L3 (T2): Physiology of puberty
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Questions and Answers

At what age does menarche typically occur?

  • 6-10 years
  • 8-14 years
  • 10-16 years (correct)
  • 13-18 years

    • Which hormone stimulates the adrenals for the development of pubic and axillary hair in boys?

  • ACTH (correct)
  • FSH
  • Testosterone
  • LH

    • What is the duration of the growth spurt in girls during puberty?

  • 4 years
  • 2.5 years (correct)
  • 1 year
  • 3 years

    • At what age does breast growth (Thelarche) usually begin in girls?

    <p>8-13 years</p> Signup and view all the answers

    What is the first pubertal sign in 25% of girls?

    <p>Pubic hair (Pubarche)</p> Signup and view all the answers

    What stimulates the adrenals for the production of pubic and axillary hair in girls?

    <p>ACTH</p> Signup and view all the answers

    What hormone leads to increased FSH and LH during puberty?

    <p>GnRH</p> Signup and view all the answers

    Which cells in the testes are under FSH control?

    <p>Sertoli cells</p> Signup and view all the answers

    What percentage of testosterone is produced from the adrenals during puberty?

    <p>5%</p> Signup and view all the answers

    What phase of the ovarian cycle is characterized by negative feedback after ovulation?

    <p>Luteal phase</p> Signup and view all the answers

    Which phase of the ovarian cycle sees the rise of estrogen with LH surge in mid-cycle?

    <p>Follicular phase</p> Signup and view all the answers

    What stimulates the production of gametes (sperms) in the testes during puberty?

    <p>FSH</p> Signup and view all the answers

    What is the average age of menarche in girls?

    <p>12.5 years</p> Signup and view all the answers

    At what age do boys typically experience deepening of voice during puberty?

    <p>14 years</p> Signup and view all the answers

    What is the average duration of puberty in boys?

    <p>3-5 years</p> Signup and view all the answers

    What is the mean weight at menarche for girls?

    <p>47.8kg</p> Signup and view all the answers

    What stimulates the zona reticularis of the adrenal cortex for the production of DHEAS and Androstenedione?

    <p>ACTH</p> Signup and view all the answers

    What is the average age for the onset of puberty in girls?

    <p>10 years</p> Signup and view all the answers

    At what age do girls usually experience the growth spurt during puberty?

    <p>12 years</p> Signup and view all the answers

    What is the average age for the onset of puberty in boys?

    <p>8 years</p> Signup and view all the answers

    What is the average duration of puberty in girls?

    <p>2-3 years</p> Signup and view all the answers

    At what age do boys usually experience the growth spurt during puberty?

    <p>12 years</p> Signup and view all the answers

    What is the average age for the onset of menarche in girls?

    <p>12 years</p> Signup and view all the answers

    What is the average age for the onset of deep voice in boys during puberty?

    <p>14 years</p> Signup and view all the answers

    What is the physiological definition of puberty?

    <p>The stage of physical maturation in an individual when they become physiologically capable of procreation</p> Signup and view all the answers

    What are the primary indicators of puberty that can be observed during a clinical examination?

    <p>Secondary sexual characteristics</p> Signup and view all the answers

    What is the significance of understanding what is normal in clinic when assessing pubertal development in children?

    <p>It enables determination of whether a child is in the early stages of puberty or late for their pubertal development</p> Signup and view all the answers

    What is the primary focus when discussing disorders of puberty?

    <p>Early or delayed puberty</p> Signup and view all the answers

    What is the range within which variations in pubertal development are still considered normal?

    <p>Both early and late sides of the normal range</p> Signup and view all the answers

    What is the key aspect of puberty that makes an individual physiologically capable of procreation?

    <p>Physical maturation and development of reproductive organs</p> Signup and view all the answers

    What is the impact of overnourishment and nutrition on puberty and adrenal development?

    <p>It can lead to precocious puberty, requiring close monitoring</p> Signup and view all the answers

    What is a clear sign of puberty in girls, indicating underlying health issues if it occurs without other signs?

    <p>Menstruation</p> Signup and view all the answers

    What is a crucial indicator of imminent menarche in girls?

    <p>Breast stage four</p> Signup and view all the answers

    What can lead to early menarche, necessitating brain MRI and further investigation?

    <p>Pituitary hypothalamic activation and acute conditions</p> Signup and view all the answers

    What affects bone growth and final adult height in girls who have had menarche?

    <p>Estrogen exposure</p> Signup and view all the answers

    Why is it essential to consider circadian rhythms in endocrine assessments?

    <p>Hormone levels vary throughout the day and are affected by circadian rhythms</p> Signup and view all the answers

    What controls puberty in the brain?

    <p>Hypothalamus-pituitary-gonadal axis</p> Signup and view all the answers

    What is a direct sign of early puberty in girls?

    <p>Breast development</p> Signup and view all the answers

    What may not always indicate central precocious puberty in girls?

    <p>Early development of pubic hair</p> Signup and view all the answers

    What is not a direct sign of puberty, but is connected to adrenal hormones?

    <p>Pubic hair</p> Signup and view all the answers

    What is crucial to recognize to avoid missing early puberty signs?

    <p>Growth spurt</p> Signup and view all the answers

    What can cause early pubic hair development in girls?

    <p>Tumors and early adrenal activation</p> Signup and view all the answers

    What is the primary cause of congenital hypogonadism in boys?

    <p>Pituitary problem affecting LH and FSH production</p> Signup and view all the answers

    What is the crucial factor for pubertal development in boys?

    <p>Presence of testes</p> Signup and view all the answers

    What is the impact of estrogen on growth and development in girls during puberty?

    <p>Determines breast development and uterine transformation</p> Signup and view all the answers

    What can cause erratic menstrual cycles in adolescence?

    <p>Ovarian hormone imbalance</p> Signup and view all the answers

    What is necessary to ensure in boys with pubertal development issues?

    <p>They do not have fertility problems later on</p> Signup and view all the answers

    What can be used to identify the genes responsible for congenital hypogonadism?

    <p>Gene panel studies</p> Signup and view all the answers

    What is the primary role of adrenal function testing in cases of concerns about precocious puberty?

    <p>To assess the early activation of the adrenal axis in children with delayed puberty</p> Signup and view all the answers

    What can an advanced bone age in a child indicate?

    <p>Exposure to hormones, as seen in a case of congenital adrenal hyperplasia (CAH)</p> Signup and view all the answers

    In boys, what is the determining factor for puberty?

    <p>Testicular volume</p> Signup and view all the answers

    What is the significance of multi-hormonal issues in the pituitary gland?

    <p>They can present clues to underlying conditions</p> Signup and view all the answers

    What does delayed puberty with low levels of LH and FSA indicate?

    <p>A congenital problem, requiring further evaluation</p> Signup and view all the answers

    Why is identifying congenital adrenal hyperplasia (CAH) crucial?

    <p>Exposure to excessive androgens can eventually lead to the activation of the pituitary axis and puberty</p> Signup and view all the answers

    At what age do girls typically experience menarche?

    <p>12 years</p> Signup and view all the answers

    What is the mean weight at menarche for girls?

    <p>45kg</p> Signup and view all the answers

    What is the typical range of body fat percentage at menarche for girls?

    <p>16-20%</p> Signup and view all the answers

    At what age do boys typically experience deepening of voice?

    <p>14 years</p> Signup and view all the answers

    What is the average age for the beginning of puberty in boys?

    <p>11 years</p> Signup and view all the answers

    What are the typical years of puberty for girls?

    <p>2-3 years</p> Signup and view all the answers

    What is the age range for early or precocious puberty in girls?

    <p>Under 8 years</p> Signup and view all the answers

    What is the age range for delayed puberty in boys?

    <p>Over 14 years</p> Signup and view all the answers

    What is the concern raised by early onset of puberty in boys?

    <p>Decreased final adult height</p> Signup and view all the answers

    What is the treatment for central or true precocious puberty in girls?

    <p>Long acting LHRH analog therapy</p> Signup and view all the answers

    What is premature thelarche?

    <p>Isolated breast development</p> Signup and view all the answers

    What is the concern with early cessation of growth due to early onset of puberty?

    <p>Decreased final adult height</p> Signup and view all the answers

    Study Notes

    Endocrinology and Puberty Dynamics

    • Gonadotropin levels are crucial in determining delayed puberty and the functioning of the hypothalamus-pituitary-gonadal axis.
    • Dynamic testing in endocrinology involves stimulating or suppressing the axis to assess hormone levels.
    • Normal gonadotropin levels in response to stimulation indicate a lower likelihood of congenital problems.
    • Delayed puberty with low levels of LH and FSA may indicate a congenital problem, requiring further evaluation.
    • Multi-hormonal issues in the pituitary gland can also present clues to underlying conditions.
    • Adrenals play a vital role, with early activation of the adrenal axis often observed in children with delayed puberty.
    • Testing adrenal function is crucial, especially in cases of concerns about precocious puberty without typical signs.
    • In boys, testicular volume is the determining factor for puberty, not just the presence of secondary sexual characteristics.
    • An advanced bone age in a child can indicate exposure to hormones, as seen in a case of congenital adrenal hyperplasia (CAH).
    • Identifying CAH is crucial as exposure to excessive androgens can eventually lead to the activation of the pituitary axis and puberty.
    • It's essential to consider a comprehensive approach, including adrenal function and dynamic testing, in evaluating cases of delayed or precocious puberty.
    • The case study demonstrates the importance of thorough evaluation, as symptoms may not always indicate a straightforward diagnosis.

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