Paediatric and Adolescent Gynaecology

Question 1

Describe the changes that occur during normal puberty

Answer 1

Increase in pulsatile secretion of LH from pituitary gland in response to an increase of pulsatile GnRH from the hypothalamus at night

Pulses then stimulate a rise in estradiol levels

Question 2

What changes are observed during the adolescent stage in puberty?

Answer 2

Psychological/Behavioural
Hormonal Changes
Independence
Peer Acceptance
Decisions Over Future

Question 3

What changes can parents observe during puberty?

Answer 3

Devolution in decision making, encouraging independence

Question 4

What history should be taken?

Answer 4

Gynaecological
- Age of Menarche
- Cycle
- Pain
Sexual (in absence of parents)
- sexual activity
- contraception
Weight gain/loss
Exercise 
REMEMBER TO ADDRESS SEXUAL ABUSE

Question 5

What should be examined ?

Answer 5

General, Breast, Gynaecological

Question 6

Define precocious puberty?

Answer 6

Precocious puberty is defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys.

Question 7

Define delayed puberty?

Answer 7

boys have no signs oftesticular development by 14 years of age
girls have not started to develop breasts by 13 years of age, or they have developed breasts but their periods have not startedby 15

Question 8

What is vulvovaginitis?

Answer 8

Persistent vulval irritation or vaginal discharge is the most common reason for the gynaecological referral of a prepubertal girl

Question 9

What is the peak age for vulvovaginitis?

Answer 9

three-seven years

Question 10

How does vulvovaginitis present?

Answer 10

yellow-green offensive discharge, soreness and itching

Question 11

What are the causes of vulvovaginitis?

Answer 11

Poor perineal hygeine, lack of estrogen, chemical irritation