Growth Patterns and Puberty RECS Learning Module

Objectives

Recognize the stages of sexual development and the range of onset of each
Know that most boys achieve a genital sexual maturity rating (Tanner) of stage 4 prior to attainment of peak height velocity
Understand factors that influence the timing of puberty
Understand the relationship between the timing of onset of puberty and final adult height
Understand the sequence of development of secondary sexual characteristics in boys and girls
Understand the timing, duration and normal range of peak height velocity in male and female adolescents
Understand the impact of relatively early or late puberty on final adult height
Understand that an individual adolescent’s bone age (skeletal maturity) and chronological age may be disparate by as much as two years and still be within normal limits
Know the average prepubertal height velocity (5-6cm/yr) and the accelerated rate (9-10cm/year) in the peak adolescent growth spurt and that completion of the pubertal growth spurt takes two to four years
Know that girls’ heights will typically increase 6-8cm after menarche has occurred
Recognize that physiologic leucorrhea commonly precedes menses by three to six months
Know that a testicular volume of <4ml is prepubertal

Describe Tanner staging.
When is the normal onset of puberty for both males and females? What is the first sign for a male? Female?
How does puberty progress in females? In males?
Approximately how much later does a boy’s growth spurt start after a girl’s?
How do you estimate a predicted target height?
On average how long does it take to complete puberty? What impact does late or early puberty have on final adult height?
How long before menses can physiologic leucorrhea occur?
How much will girl’s height increase after menarche?
What defines “precocious” puberty for girls? Boys?
What work-up do you do to investigate precocious puberty?
Describe how a bone age is evaluated. What is considered normal standard deviation?

Reviewed 11/2017