Puberty Flashcards

1
Q

Pubertal Timing

A
  • 50% has to do with genetics and ethnicity
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2
Q

Puberty MOA

Females

A
  • Estradiol levels progressively increase -> Maturation of female genital tract and breast development
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3
Q

Puberty MOA

Males

A
  • Testosterone level increases x20 -> Correlates with physical stages of puberty and degrees of skeletal maturation
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4
Q

Physical Growth

Females

A
  • Growth spurt begins nearly 2 years earlier in girls
  • Peak height: between 11.5-12 years old
  • 83-89% of total height attained: age 11
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5
Q

Physical Growth

Males

A
  • Growth spurt lasts longer in boys than girls
  • Peak height: between 13.5-14 years old
  • Mass double between 10-17 years old
  • 83-89% of total height attained: age 12
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6
Q
Psychosocial Development
Early Adolescence (10-13 yo)
A
  • Development of secondary sex characteristics
  • Feel more comfortable with same sex
  • Concrete thinking
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7
Q
Psychosocial Development
Middle Adolescence (14-16 yo)
A
  • Rapid pubertal growth/development subsides
  • Emotions and wide mood swings
  • Formal operations
  • Abstract thinking
  • Self-centered
  • Peers determine standards for identification
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8
Q
Psychosocial Development
Late Adolescence (17+ yo)
A
  • Dating becomes intimate
  • Abstract thinking
  • Period of idealism
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9
Q

1st measurable sign of puberty in girls

A
  • Height spurt

- 1st conspicuous sign is breast buds (8-11 yo)

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10
Q

1st measurable sign of puberty in boys

A
  • Scrotal and testicular growth
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11
Q

Tanner Stages
Boys
Stage 1

A
  • Infantile until puberty
  • No true pubic hair, fine velus over the pubes
  • Genitalia increase slightly in size over time, but little change to general appearance
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12
Q

Tanner Stages
Boys
Stage 2

A
  • Scrotum begins to enlarge, reddening and change in skin texture
  • Sparse growth of slightly pigmented hair, usually straight and only slightly curly, begins at either side of base of penis
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13
Q

Tanner Stages
Boys
Stage 3

A
  • Penis increases in length, small increase in breadth
  • Further growth of scrotum
  • Hair spreads over pubis symphysis, considerably darker, coarse, and more curly
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14
Q

Tanner Stages
Boys
Stage 4

A
  • Length and breadth of penis increase more, glans has developed
  • Scrotum is further enlarged and scrotal skin becomes darker
  • Hair is adult in character, covers area considerably smaller than most adults, no spread to medial surface of thighs
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15
Q

Tanner Stages
Boys
Stage 5

A
  • Genitalia are adult in size/shape

- Hair is distributed in inverse triangle, spread to the top of medial thigh, but not above base of triangle

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16
Q

Tanner Stages
Girls
Stage 1

A
  • No breast development

- No pubic hair

17
Q

Tanner Stages
Girls
Stage 2

A
  • Breast budding appears, some palpable breast tissue under nipple, areola is slightly enlarged
  • Small amount of long pubic hair along vaginal lips
18
Q

Tanner Stages
Girls
Stage 3

A
  • Breast is more distinct, no separation between contours of two breasts
  • Hair is darker, coarser, curlier, and spreads sparsely over pubic symphysis
19
Q

Tanner Stages
Girls
Stage 4

A
  • Breast further enlarged and greater contour distinction, nipple including areola forms a secondary mound on breast
  • Hair is adult in type, area covered is smaller than most adults, no pubic hair on inside of thighs
20
Q

Tanner Stages
Girls
Stage 5

A
  • Breast is fully developed, distinct contours, areola has receded into general contour of breast
  • Inverted triangle pattern of pubic hair
21
Q

Adolescent Lipid Panels

A
  • 9-11 yrs: Universal screen w/nonfasting non-HDL chol or fasting lipid screen
  • 12-17 yrs: fasting lipid profile if FH newly positive, parent with dyslipidemia, any other RF
  • 18-21 yrs: nonfasting non-HDL chol or fasting lipid profile
22
Q

PP in genders

A

Male < age 9

Female < age 8

23
Q

Diagnosing PP

A
  • X-ray L hand to determine bone age
  • Labs: LH, FSH, Estradiol/Testosterone levels
  • If Central PP is Dx, get MRI of brain to r/o abnormalities of pituitary gland
24
Q

Risks if Cryptorchidism is untreated

A
  • Infertility

- Testicular malignancy

25
Q

Cryptorchidism labs

A
  • Infants between 2-6 months: measure LH, FSH, Inhibin B, and Test to determine if testes are present
  • After 6 months: HCG stimulation test to confirm absence or presence of functional abdominal testes
26
Q

Gynecomastia

A
  • Occurs in 75% of normal pubertal boys, self-limiting
  • More common in obese boys
  • Typically resolves in 2 years
27
Q

Turner Syndrome

Girls

A
  • Short stature
  • Infertile
  • Webbed (extra skin) neck
  • Swelling (lymphema) in hands/feet
  • Heart Defects
  • Kidney Problems
  • Widely spaced nipples
  • Brown spots on skin
28
Q

Klinefelter Syndrome

Boys

A
  • Tall stature
  • Narrow chest
  • Wider hips
  • Female-type pubic hair pattern
  • Breast development
  • Osteoporosis
  • Testicular atrophy