Notes in 04 Growth and Puberty

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Published	02/13/2024	Girls usually reach Tanner stage II at age {{c1::9}}
Published	02/13/2024	Boys usually reach Tanner stage II at age {{c1::11}}
Published	02/13/2024	The {{c1::Tanner}} stages of sexual development are assigned independently to genitalia, pubic hair, and breast
Published	02/13/2024	In Tanner stage {{c1::I}}, a person is pre-pubertal (childhood) with no pubic hair and a flat chest
Published	02/13/2024	In Tanner stage {{c1::II}}, pubic hair appears (pubarche), breast buds form (thelarche), and testicular enlargement occurs
Published	02/13/2024	In Tanner stage {{c1::III}}, the pubic hair coarsens, the penis size increases, and the breast enlarges
Published	02/13/2024	In Tanner stage {{c1::IV}}, the penis width and glans increases and the breast enlarges with raised areola
Published	02/13/2024	In Tanner stage {{c1::V}} (adulthood) the penis and testis enlarge to adult size and the areola flattens
Published	02/13/2024	Lack of menses is considered normal at age < {{c1::15}} if development of secondary sex characteristics has been appropriate
Published	02/13/2024	What is the next step in management for a 14-year-old girl that presents with lack of menses? Breast and pubic hair are tanner stage 3.{{c1::Reassuran…
Published	02/13/2024	The pathogenesis of hypogonadotropic hypogonadism involves loss of {{c1::pulsatile GnRH}} secretion
Published	02/13/2024	What is the next step in management for a healthy 12-year-old male that presents with delayed growth spurt, delayed puberty, and delayed bone age?{{c1…
Published	02/13/2024	Delayed puberty is the lack of secondary sex characteristics by age {{c1::13}} in females and age {{c1::14}} in males or lack of menses by age {{c1::1…
Published	02/13/2024	Female puberty occurs through the following stages:7 years: {{c1::Adrenals (Adrenarche)}}8 years: {{c1::Breasts (Thelarche)}}9 years: {{c1::Pubic hair…
Published	02/13/2024	{{c1::Constitutional delay of growth and puberty (CDGP)}} is the isolated, temporary halting of skeletal growth in the absence of other causal physica…
Published	02/13/2024	Constitutional delay of growth and puberty is quantified by {{c1::bone age}} assessment via radiographic studies of the left hand and wrist
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Published	02/13/2024	In general:Children grow {{c1::taller::height}} every yearThey grow {{c1::faster::rate}} throughout pubertyThey {{c1::stop}} growing at the …
Published	02/13/2024	The phases of growth are distinct but congruent and go in the following order:{{c1::Prenatal::1}}{{c1::Infancy::2}}{{c1::Childhood::3}}{{c1::Adolescen…
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Published	02/13/2024	When measuring the height and weight of an infant (0-2 years old) we use the {{c1::WHO growth charts}} which are developed from data using the gr…
Published	02/13/2024	From ages 2-20, we use {{c1::growth charts}} from the {{c1::CDC::what organization?}} which better align with the nutrition standards of what we have …
Published	02/13/2024	The {{c1::growth velocity}} charts are derivatives of the growth charts and tells us how fast an individual is growing at a certain tim…
Published	02/13/2024	Initially, a child will grow {{c1::rapidly}} before decreasing their growth velocity. Eventually, when puberty starts, their growth velocity will {{c2…
Published	02/13/2024	There are multiple ways in which we can get a final height estimation, but one of them includes looking at X-rays of the {{c1::hand}} at different tim…
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Published	02/13/2024	{{c1::Puberty}} is the period of transition between childhood and adulthood, characterized by the development of secondary sexual characteristics, gon…
Published	02/13/2024	In puberty, {{c3::GnRH}} is produced in the hypothalamus in a {{c1::pulsatile}} manner to stimulate the secretion of {{c2::LH}} and {{c2::FS…
Published	02/13/2024	In puberty, the GnRH pulse generator has {{c1::many}} inputs controlling the timing of onset as well as the frequency and amplitude of pulsatility
Published	02/13/2024	As there are more and more pulses of GnRH, you make more and more estradiol and testosterone and puberty {{c1::progresses}}
Published	02/13/2024	If you give constant GnRH stimulation, levels of LH and FSH end up {{c1::decreasing to near 0}}. This signals that the pulsatile manner of GnRH r…
Published	02/13/2024	Neural control of the pulse generator releasing GnRH resides in the {{c1::medial basal}} hypothalamus and includes the arcuate region
Published	02/13/2024	GABA {{c1::inhibits}} GnRH release (juvenile pause)
Published	02/13/2024	As {{c1::puberty}} approaches, GABA inhibition of GnRH wanes
Published	02/13/2024	{{c1::Increased}} KISS1 mRNA expression and secretion of kisspeptines re-awakens GnRH secretion
Published	02/13/2024	Glutamate is an important {{c1::stimulator}} of GnRH secretion via its actions on NMDA and kainate receptors
Published	02/13/2024	GnRH secretion is {{c1::stimulated}} by factors such as norepinephrine, dopamine, TGFalpha, and neuregulin signaling
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Published	02/13/2024	Normal pubertal age for girls is between {{c1::8}} and {{c1::13}} years old
Published	02/13/2024	In boys, testicular volume achieving {{c1::4}} mL means that puberty has started
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