precocious puberty and puberty scale

Question 1

pp before what ages in both males and females

Answer 1

Precocious puberty should be considered whenever secondary sexual characteristic appear before 8 years of age in females and before 9 years of age in males.

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Causes of Gonadotrophin-dependent precocious puberty (GDPP)
Idiopathic (>90%)
Brain tumours
Cranial radiotherapy
Structural damage to the brain, for example, from:
Hydrocephalus
Post-infection (meningitis)
Traumatic head injury
Causes of Gonadotrophin independent precocious puberty (GIPP)
Gonadal tumours
Adrenal or liver tumours (may cause virulisation)
Congenital adrenal hyperplasia

Question 2

tx for this

Answer 2

GnRH analogues can play a role to suspend progression of puberty

if left untreated can lead to accelerated skeletal develppment resulting in reduced height

Question 2

tx for this

Answer 2

GnRH analogues can play a role to suspend progression of puberty

if left untreated can lead to accelerated skeletal develppment resulting in reduced height

Question 3

You are a FY2 called to see a 3 day old neonate on the postnatal ward. The baby has had several episodes of green vomiting. The baby has been urinating every 2 hours or so, but is yet to pass meconium. The baby was born at 41 weeks.

An abdominal X-ray shows a ‘bubbly’ appearance of the intestine with a lack of air-fluid levels.

Which of the following genetic conditions is likely present in this baby?

Answer 3

`CF with mecoium ileus

Question 4

fluid regime how to calculate

Answer 4

100ml/kg for first 10kg, 50ml/kg for the second 10kg, 20ml/kg for each kilo over 20

Question 5

if cannot walk by 18months what do you do

Answer 5

refer to secondary care

Question 6

A ten year old boy is referred by his GP to a paediatric urology clinic. He attends with his father. The boy says that he is anxious about the small size of his penis and that he has not started to develop any pubic hair. What is the first sign of puberty in boys and girls?

Answer 6

Enlargement of the testes >4ml in boys and development of the breasts in girls

Testicle enlargement occurs from age 9 years in boys and breast development begins at age 8.5 years in girls

Question 7

what tanner stage

under 3ml of testicular volume

Answer 7

1

Question 8

stage 2 men scrotal skin changes what happens in stage 3

Answer 8

increase in size of penis with further t enlargement

Question 9

stag 5 is full development and 4 is fiuther enlargement in males what baout women stage 1

Answer 9

no pubic hair, elevation of papilla in breasts only

Question 10

2 is sparse growth around labia breast bud stage
stage 3 breasts enalrge
4 project and 5 is what

Answer 10

medial surface of thighs pubic hair and recession of areola to the contour of the breast. projection of papilla only

Question 11

males first sign

Answer 11

testicular developmnent aroudn 10yr

Question 12

when may sperm be found in urine

Answer 12

SMR 3

Question 13

when to refer a man

Answer 13

penile growth or t enalrge before 9
steep upward growth trend
new onset polydipsia, polyuria or headaches
hisotry of CNS disorders

Question 14

first sign in females

Answer 14

appearance of breast buds between 8-12 yr