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
