PRECOCIOUS AND DELAYED PUBERTY Flashcards Preview

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Flashcards in PRECOCIOUS AND DELAYED PUBERTY Deck (21):
1

What is the definition of precocious puberty in females?

Sexual maturation takes place before the age of 8.

(9 in males)

2

What does the term thenarche mean?

First stage of breast development

3

What does the term adrenarche mean?

First stage of pubic hair development

4

What is the most common cause of precocious puberty in females?

Idiopathic in 74% of cases

5

What are the four organs/systems that may be affected where there is a non-idiopathic cause of precocious puberty?

CNS
Thyroid
Adrenals
Ovary

6

What are the CNS causes of precocious puberty?

Infection - meningitis, encephalitis, abscess

Tumours - gliomas, neurofibromas, ependymoma, hamartoma

Head trauma

Hydrocephaly

7

Does hyper or hypothyroidism cause precocious puberty?

Hypothyroidism

8

What are the adrenal causes of precocious puberty?

Congenital adrenal hyperplasia

Adrenal tumours

9

What are the ovary related causes of precocious puberty?

Oestrogen secreting tumours especially granulose cell tumours

Premature oestrogen secretion eg McCune-Albright syndrome

10

What is McCune-Albright syndrome?

A complex genetic disorder affecting the bone, skin, and endocrine systems that is associated with hyperfunctioning endocrine disease, fibrous dysplasia and café au lait macules.

11

What are the management options for someone with precocious puberty?

Endocrinologist referral - suppression of oestrogen and androgen production by GnRH analogues.

Psychological support

Surgical removal of tumour

12

What is the definition of delayed puberty in females?

No signs of secondary sexual development by the age of 13.

13

What is the most common cause of delayed puberty in females?

Gonadal failure

14

What are the categories of causes of delayed puberty?

Idiopathic
CNS
Thyroid
Adrenal
Ovary
Genetic
Chronic illness

15

What are the CNS causes of delayed puberty?

Infection - meningitis, encephalitis, abscess

Tumours - pituitary, destructive

Head trauma

16

Does hyper or hypothyroidism cause delayed puberty?

Hypothyroidism

17

What are the adrenal causes of delayed puberty?

Congenital adrenal hyperplasia

18

What are the ovary related causes of delayed puberty?

Gonadal failure
PCOS
Resistant ovary syndrome

19

What are the genetic diseases associated with delayed puberty?

Turner syndrome
Prader-Willi syndrome
Laurence-Moon-Biedl syndrome
Androgen insensitivity syndrome
Gonadal dysgenesis
Kalmann's syndrome

20

What chronic illnesses can lead to delayed puberty?

Anorexia nervosa
Diabetes mellitus
Renal disease
Cystic fibrosis

21

What investigations would you do in someone with delayed puberty?

Full endocrine profile - LH, FSH, Prolactin, TFT, 17-OH progesterone
Chromosomal analysis
Bone age studies
Imaging - CT or MRI head