Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Obs/Gynae > Puberty and Menopause > Flashcards

Puberty and Menopause Flashcards

(55 cards)

Start Studying
1
Q

What is puberty?

A

Process of reproductive and sexual development and maturation that which changes a child into an adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

At what age does Puberty start?

A

Begins between ages 8 to 13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What two physiological processes influence puberty?

A

Gonadarche and Adrenarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What activates GnRH?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe Gonadarche

A

Activation of the gonads by the pituitary gland hormones( follicle stimulating and luteinizing hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

At what age do secretions for GnRH start? And to what frequency are the secreted?

A

From the age of 8 to 9, GnRH is secreted in pulsations of increasing amplitude and frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain the process of Adrenarche?

A

Zona reticularis of the adrenal glands begins to secrete dehydroepindrosterone (DHEA) and androsterone
Results in androgenic changes i.e growth of pubic and axillary hairs, maturation of apocrine sweat glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does adrenarche begin?

A

About years before true puberty.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the sequence of pubertal maturation?

A

Growth Spurt
Thelarche
Pubarche
Peak Growth Velocity
Menarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Thelarche and when does it first occur? What causes it?

A

-Breast development due to action of estradiol
-2-3 years before menarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Pubarche and when does it occur and what is it dependent on?

A

-Appearance of first pubic hair and axillary hair
-Usually after thelarche and dependent on adrenal androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Pubarche usually associated with?

A

-Development of acne and apocrine body odor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is and causes the growth Spurt?

A
  • Accelerated increase in height
    -Due to the effect of growth hormones and estrogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When does the growth Spurt usually occur?
How does it differ between girls and boys?

A

-Begins around 11years and mostly ceases by 15years
-Earlier in girls than in boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is key feature of the first menstrual bleeding?

A

The first menstrual bleeding is most of the times not influenced by ovulation but rather the effects of estrogen on the endometrial lining. May take over 2-3 years before the menstrual cycle establishes a regular pattern due to immaturity of the HPG axis. Initial cycles are anovulatory and can be unpredictable and irregular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe Tanner’s Staging of breast and pubic hair development?

A

REFER TO HANDOUT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What factors influence the onset of puberty?(5)

A

Genetics
Race
Body weight
Social environment
Overall health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What issues arise with puberty?

A

Psychological issues like depression
Anemia
Acne
Gynecological conditions
Musculoskeletal injuries
Sexually transmitted infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the two categories of puberty?

A

1.Precocious
2.Delayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the two types of precocious Puberty?

A

1.Central-Gonadotropin dependent
Aetiology is unknown but 25% due to CNS malformation or brain tumours

2.Peripheral -gonadotropin independent
Caused by oestrogen secretion such as exogenous ingestion or a hormone-producing tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the causes of central precocious puberty? And what is the most common cause?

A

most common cause is idiopathic
CNS lesions (gliomas, craniopharyngiomas)
Genetics
Pituitary gonadotropin-secreting tumors
CNS infections (meningitis)
Head trauma
CNS anomaly (hydrocephalus)
Iatrogenic (radiation, chemotherapy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the typical presentation of someone with central precocious puberty? And why?

A

-Taller than peers during adolescence but shorter by adulthood
Due to early epiphyseal closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What investigations are done in central precocious puberty?

Study These Flashcards
A

FSH and LH (mainly LH): elevated
GnRh stimulation test (gold standard)
High GnRH High FSH and LH
Serum oestrogen (elevated)
Imaging
X-ray of hand, left wrist: allows comparison between skeletal maturation and chronological age

24
Q

What is the management for central precocious puberty?

Study These Flashcards
A

-GnRH agonist e.g goserelin
-Manage underlying cause

25
Why is an X-ray of the hand or wrist done?
To explain bone age, as children develop,their bones change in size and shape. These changes can be seen radiographically and can be correlated with chronologic age. Thus, the radiographic "bone age" is the average age at which children in general reach a particular stage of bone maturation. Girls with early estrogen excess from precocious puberty show growth-rate acceleration, rapid bone-age advancement, and early epiphyseal closure, which leads to short stature
26
What are the causes of Peripheral precocious puberty?
Oestrogen or testosterone producing tumours Adrenal or ovarian (granulosa cell tumor most common) Other causes include Ovarian cysts Ovarian tumours Primary hypothyroidism Exogenous androgen or oestrogen exposure McCune-Albright syndrome
27
What is the triad for McCune Albright Syndrome?
-polyostotic fibrous dysplasia, -irregular caf~-au-lait spots -Endocrinopathies.
28
What investigations are done in Peripheral precocious puberty?
Pelvic sonography Measuring serum hormonal levels to check the levels of FSH, LH and estrogen Thyroid function test
29
What is the management for peripheral precocious puberty?
Gonadotropin releasing hormone analogue therapy like leuprolide acetate or triptorelin
30
What is delayed puberty?
-When no signs of secondary sexual characteristics by the age of 13 years. -In girls, considered delayed when there is no breast development by age 13 -Also considered delay if menses have not commenced by age 15 or within 3 years of thelarche
31
What are the types of delayed puberty? Which of them is the most common?
-Hypergonadotrophic hypogonadism -Hypogonadotrophic Hypogonadism -Constitutional Delay(Most common)
32
What are the characteristics of constitutional delay?
-Adolescents lack both secondary sexual characteristics and pubertal growth spurt by age 13 years
33
What is the cause of Constitutional delay?
The probable cause is a delay in reactivation of the GnRH pulse generator
34
What are the causes of Hypogonadotrophic Hypogonadism?
Abnormalities of the hypothalamus or pituitary gland e.g Kallman syndrome Causes include use of steroids, hyperprolactinemia, chronic illness, malnutrition , anorexia nervosa, severe pituitary gland infections, injury or tumors
35
What is Kallmans Syndrome?
-Genetic disorder characterized by delayed puberty and anosmia. caused by underdevelopment of specific special neuron responsible for signals the hypothalamus to produce the gonadotropin releasing hormones. Since the hypothalamus and the olfactory system develop from the same cells the patient also presents with anosmia
36
What are the causes of hypergonadotropic hypogonadism?
Abnormalities in the ovaries resulting in little or no production of estrogen Turners syndrome( ovarian dysgenesis) Androgen insensitivity syndrome Chemotherapy and radiations Infections such as mumps Premature ovarian failure (POF) can occur and can be: Idiopathic Part of autoimmune disorder Following chemo or radiotherapy for childhood cance
37
What is the management of delayed puberty?
reat the underlying cause Hormonal therapy Low dose of estrogen and monitor developmental changes Add progesterone to start menstruation Oral contraceptive pills to maintain normal levels of sex hormones
38
Define menopause?
Menopause refers to a point in time that follows 1 year after the complete cessation of menstruation
39
Define Perimenopause
The period beginning with the first clinical biological and endocrinological features of approaching menopause and ends 12 months after the EMP.
40
Define Premenopause ?
Period prior to menopause
41
Define climasteric ?
Period of time during which a woman passes through the reproductive to the non reproductive stage. Covers 5-10 years of menoapuse.
42
Define menopausal transition?
the period between onset of irregular menstrual cycle and the last menstrual cycle. Begins between ages 45 to 55 Average age of women experiencing their final menstrual period (FMP) is 51.5 years, but a halt to menses from ovarian failure may occur at any age.
43
Define premature menopause?
-Spontaneous menopause occurring 2 SD below the mean estimated age for the reference population. -Permanent cessation of menses before the age of 40
44
Describe induced menopause?
cessation of menstruation following bilateral oophorectomy or iatrogenic ablation of ovarian function.
45
What are the signs and symptoms of menopausal transition.
Menstrual pattern Shorter cycles (typical) Longer cycles (possible) Irregular bleeding Vasomotor Hot flashes Night sweats Sleep disturbances Psychological/cognitive Worsening PMS Depression Irritability Mood swings Poor concentration Poor memory Sexual dysfunction Vaginal dryness Decreased libido Dyspareunia Somatic Headache Dizziness Palpitations Joint aches and back pain Others Urinary incontinence Dry, itchy skin Weight gain Osteoporosis
46
Define Premature menopause ?
Idiopathic Surgery –removal of the ovaries, total hysterectomy Ovarian insufficiency –failure of adequate ovarian function Causes ; idiopathic Genetic disorders like turners syndrome, fragile X Iatrogenic causes like chemotherapy and radiations Toxins: smoking
46
Describe the physiology of menopause?
Numerical depletion of oocyte resulting in low estrogen production Negative feedback to the hypothalamus lost Increased production of FSH and LH by the pituitary gland High levels of FSH results into desensitization of the FSH receptors in the ovarian follicles Eventually, no or less production of estrogen hence menopause
46
What are the effects of estrogen deficiency?
Bones Reduced bone density which results into osteoporosis Cardiovascular system Increased risk of atherosclerosis – increased risk of coronary artery disease Urinary tract Atrophy of the urinary tract system resulting into increased risk of urinary tract infections, urine incontinence, dysuria, urgency and frequency
47
How is menopause diagnosed?
1.Diagnosis is largely clinical Cessation of menstruation for consecutive 12 months 2.Appearance of menopausal symptoms eg hot flushes and night sweats 3.Serum estradiol < 20pg/ml 4.Serum FSH and LH > 40mIU/ml
48
What is the management of menopause?
Non hormonal Life style modification Diet Exercise Sleep hygiene Hormonal Hormonal replacement therapy
49
How does menopausal HRT work?
Restores premenopausal physiological state hence relieving symptoms of menopause
50
What drugs are used for Menopause HRT? And what is their MOA?
1.Tibolone : inhibits bone resorption by reducing osteoclastic activity, improves VMS and urogenital atrophy, improve libido 2.Selective estrogen receptor modulators(SERMs): eg raloxifene and tamoxifen treats osteoporosis
51
What are the indications of HRT?
Depression Joint aches and pain Hot flushes Vulvovaginal atrophy
52
What are the contraindications of HRT?
History of breast cancer, ovarian cancer and uterine cancer History of chronic heart failure Liver disease Pregnancy Thromboembolic events
53
What are the side effects of HRT?
Venous thromboembolism Pulmonary embolism Thrombogenic stroke Coronary heart disease Breast and endometrial cancer Vaginal bleeding

Obs/Gynae (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions