what imaging? to eval for what? bc why?

A
  • MRI
  • CNS lesions
  • less common in boys
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21
Q

what diagnostic test will help you differentiate between abnormal pubertal processes?

A

*bone xray to assess bone age

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22
Q

if bone age is 2y older than actual age, expect?

A

PP

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23
Q

if bone age is delayed but child has a normal growth chart, what do you expect?

A

constitutional growth delay

24
Q

causes of peripheral PP can include?

A
  • adrenal tumor
  • genetic abnormality
  • exposure to meds
  • ovarian cysts/tumors
  • tumors of testes
25
if bone age is >12y with no signs of puberty, what do you expect?
*delayed puberty
26
sexual differentiation is completed at ______w gestation
*12
27
PP is more common in boys or girls?
*girls
28
T or F: obesity is a cause of PP
True
29
PP: girls who present WITH pubic or armpit hair BUT NO BREAST DEVELOPMENT. obtain what 2 labs?
* androgen | * 17-hydroxyprogesterone
30
female presents with PP. what lab do you draw and why?
* estradiol | * r/o ovarian tumor/cyst
31
for PP obtain an xray of?
left hand and wrist
32
treat central PP with what?
*GnRH analogues until time to resume puberty
33
treat peripheral PP with what?
*treat underlying cause
34
benign premature adrenarche is described as
*early development of pubic hair, axillary hair, body odor, acne
35
pt has benign premature adrenarch (BPA), what labs do you draw and why?
* prob LH/FSH, sex hormones, and GnRH to see where the issue is. * to r/o late onset CAH or adrenal tumors
36
benign premature thelarche is?
isolated breast development wihtout other signs of puberty. * most common in girls under 2 * if onset >36m OR AW other signs of puberty REFER
37
PP In boys: testes enlarged >2cm indicates what?
central PP
38
PP in boys: testes remain small indicates what?
Gonadotropin-independent causes
39
PP in boys: testes asymmetric or unilaterally enlarged
*tumors
40
peripheral PP In boys but labs are negative for CAH. what next?
get imaging of liver, adrenals, testicles to look for tumors
41
familial male PP or McCune Albright Syndrome (GNAS mutation) will be treated with what?
* agents that block steroid synthesis = ketoconazole | * antiandrogens = sprionolactone + aromatase inhibitors [anastrazole or letrozole]
42
symmetric testes >2.5cm or >4ml indicate onset of puberty. T or F?
true
43
girls SMR 2:
breast buds; straight/fine hair
44
girls SMR 3:
breast & areola grow; coarse/dark hair spreads
45
girls SMR 4:
nipple & areola form separate mound; adult-like hair sparing thighs
46
girls SMR 5:
areola rejoins breast contour; hair inverted triangle (adult)
47
boys SMR 2:
* testes increase in size * scrotum reddens * straight hair at base
48
boys SMR 3:
* penis grows LONGER | * curly/coarse hair
49
boys SMR 4:
* penis grows WIDER | * adult-like hair sparing thighs
50
boys SMR 5:
*penis and pubic hair fully developed
51
gynecomastia occurs btwn ages _______ and usually disappears in ____y
* 14-15 | * 2y
52
girls growth spurt onset, peak, end
* 9 * 11.5 (SMR 3-4) * 16y
53
boys growth spurt onset, peak, end
* 11 * 13.5 * 18y
54
central delayed puberty labs
LOW FH/LSH
55
primary gonadal failure labs
HIGH LH/FSH
56
delayed puberty ST primary gonadal failure is usually secondary to what 2 dx in girls?
* turners | * PCOS
57
delayed puberty ST primary gonadal failure is usually secondary to what DX in boys?
*Klinefelter

CMN572 (13 decks)

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