5) Puberty and Menopause Flashcards Preview

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Flashcards in 5) Puberty and Menopause Deck (28)
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1
Q

What is thelarche?

What ages does it occur at?

A

Development of breast (8-11)

2
Q

What is pubarche?

What ages does it occur at?

A

Development of axillary and pubic hair (11-12)

3
Q

What is menarche?

What ages does it occur at?

A

First menstrual period (<16, 95% between 11-15)

4
Q

What is adrenarche?

What ages does it occur at?

A

Onset of increase in androgen secretion (11-12)

5
Q

What is puberty?

A

When sexual maturation and growth are completed and result in ability to reproduce

6
Q

What changes occur during puberty?

A
Accelerated growth (spurt)
Maturation of primary sexual characteristics (gonad and genitals)
Appearance of secondary sexual characteristics
Menstruation and spermatogenesis begin
7
Q

What is the growth spurt dependent on?

A

Growth hormone and steroids

8
Q

Why are men usually larger?

A

Growth spurt is longer and growth is faster (10cm/yr)

9
Q

What stops the growth spurt?

A

Closure of epiphyseal growth plates

10
Q

What is the critical weight for girls to enter menarche?

A

47kg

11
Q

What evidence supports the critical weight theory?

A

Malnutrition associated with delayed menarche
Primary amenorrhoea in lean female athletes
Anorexia associated with missed periods

12
Q

What hormonal changes trigger the onset of puberty?

A

Activation of GnRH by arcuate area of brain (KISS neurones)

Increases LH and FSH = sexual steroid secretion

13
Q

What is the mechanism behind the growth spurt?

A

GH secretion from pituitary leading to increased TSH, metabolic rate, promotion of tissue growth and increased androgens (bone and muscle growth)

14
Q

How can pubertal development be classified?

A
Tanner Standard (5 stages) 
Growth velocity
15
Q

What is the sequence of development in girls?

A

Breast development -> pubic hair -> growth spurt -> menarche

16
Q

What is the sequence of development in boys?

A

Testicular volume > 4ml -> pubic hair -> spermatogenesis -> growth spurt

17
Q

What is precocious puberty?

A

Onset of puberty occurring younger than 2SD before average age
Girls < 8 Boys < 9

18
Q

What are some gondatropin dependent causes of precocious puberty?

A

Tumours: gliomas, pineal
CNS injury or trauma
Congenital
Gonadotropin secreting tumours

19
Q

What are some gondatropin independent causes of precocious puberty?

A

Congenital adrenal hyperplasia
Tumours: adrenal, HCG secreting liver, pineal, gonadal
Testotoxicosis
Exogenous oestrogen or androgen exposure

20
Q

What ages is puberty considered to be delayed?

A
Girls = 13 (15-16 in primary amenorrhoea)
Boys = 14
21
Q

What are the causes of delayed puberty?

A

Gonadal failure

Gonadal deficiency

22
Q

What is Turner’s syndrome? Describe some symptoms:

A

45, X

Short stature, gonadal dysgenesis, cardiac and skeletal malformation

23
Q

What are the ‘Seven Dwarves’ of menopause?

A

Itchy, twitchy, sweaty, sleepy, bloated, moody, forgetful

24
Q

Describe the pre-menopause stage:

A

From age 40
Follicular phase shortens, ovulation early or absent (reduced fertility)
Decreased oestrogen

25
Q

Describe the menopause stage:

A

Cessation of menstrual cycles
Ages 49-50
No more follicles or oestrogen

26
Q

What changes occur in the menopause?

A
Vascular changes = hot flushes 
Regression of uterus 
Thining of cervix
Involution of breast 
Pelvic floor lax (incontinence) 
Decreased bones mass
27
Q

What is hormone replacement therapy?

A

Giving oestrogen orally or topically

Relieves symptoms and improves wellbeing

28
Q

What are the disadvantages of HRT?

A

Risk of breast cancer and thromboembolism