14547044
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
over 5 years ago
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| Question | Answer |
| 1. TRUE/FALSE - definitions and normal puberty. A. The onset of puberty in females is defined as stage 1 breast development. | False. Thelarche (palpable breast buds) is usually the first marker of puberty but B1 is pre-pubertal breast development. |
| 1. TRUE/FALSE - definitions and normal puberty. B. The onset of puberty in males is defined as the appearance of pubic hair. | False. Achievement of testicular volume 4ml. |
| 1. TRUE/FALSE - definitions and normal puberty. C. Females enter puberty earlier than males. | True. Mean age of onset 10.9 years compared to 11.75 years for males. |
| 1. TRUE/FALSE - definitions and normal puberty. D. Peak height velocity occurs at stage 4 breasts in girls. | False. Occurs at B3. |
| 2. TRUE/FALSE - precocious puberty. A. Central precocious puberty (CPP) is rarely pathological in males. | False. ~75% have a pathological CNS lesion. |
| 2. TRUE/FALSE - precocious puberty. B. Low or undetectable gonadotropins in the presence of pubertal signs suggest pseudo (peripheral) precocious puberty. | True. In pseudo precocious puberty, there is peripheral activation rather than central hence low/pre-pubertal LH and FSH but elevated/pubertal sex steroids for age. Examples are CAH, Gn-independent (McCune-Albright, testotoxicosis, adrena/testes/ovarian tumours, iatrogenic). |
| 2. TRUE/FALSE - precocious puberty. C. CNS tumours can cause CPP. | True. |
| 2. TRUE/FALSE - precocious puberty. D. The definition of CPP in females is stage 2 breast development before the 9th birthday. | False. Lower limit of normal is puberty is breast development at 8 years. For CPP, need to confirm hormonal status (pubertal gonadotropins) +/- bone age +/- USS pelvis (uterus:cervix >1, endometrial echo present, ovarian volume >1.5ml, follicles >6mm). |
| 3. TRUE/FALSE - normal variants. A. Medical treatment is often required for premature thelarche. | False. Most common during first two years of life, breasts often fluctuate in size. May have second peak ~6yo. Need follow up as may be the first manifestation of central precocious puberty. |
| 3. TRUE/FALSE - normal variants. B. Congenital adrenal hyperplasia (CAH) is often detected on routine baseline investigations for premature adrenarche. | False. |
| 3. TRUE/FALSE - normal variants. C. Gynaecomastia always requires extensive investigation. | False. Generally limited work up required. Education, counselling, clinical follow up for typical cases. If atypical/progressing, consider bone age, pelvic USS, LH, FSH, oestradiol, prolactin +/- GnRH test. |
| 4. TRUE/FALSE - delayed puberty. A. Pubertal delay may be associated with poor sense of smell. | True. |
| 4. TRUE/FALSE - delayed puberty. B. High gonadotropins are suggestive of a primary gonadal problem. | True. High LH and FSH levels, low testosterone or oestradiol levels. |
| 4. TRUE/FALSE - delayed puberty. C. Constitutional delay of growth usually requires medical treatment. | False. Generally reassure, watch and wait. GH therapy not indicated but consider if there are psychological consequences (short course of low dose androgen). |
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