Week 203 - Puberty Flashcards
Where is the common place for the nipple?
4th intercostal space (mid-clavicular line)
When do you examine lactating breasts?
After breastfeeding
On examination how would a breast cancer feel?
Firm, Hard, Irregular
Usually painless
What is a fibroadenoma of the breast?
Benign lump (part of terminal duct lobule)
Smooth, Mobile, Discrete & Rubbery
2nd most common cause of breast mass in women <35 yrs
What are the characteristics of a breast cyst?
Smooth-fluid filled sac
Most common in women 35-50yrs
May be hard and painful
Benign
What is cyclical mastalgia?
Breast pain that coincides with the period (usually 3 days before)
What drugs can cause gynaecomastia?
Cannabis Oestrogen (used in treatment of prostate cancer) Spironolactone Cimetidine Digoxin
What are the risk factors for breast cancer?
↑age Early menarche Nulliparity Late menopause Prolonged HRT Postmenopausal obesity
What does LH act on?
Leydig cells (testes) - ↑testosterone Ovary - ↑Oestrogen
What does FSH act on?
Gonads
↑Sperm (acts on Sertoli cells)
↑Ova
What are first signs of puberty?
↑Size of testes (>4 mls) - Male
Breast Development - Female
What is Oxandrolone and what is it used for?
Given to boys to induce puberty & growth, has no compromising effect in final height (non-aromatizable anabolic steroid)
What is early puberty?
<8 yrs in Girls
What is late puberty?
No testicular development (14 yrs
Absence of breast development >13 yrs or menstruation has not occurred within 3 yrs of breast formation
What hormones would be elevated in Adrenache?
Androstenedione & DHEA
What hormones are elevated in Gonadarche?
Primarily GnRH (LH, FSH and their subsequent hormones)
What is the commonest cause of precocious puberty following a disconcordant pattern?
Congenital Adrenal Hyperplasia (CAH)
↑17 hydroxy progesterone –> testosterone
↓Cortisol
What is Thelarche?
Isolated Breast Development
LHRH test = FSH>LH
What is McCune Albright Syndrome?
(G protein act) Genetic disorder of bones, skin pigmentation & hormonal problems along with premature puberty
Cafe au lait spots
What is given for premature puberty?
GnRHa
Cyprosterone can be given to block the initial LH/FSH surge (peripherally)
Why is hypothyroidism associated with premature non-consonant development?
TRH stimulates both TSH & FSH receptors
Which hormone secreted by Sertoli cells induces regression of Mullerian ducts in males?
Anti-Mullerian Hormone
What are the dominant adrenal hormones involved in puberty?
DHEAS
Testosterone
What do hamartomas cause?
Secrete cytokines that promote Gonadotrophin secretion
Central Precocious Puberty
What do the mesonephric ducts form?
efferent ductules and epididymis, ductus deferens and ejaculatory duct
seminal vesicles form as an outgrowth of ductus deferens
