TRH's puberty; 4.8 Flashcards Preview

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Flashcards in TRH's puberty; 4.8 Deck (20):
1

What is the pattern of Hypothalamic-Pituitary-Gonadal (HPG) axis activity from birth to puberty?

Born → active, but ineffective, HPG (6-8wks) → suppressed (years) → suppression released → active and effective HPG

2

What is adrenarche?

Adrenarche, AKA pubarche, is pubic hair growth

3

What causes adrenache/pubarche?

Development of the adrenal zone reticularis → androstenedione and DHEA

4

What is thelarche?

Breast development

5

What causes thelarche?

Increasing estrogens

6

What is gonadoarche?

Production of ovarian hormones and mature gametes

7

What is Gonadotropin Dependent Precocious Puberty (GDPP)?

"True" precocious puberty

8

What causes GDPP?

Idiopathic (80%)
CNS related (20%)

9

How is GDPP diagnosed?

GnRH analog stimulation test...gonadotropin levels are induced by GnRH stimulation

(Does NOT happen with GIPP)

10

What is the best test for Central Precocious Puberty (CPP)?

LH < 0.1 → prepubertal
LH > 0.3 → pubertal

11

What is Gonadotropin Independent Precocious Puberty (GIPP)?

"False alarm"

12

What causes GIPP in girls?

Ovarian cysts
Ovarian tumors

13

What causes GIPP in boys?

Leydig cell tumors
hCG secreting germ cell tumors
Familial male-limited precocious puberty

14

What is familial male-limited precocious puberty caused by?

Activating mutation of LH receptor

15

What are the signs and symptoms of GIPP?

One or two signs of puberty, but not all...and not staged similarly

Display adrenarche

Bone age > actual age AND adrenarche in boys and thelarche in girls

16

What would cause precocious adrenarche?

Adrenal gland tumors
CAH

17

What would cause bone age > actual age And adrenarche/thelarche?

hCG secreting tumors
Gonadal tumors
Exposure to exogenous sex steroid hormones

18

What can cause children to be shorter than average?

Overly sensitive to E2...high levels of E2 → fusion of epiphyses

19

What is seen with complete AIS?

Phenotype is "super" female w/o menses

20

What is seen with partial AIS?

Ambiguous genitalia
Gynecomastia
Partial masculinization during puberty