Puberty CPC

Question 1

The physical and biochemical changes associated with activation of the hpg axis that leads to adult reproductive function.

Answer 1

Puberty

Question 2

Gonadotropin levels are high/low after birth up to 2 years

Answer 2

high

Question 3

Role of gonadotropin in neonates

Answer 3

due to release of suppression from maternal E/P–> gonadotropin release –> transient E,T secretion induced by high FSH/LH –> development of ovarian cysts in females

Question 4

During childhood, FSH/LH are suppressed/upregulated

Answer 4

suppressed –> low level pulses –> E/T suppression due to central suppression of hypothalamus

Question 5

Children with gonadal dysgenesis have FSH/LH levels similar/less than normal children

Answer 5

similar –> GnRH will stimulate FSH/LH in these agonadal children –> suggests hypothalamic regulation in childhood vs. gonadal regulation

Question 6

Pre-puberty events

Answer 6

return of GnRH pulsatility -

Question 7

____ is the marker for GnRH

Answer 7

LH –> able to measure peripherally//short half life so mirrors gnrh pulsatility (FSH has a longer half life and can’t mirror the pulses)

Question 8

In early pre-puberty, LH pulse is observed ____

Answer 8

at night –> eventually occurs throughout the whole day

Question 9

T/F at midpuberty, sufficient gonadal estrogen secretion leads to proliferation of the endometrium and the first menarche occurs

Answer 9

T

Question 10

Cycles are anovulatory during the first ___ years following menarche

Answer 10

1-2

Question 11

_____ is the first sign of puberty in males.

Answer 11

growth of testes

Question 12

Adrenarche

Answer 12

increase in secretion of androgen precursors from the zona reticularis of the adrenal gland –> axillary and pubic hair

Question 13

T/F adrenarche is under control of acth

Answer 13

F –> not under direct control

Question 14

Gonadarche

Answer 14

activation of sex steroid secretion by ovary/testis –> breast tissue, sexual maturation

Question 15

T/F adrenarche and gonadarche are regulated independently

Answer 15

T

Question 16

T/F adrenarche occurs normally in individuals without normal gonads

Answer 16

T –> turner’s

Question 17

T/F Gonadarche occurs in individuals with primary adrenal insufficiency

Answer 17

T

Question 18

T/F premature adrenarche leads to premature gonadarche

Answer 18

F

Question 19

Which stage of female pubertal development? breast development

Answer 19

thelarche

Question 20

Which stage of female pubertal development? androgen production from adrenals

Answer 20

adrenarche

Question 21

Which stage of female pubertal development? development of pubic/axillary hair

Answer 21

pubarche

Question 22

Which stage of female pubertal development? onset of menstruation

Answer 22

menarche

Question 23

T/F breast development before age 8 or after age 13 requires further evaluation in any girl

Answer 23

T

Question 24

Puberty onset factors

Answer 24

genetic, environmental, toxic, nutritional, hormonal

Question 25

T/F good genetic correlation in onset of puberty

Answer 25

T

Question 26

Decreasing age of menarche attributed to better/worse nutrition, more/less physical activity, more/less obesity

Answer 26

better, less, more

Question 27

GnRh pulsatile secretion modulated by ____ nucleus

Answer 27

arcuate

Question 28

GABA ____ as gnrh increases at gonadarche

Answer 28

declines –> inacitvate receptor or reduce gaba –> premature menarche and ovualtion

Question 29

GABA inhibits/coactivates GnRH

Answer 29

inhibits

Question 30

NPY inhibits/coactivates GnRH

Answer 30

inhibits

Question 31

T/F Leptin is necessary for gonadarche

Answer 31

T

Question 32

_____ has a receptor ____ which stimulates GnRH and has a key role in activation of gonadotropic axis at puberty.

Answer 32

kisspeptin 121 and gpr54/kiss1