METHODICAL INSTRUCTIONS
MINISTRY OF PUBLIC HEALTH OF UKRAINE
National Pirogov Memorial Medical University, Vinnytsya
CHAIR OF OBSTETRICS and Gynecology №1
METHODICAL INSTRUCTIONS
for practical lesson
« Gynecological disorders of childhood and adolescence»
MODULE 4: Obstetrics and gynecology
Topic 12
I. Topic: Abnormalities of sexual development of girls. Classification, clinical picture, diagnostics and principles of treatment
II. Class duration – 4 hours.
III. Educational objectives:
The student must know:
1. Special methods of examination in girls with abnormalities of sexual development.
2. Deontology of communication with patients with such pathology in juvenile age.
3. Estimate data of general clinical, special, hormonal, roentgenological, medical and genetic examination of girls with abnormalities of sexual development.
The student must be able to:
• Examine of a patient with abnormalities of sexual development.
• Make diagnostics and treatment.
• Interpret data of clinical and laboratorial and instrumental examination.
IV. Advice to the student.
Disorders of Puberty
• Delayed Puberty
o Delay of puberty can be caused by anatomic abnormalities, chromosomal disorders, neoplastic growths, or nutritional deficiencies.
o Commonly presents as a physical delay in maturation combined with amenorrhea.
o Causes of delayed puberty can be classified, based on the level of follicle stimulating hormone (FSH) present, as outlined in Table 30.5.
o Hypergonadotropic Hypogonadism (High FSH)
A sufficient amount of gonadotropins are present, but the end organs are not responsive and therefore do not produce sex steroids.
▪ Gonadal dysgenesis
▪ Present as phenotypic female with persistent prepubertal development. Usually lack breast development.
▪ May have some secondary sex characteristics and spontaneous menstruation. Most often associated with primary amenorrhea.
|Table 30.5 An Overview of Causes of Delayed Puberty |
|FSH Level |
|Differential Diagnosis |
| |
|High >30 mIU/mL |
|Gonadal dysgenesis syndromes: Turner's syndrome, Sweyer's syndrome |
|Primary ovarian failure |
| |
|Low ................
................
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