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Gen Med (Endocrine) > Reproductive - Disorders of Puberty > Flashcards

Reproductive - Disorders of Puberty Flashcards

1
Q

What is the normal age range for entering puberty in girls?

A

8 - 13 years

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2
Q

What is the normal age range for entering puberty in boys?

A

9 - 14 years

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3
Q

Is delayed puberty more common in boys or girls?

A

Boys

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4
Q

Is precocious puberty more common in boys or girls?

A

Girls

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5
Q

Define what is meant by delayed puberty in girls?

A

The lack of any breast development by the age of 13 years

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6
Q

Define what is meant by delayed puberty in boys?

A

A testicular volume < 4mls by 14 years

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7
Q

What is the most common cause of delayed puberty in both sexes?

A

Constitutional delay

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8
Q

Is a pathological cause for delayed puberty more likely in boys or girls?

A

Girls

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9
Q

What are some central causes of delayed puberty, with an intact hypothalamic-pituitary axis?

A

Constitutional delay, chronic disease, malnutrition

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10
Q

What are some central causes of delayed puberty, caused by secondary hypogonadism?

A

Pituitary disease, GnRH deficiency

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11
Q

What are some peripheral causes of delayed puberty?

A

Turner’s/Klinefelter’s syndrome, bilateral testicular damage

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12
Q

What physical sign may be seen in adolescents with constitutional pubertal delay?

A

Short stature

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13
Q

What investigation may be useful to support a diagnosis of constitutional pubertal delay?

A

Bone age radiograph

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14
Q

Why should TFTs be performed in individuals with delayed puberty?

A

Hypothyroidism can be a cause

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15
Q

How can puberty be induced in those with constitutional pubertal delay?

A

A short course of oestrogen or testosterone

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16
Q

Precocious puberty is defined as signs of puberty before what age in girls?

A

8 years

17
Q

Precocious puberty is defined as signs of puberty before what age in boys?

A

9 years

18
Q

What are some peripheral (gonadotrophin-independent) causes of precocious puberty?

A

Ovarian/testicular/adrenal tumours or CAH

19
Q

Is the cause of central precocious puberty more likely to be pathological in boys or girls?

A

Boys

20
Q

What will a bone radiograph show in children with precocious puberty?

A

Advanced bone age

21
Q

What imaging investigation is indicated in all boys, and girls aged < 6 years, with precocious puberty?

A

Pituitary MRI

22
Q

What blood test is a reliable indicator of whether a boy has entered puberty or not?

A

Early morning testosterone

23
Q

In a child with precocious puberty, very high levels of either testosterone or oestrogen with suppressed gonadotrophin levels suggests what?

A

Peripheral precocious puberty

24
Q

Which gonadotrophin is the most reliable indicator of whether a child’s gonadotrophins are at pubertal or pre-pubertal levels?

A

Serum LH

25
Q

If the picture of precocious puberty is unclear, what stimulation test can be used?

A

GnRH stimulation test

26
Q

In the GnRH stimulation test, what will happen if there is central precocious puberty?

A

Gonadotrophin levels will rise

27
Q

In the GnRH stimulation test, what will happen if there is peripheral precocious puberty?

A

No change in gonadotrophin levels

28
Q

What medication can be used to halt puberty in children with idiopathic precocious puberty?

A

Gonadotrophin agonists

29
Q

What is the main complication of precocious puberty?

A

Diminished final adult height

30
Q

How is androgen insensitivity syndrome inherited?

A

X linked

31
Q

Explain the genotype and phenotype of a child with androgen insensitivity syndrome?

A

Genotypically male but phenotypically female

32
Q

What are the two main features of androgen insensitivity syndrome?

A

Primary ‘amenorrhoea’ and bilateral undescended testes

33
Q

How is a diagnosis of androgen insensitivity syndrome made?

A

Karyotyping

34
Q

How is androgen insensitivity syndrome managed?

A

Counselling, oestrogen therapy and bilateral orchidectomy

Gen Med (Endocrine) (12 decks)

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