Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Case 2 > Puberty (normal and abnormal) > Flashcards

Puberty (normal and abnormal) Flashcards

(72 cards)

Start Studying
1
Q

What is puberty

A

The process of becoming sexually mature (fertile)

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

What is adolescence

A

The process of rapid physical and physiological maturation between childhood and adulthood

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

What are the non-pathological influences on the timing of puberty

A

Genetic: racial, familial, sex. Endocrine pathology: hypothalamo-pituitary, gonadal, adrenal. Environment: socioeconomic, secular trend, light and dark rhythms. Health linked to stress: emotional and physical. Drugs and body composition influence physical

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

What is menarche onset

A

Puberty starting

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

Who have earlier menarche

A

Those from urban areas and those from a higher socio-economic background

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

When do boys start puberty compared to girls

A

One year later

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

What is the normal puberty range for girls

A

8-18

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

When is girls peak growth

A

9-14

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

What is the normal puberty range for boys

A

10-15

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

What is boys peak growth

A

10-16

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

What is a prader orchidometer

A

It is used to assess testicular volume in young boys. When the beads become yellow it indicates the onset of puberty

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

Describe the Tanner stages of female development

A

5 stages of female breast and pubic hair development. Stages 3-4 are intermediate stages

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

Describe uterine volume between 0-8

A

Remains fairly constant between 2-1.5ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe uterine volume between 8-14

A

Uterine volume increases to 40-14ml

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

What is ovarian volume from 0-5

A

0.4-1.0 ml

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

What is ovarian volume from 6-10

A

0.4-1.9 ml

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

By the time a girl reaches 16 what is her ovarian volume

A

1.8-22ml

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

How do ovaries change post puberty

A

from 0.6-6 ml

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

What regulates pubertal changes

A

Endocrine changes

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

In females what are aromatides (e.g. LH) converted to

A

Oestrogen

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

In men what is LH converted to

A

Testosterone and FSH used in sperm production

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

What do the phases of testicular function show

A

That post-natal boys go through a mini puberty

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

What effect does the gonadal feedback to the hypothalamic pulse generator have

A

A powerful inhibitory effect which prevents further production of LH and FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What happens to the inhibitory feedback loop at the onset of puberty

A

It is impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the gender difference in growth spurt
Girls grow fastest in their first few years of puberty. Girls pubertal peak is two years before boys
26
What is the relationship between growth hormone secretion and height velocity in puberty
The higher the mean 24-hour GH the greater the height velocity in cm/month
27
What is the effect of age on skeletal growth proportions
Growth doesn't affect all parts of the skeleton equally
28
Describe the critical weight hypothesis
Different races have different critical weights at which menarche will occur. A minimum level of stored, easily mobilised energy is necessary for ovulation and menstrual cycle in girls. Having a minimum level of stored energy makes physiological sense as if you become pregnant it drains energy stores therefore you must have a store to become pregnant
29
What prevents the onset of pubertal development
Anorexia nervosa which is deliberate starvation
30
What does leptin stimulate
Reproductive axis (links nutritional store to puberty). Leptin has gonadal function
31
Describe congenital leptin deficiency
Normal birth weight, severe early onset obesity and hyperphagia, clincally and biochemically prepubertal aged 8 years, severely decreased serum leptin concentration, homozygous guanine nucleotide deletion of leptin gene
32
Describe the effect of congenital leptin deficiency on puberty
Homozygous misense mutation of leptin gene impaired mutant protein secretion. 34 yr old female- primary amenorrhoea. 22 yr old male- prepubertal, biochemical hypothalamic hypogonadism (very physiologically abnormal, means hypothalamic mediated hypogonadism)
33
What do mutations result in
Implications on the timings of the onset of puberty
34
What are the causes of delayed puberty
Constitutional delay- hypogonadotrophic hypogonadism, hypergonadotrophic hyopgonadism
35
Describe the causes of hypogonadontrophic hypogonadism
CNS disorders: tumours, other acquired disorders, congenital disorders. Isolated gonadotrophin deficiency. Multiple pituitary hormone deficiency. Others: Prader-Willi and Laurence-Moon-Bardet-Biedl syndromes, chronic disease, weight loss, anorexia, increased physical activity in females, hypothyroidism
36
Describe the causes of hypergonadotrophic hypogonadism
Klinefelter syndrome. Other forms of testicular failure, anorchia, cryptochidism. Turner syndrome, otehr forms of primary ovarian failure. XX & XY gonadal dysgenesis.
37
What is hypergonadism
A failure of feedback resulting in increased gonadotrophin levels
38
What is the effect of delayed puberty:
Relatively short stature, low self-esteem confidence and inadequacy, rejection, disturbed relationship with parents, attention seeking and immature behaviour, persistence of psychological features into adult life.
39
What does it mean if you have the correct height ages for bone age
You are normal and will achieve normal growth
40
What results in a greater peak height
Early onset of puberty
41
What is involves in treatment of delayed puberty
Investigations, reassurance, testosterone, ethinyloestradiol
42
What investigations would you do if indicated into delayed onset of puberty
Bone age, karyotype, gonadotrophins, sex steroids and LHRK usually helpful
43
Describe the use of testosterone in delayed puberty
Started from ages 14 years until testicular volume >8mls
44
What are the two different types of testosterone you can give
Sustanon (50-100mh monthly I/M). Testosterone undecanoate (40mg daily orally)
45
If there is no testicular enlargement despite virilisation what is required
Pituitary-gonadal testing
46
Describe ethinyloestradiol
5-10mg daily until puberty established
47
Do you use growth hormone in delayed onset puberty
No, no benefit
48
Describe how treatment for delayed onset puberty works
You give a low dose of testosterone to activate hypothalamic balance= GnRH= testosterone development. Testosterone is given as monthly injections. Sustanon is not very good as much is metabolised
49
What do you have to be careful with when someone has delayed onset puberty
You don't miss an underlying pathology
50
How is oestrogen given to females
Orally
51
How is testosterone given to males
Via intramuscular injections
52
Describe Kallmann's syndrome
Hypogonadotrophic, anosmia, usually X-linked, mutation in KAL 1 gene, olfactory hypo/agenesis. You have failure of pubertal development and no sense of smell (anosmia).
53
Describe Prader-Willi syndrome
Neonatal hypotonia and poor feeding, later hyperphagia and obesity, behavioural problems, poor growth, hypogonadotrophic hypogonadism, loss of paternal allele at 15q11-13 (loss of paternal allele on long arm of chromosome 15), possible benefit from GH therapy. Failure of GnRH production= hypogonadism.
54
Describe Turner's syndrome
Missing/ major abnormality in X chromosome. Not all individuals have obvious features
55
Describe vanishing testes
Can't find testes as they have undergone torsion after 1st trimester
56
What are the types of precocious puberty
Isolated breast development. Isolated pubic hair development and signs of androgen excess. Central precocious puberty. Gonadotrophin-independent precocious puberty. Other rare causes
57
Describe isolated breast development
Premanture thelarce
58
Describe isolated pubic hair development and signs of androgen excess
adrenarche, congenital adrenal hyperplasia- adrenal tumours
59
Describe central precocious puberty
Idiopathic, 2y to intracranial tumours
60
Describe gonadotrophin-independent precocious puberty
McCune-Albright syndrome, testotoxicosis
61
Describe other rare causes of precocious puberty
Hypothyroidism, gonadotrophin secreting tumours, exogenous steroids, rare syndromes e.g. Kabuki
62
Describe central precocious puberty
Cause of precocious puberty. Large tumour impairing feedback mechanism to prevent early onset puberty.
63
What are type 1 neuropathies
A cause of precocious puberty
64
Describe hypothalamic haematoma
A cause of precocious puberty. Activates hypothalamic pituitary axis
65
Describe congenital adrenal hyperplasia
A cause of precocious puberty. No oestrogen (excess androgen), no breasts
66
Describe ovarian granulosa cell tumour
A cause of precocious puberty. Large mass in pelvis, hormonally active so secretes oestrogen
67
Describe gonadotrophin-releasing hepatoblastoma
A cause of precocious puberty. Low pH, liber tumour, secreting hCG, hCG binds to LH receptor resulting in testicular growth
68
In boys what is often the underlying cause of precocious puberty
Something serious
69
How do you treat premature thelarche and adrenarche
No treatment
70
How do you treat secondary precocious puberty
Treat underlying condition (e.g. C.A.H, cerebral tumour etc.)
71
How do you treat gonadotrophin dependent precocious puberty
LHRH analogue (need to replace missing hormones)
72
How do you treat gonadotrophin independent precocious puberty
Anti-androgen (e.g. cyproterone, flutamide). Aromatase inhibior (e.g. tesolactone and spironolactone). Steroid biosynthesis inhibitor (e.g. ketoconazole). All harder to treat as not associated with gonasotrophin production. Possible use of growth hormone

Case 2 (8 decks)

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