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17 Cards in this Set
- Front
- Back
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1. Delayed Puberty?
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a. No signs of puberty in girls by age 13 yrs or in boys by age 14 yrs.
b. May be caused by gonadal failure, chromosomal abnormalities (turner, Klinefelter), hypopituitarism, chronic disease, or malnutrition. |
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2. Precocious puberty?
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a. Secondary sexual characteristic onset before age 8 in girls and 9 in boys.
b. Children in different ethnic groups undergo puberty differently. c. African-American girls often do so earlier than white girls. |
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3. True (central) precocious puberty?
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a. Gonadotropin-dependent.
b. Hypothalamic-pituitary-gonadal activation leading to secondary sex characteristics. |
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4. Precocious pseudopuberty?
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a. Gonadotropin-independent.
b. No Hypothalamic-pituitary-gonadal activation. c. Hormones usually are either exogenous (birth control pills, oestrogen creams) or from adrenal/ovarian tumours. |
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5. Premature Adrenarche?
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a. Early activation of the adrenal androgens (typically in girls ages 6-8), w/gradually increasing pubic/axillary hair development and body odor.
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6. Premature Thelarche?
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a. Early breast development (typically in girls ages 1-4)
b. W/o pubic/axillary hair development of linear growth acceleration. |
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7. In who is true precocious puberty more common, boys or girls?
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a. Girls.
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8. Cause of True precocious puberty?
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a. Stems from secretion of hypothalamic GnRH w/normal-appearing, but early, progression of pubertal events.
b. Sexual precocity is idiopathic in >90% of girls, whereas a structural CNS abnormality is present in 25-75% of boys. |
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9. 3 main patterns of precocious puberty?
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a. Girls <6 yrs at onset: Rapidly progressing sexual precocity, characterized by early physical and osseous maturity w/loss of ultimate height potential.
b. Girls over 6: Slowly progressing variant w/parallel advancement of osseous maturation and linear growth and preserved height potential. c. In a small percentage of girls, there is spontaneous regression or unsustained central precocious puberty at a young age, w/normal pubertal development at an expected age. |
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10. In what 2 conditions do you see Café-au-lait spots?
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a. Neurofibromatosis
b. McCune-Albright disease. |
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11. Sex hormones in Precocious puberty?
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a. Usually appropriate for observed stage of puberty but inappropriate for child’s chronological age.
b. Serum estradiol is elevated in girls c. Serum testosterone is elevated in boys. d. Serum LH is undetectable in prepubertal girls but is detectable in 50-70% if girl’s with precocious puberty. |
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12. Helpful diagnostic tool for precious puberty?
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a. Gonadotropin-releasing hormone (GNrH) stimulation test
b. Measuring response time and peak values of LH and FSH after IV administration of GnRH. |
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13. How do bone age radiographs shows up in precocious puberty?
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a. Bone age radiographs are advanced beyond chronological age in precocious puberty!
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14. When is pelvic U/S indicated?
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a. If gonadotropin-independent causes of precocious puberty are suspected based on exam. (ovarian tumour/cysts, adrenal tumours)
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15. Goal of treating precocious puberty?
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a. To prevent premature closure of the epiphyses, allowing the child to reach full adult growth potential.
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16. Tx of Central precocious puberty?
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a. GnRH agonists
b. These analogues desensitize the gonadotropic cells of the pituitary to the stimulatory effects of GnRH produced by the hypothalamus. c. Girls w/slowly progressive puberty do not seem to benefit from GnRH agonist therapy in adult height prognosis. |
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17. complete
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17. complete
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