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Gynecology > 3 - Puberty and Pubertal Disorders > Flashcards

3 - Puberty and Pubertal Disorders Flashcards

1
Q

What is pubarche?

A

appearance of pubic hair

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2
Q

What is the first line treatment for Mullerian Agenesis?

A

create neo-vagina with dilators

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3
Q

In boys, puberty is considered precocious if it occurs before this age.

A

< 9 years old

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4
Q

In this condition the upper vagina and uterus fails to form or fuse as a result of a failure of the lateral fusion of mullerian ducts.

A

Mullerian Agenesis

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5
Q

What is the diagnostic criteria for POI?

A

amenorrhea plus elevated FSH levels on 2 separate occasions

remember hormones secreted in pulsatile fashion

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6
Q

What 2 factors result in males generally being taller than females?

A
  • have 2-3 years of extra “pre-pubertal growth”

- have larger max growth spurt

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7
Q

Growth spurt in boys usually occur in between these Tanner stages

A

Tanner stage 3-4

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8
Q

How long after the growth spurt do FEMALES begin gaining weight?

A

6-9 months later

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9
Q

How is peripheral PP treated?

A

treat underlying cause

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10
Q

Cafe au lait spots and polycistic lesions in the setting of precocious puberty is consistent with this diagnoses.

A
  • McCrune Albright Syndrome
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11
Q

What cells are responsible for secreting AMH in males?

A

Sertoli cells

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12
Q

In relation to the growth spurt, when do females on average have menarche?

A

menarche occurs 6 months after growth spurt

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13
Q

This needs to happen for puberty to be complete.

A

full achievement of reproductive capabilities (ovulatory cycles needs to be present)

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14
Q

What is the first line treatment for POI?

A

Transdermal 18 B-estradiol [estrogen] - start low and increase every 6 months

add progesterone later (if added too early will mess up thelarche)

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15
Q

What is the most common cause of central PP?

A

idiopathic (85%)

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16
Q

What is the most common anatomical cause of delayed puberty?

A

imperforate hymen

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17
Q

Menarche should coincide with what bone age?

A

age 13

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18
Q

What is the most common cause of delayed puberty in females?

A

primary ovarian insufficiency

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19
Q

A short stature, streak gonads, and a webbed neck is consistent with this phenotype.

A

Turner’s Phenotype

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20
Q

An increase in this hormone leads to an older bone age.

A

Estrogen

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21
Q

At what breast Tanner stage do females most often have menses?

A

Tanner Stage 4 (62%)

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22
Q

What is the first sexual sign of puberty in 85% of girls?

A

thelarche

23
Q

Amenorrhea with blood behind the hymen (e.g. hematocolpos) is a hallmark sign of this diagnosis.

A

imperforate hymen

24
Q

What is the most common type of incomplete precocious puberty?

A

precocious thelarche

25
Q

This condition is characterized by an absence of some or all of an X chromosome.

A

Turner’s Syndrome

26
Q

What diagnostic study is used to assess bone age?

A

xray of non-dominant hand and wrist

27
Q

What is thelarche?

A

appearance of breast tissue

28
Q

How does obesity affect the onset of puberty?

A

obesity leads to an earlier onset of puberty

29
Q

What is the most common cause of Karyotype causing delayed puberty?

A

Turner’s Syndrome

30
Q

What is menarche?

A

when first menses occurs

31
Q

How is central PP medically treated?

A

GnRH agonists - Synarel or Lupron

32
Q

How is an imperforate hymen treated?

A

hymenectomy

33
Q

What ducts form the uterine?

A

mullerian (paramesonephric) ducts

34
Q

What test do you use to differentiate between central and peripheral PP?

A

GnRH stimulation test

35
Q

How is delayed puberty defined in females?

A
  • no menses by age 15

- no secondary sexual characteristics by age 13

36
Q

What findings on the GnRH stimulation test are consistent with central vs. peripheral PP?

A
  • central = LH > FSH

- peripheral = FSH > LH

37
Q

What is the most common neoplasm associated with delayed puberty?

A

craniopharyngioma

38
Q

Breast development should coincide with what bone age?

A

age 11

39
Q

What is the necessary treatment for a patient with Swyer’s Syndrome?

A

remove gonads d/t greater risk of malignancy

40
Q

What is the most common cause of delayed puberty in males?

A

constitutional

41
Q

On average this sexual sign follows thelarche in 85% of girls.

A

pubarche

42
Q

How is precocious puberty defined in girls?

A

Pubertal development 2.5 SD below mean

prior to age 6 in AA, prior to age 7 in caucasian

43
Q

Adolescent menstruation has a cycle range of how many days?

A

21-45 days

44
Q

What is the most common type of PP in girls?

A

central or GnRH dependent

45
Q

What are the 2 main consequences of precocious puberty in girls?

A
  • shorter adult height

- increase risk of sexual abuse

46
Q

T/F: Hormonal changes occur before physical signs of puberty.

A

True

47
Q

In males what is the relationship between height and weight gain during puberty?

A

males gain height and weight at the same time

48
Q

Absence of this hormone results in hypogonadal hypogonadism which results in the patient being unable to enter puberty.

A

kisspeptin

49
Q

This hormone produced by adipocytes is required for the onset of normal puberty.

A

leptin

50
Q

How is premature (precocious) thelarche defined?

A

onset of thelarche prior to age 7 in whites, 6 in blacks

51
Q

In this condition there is a mutation of the SRY gene resulting in non-functioning ovaries. The patient will not have a growth spurt or breast development. They will have a vagina, uterus. The gonads will be testicles and streak.

A

Swyer’s Syndrome

52
Q

What is the first somatic sign of puberty in girls?

A

pubertal growth spurt

53
Q

Patients with Turner’s syndrome are at an increased risk of this life threatening vascular complication.

A

thoracic aortic rupture

54
Q

what is the most common cause of oligomenorrhea?

A

PCOS

Gynecology (8 decks)

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