Puberty

Question 1

What are the four main events that occur in puberty?

Answer 1

• Secondary sex characteristics appear and mature
• Adolescent growth spurt occurs
• Fertility is achieved
• Profound physiological and psychological effects are observed

Question 2

When are the three puberties of life?

Answer 2

1. Prenatal spike
2. Postnatal spike
3. Adolescent spike

Question 3

Why might a young patient with head trauma present with early onset of puberty?

Answer 3

Trauma may have caused damage to the gonadostat

Question 4

What is the order of events in girls’ puberty?

Answer 4

1. Breast budding
2. Growth spurt
3. Pubic hair
4. Menarche

Question 5

What is the order of events in boys’ puberty?

Answer 5

1. Testicular enlargement
2. Pubic hair
3. Penile enlargement
4. Height spurt

Question 6

Define:

• Thelarche
• Pubarche
• Godarche

Answer 6

• Thelarche: breast development
• Pubarche: pubic hair development
• Godarche: gonadal development

Question 7

What is the effect of insulin on the ovaries?

Answer 7

Interferes with the production of androgens in the thecal cells

Question 8

What would the LH levels in someone with premature ovarian failure be like?

Answer 8

Elevated

• Very irregular periods, once or twice per year

Question 9

Describe LH and FSH release in the 3 stages of puberty.

Answer 9

Early - tonic phase increases, night pulses begin

Mid - greater increase in tonic phase, higher amplitude in night pulses

Late - day and night pulses

Question 10

What changes occur in the childhood to puberty transition?

Answer 10

• Turn off gonadostat
• Increased pulsatile GNRH and LH/FSH secretion
• Increased sex steroid production
• Reduced sensitivity to negative feedback from sex steroids

Question 11

What is the relationship of Kisspeptin to puberty?

Answer 11

• Expressed where gonadostat thought to lie
• Kisspeptin neurons send projections to preoptic nucleus
• Inactivation of receptor leads to failure to go into puberty

Question 12

What is the kisspeptin receptor?

Answer 12

GPR54

Question 13

Inhibin is produced by ___ cells in males and ___ cells in females

Answer 13

Leydig in males

Granulosa in females

Question 14

What is the role of leptin in puberty?

Answer 14

• Adipostatic hormone
• Increased leptin with increased fat mass
• Facilitatory signal to influence timing of puberty

Question 15

What is adrenarche?

Answer 15

• Increased adrenal androgen production
• Occurs in late childhood
• Produces pubarche
• NOT a sign of puberty

Question 16

How does body composition change during/after puberty?

Answer 16

• Lean mass, skeletal mass M 1.5x > F

- Fat mass F 2x > M