Week 5- Adolescent Health Flashcards
In girls and boys, what is the first sign of puberty?
Girls:
- 85% thelarche
- 15% pubarche
- blacks and asians earlier
- menarche is usually within two year
Boys
- 95% gonarchem starts 9 and 14 y.o
What is Tanner staging for girls and boys?
Breast:
- Tanner 0: nothing
- 1: breast bud
- 2: breast tissue, areola and papilla in contour of breast
- 3: areola and pappilla elelvated
- 4:
- 5: pappilla only elevated
Pubic Hair
- 1: nothing
- 2: straight hairs
- 3: curly hairs covering pubis
- 4: more curly hairs but not yet to thighs
- 5: extending to thighs
What is the normal testicular size prepubertal and adult
2.0 cm
4-6 cm
What Tanner stage do boys have peak growth velocity?
Tanner 4- this is also when they are most likely to get gynecomastia because of high circulating androgens and peripheral conversion to estrogen
Boys have a later peak growth velocity and reach their final height later
What is the def’n of precocious puberty?
Girls: breast budding or pubarche <8 y.o OR menarche by 10 y.o
Boys: gonarche or pubarche <9 y.o
8-9-10
How to classify premature puberty? How to classify delayed puberty?
Premature puberty
GnRH dependent (central)
- idiopathic in 75% in girls but only 10% of boys
GnRH independent (peripheral)
Delayed puberty
Hypergonadotrophic
Hypogonadotrophic
NB: constitutional delay of puberty is a diagnosis of exclusion
McCune-Albright Syndrome
genetic, inappropriate G-protein signalling…unilateral cafe au lait spots, bone abnormalities
What is the def’n of delayed puberty?
Girls:
- no breasts by 13
- no menarche by 16
- > 5 yrs between thelarche and menarche
What percentage of teens report:
- bullying
37%
Suicide attempts and thoughts up from 2008
Teen pregnancy going down, condom use going up, decreased sex with substance use
