Delayed Puberty Flashcards
0
Q
Etiology
A
Constitutional growth delay Hypopituitarism Kallmann syndrome Chronic illness Malnutrition/eating disorder Rigorous physical activity Hypothyroidism Hyperprolactinemia Turner syndrome Klinefelter syndrome Gonadal failure
1
Q
Definition
A
> 14yo in boys
>12yo in girls
2
Q
Diagnosis
A
consider karyotype especially girls w/short stature
bone age (especially for constitutional delay)
random LH/FSH helpful IF elevated
GnRH stim test (especially for constitutional delay)
hCG stim test if male w/cryptorchidism, small testes
TFT’s, prolactin
CNS, pelvic imaging
3
Q
Treatment
A
Underlying cause Short course hormones if: - boy >14, girl >12 - few/no signs of puberty - severe psychosocial distress LOW dose (minimize SE) testosterone (or oxandrolone)/estrogen Sx of puberty 1-2mos after starting SE: acne, rapid weight gain, gynecomastia, liver dysfunction, early epiphyseal closure
